Osteoporosis is a disease that causes bones to thin and weaken. Women are 4 times more likely than men to develop osteoporosis. About 10 million Americans have been diagnosed with the disease and another 34 million have been diagnosed with low bone mass, placing them at risk. Over half of Americans over 55 years old have osteoporosis or are at risk. For the past 10 years bisphosphonate drugs have been the primary choice to treat or prevent osteoporosis. Recently 2 studies were presented at the American Academy of Orthopaedic Surgeons annual meeting that suggest these drugs may reduce bone quality and increase the risk of a serious and unusual type of fracture of the femur if taken for more than 4 years. The femur is one of the largest bones in the body. Fractures of the femur are considered a serious injury. This follows reports about a year ago that bisphosphonates may cause bone loss in the jaw.

Bisphosphonate drugs include alendronate (Fosamax), risedronate (Actonel), ibandronate (Boniva), and zoledronic acid (Reclast). These drugs are believed to work by inhibiting cells that break down bone. These medications are considered safe and effective for the treatment of osteoporosis. They are also used to prevent osteoporosis.

The National Osteoporosis Foundation (NOF) has recognized that reports of serious conditions associated with the use of bisphosphonates may cause concern for patients taking these medications. They maintain that these reports involve a very small percentage of people taking these medications and that it is not clear if these problems are associated with the medications. Based on the current information available, the NOF believes that for most people the benefit of taking these medications outweighs the risk of these serious conditions. Studies have shown that bisphosphonates can reduce the risk of hip fracture by 40% or more. More than 20% of people over 50 years old who suffer hip fracture die within a year. Others never fully recover. Patients who have concerns about taking these medications should discuss them with their doctor. Anyone taking these medications should report any unusual aches or pains, especially of the hip or thigh, to their doctor.

Adequate amounts of calcium and vitamin D are important for bone health. Adults under age 50 should get 1,000 mg of calcium and 400 to 800 IU of vitamin D per day. Those over 50 should get at least 1,200 mg of calcium and 800 to 1,000 IU of vitamin D per day. A diet rich in fruits, vegetables and calcium-rich foods is very important to bone health. Regular exercise is also important.

References: http://www.nof.org/osteoporosis/diseasefacts.htm, http://www.nof.org/news/pressreleases/F-1_Special_Concerns_About_Bisphos_2009.pdf, http://latimesblogs.latimes.com/booster_shots/2010/03/bisphosphonates-osteoporosis-medications.html.

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