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FRIDAY, June 20, 2003 (HealthDayNews) -- Existing drugs for osteoporosis and bone loss may be more worthwhile than previously thought.
That's the picture emerging from research being presented today through Sunday at the Endocrine Society's annual meeting in Philadelphia.
A seven-year follow-up investigation into the osteoporosis drug Actonel (risedronate sodium tablets) revealed a reduced number of new vertebrae fractures. The drug also appears to be safe even for this prolonged time period.
"Treatment of osteoporosis is long-term. So obviously one needs reassurance about the fact that prolonged treatment will have sustained efficacy and a similar safety profile," says Dr. Jean-Marc Kaufman, lead author of the study who is also with the Unit for Osteoporosis and Metabolic Bone Disease at Ghent University Hospital in Belgium.
The study involved 164 women, 81 of whom had received a placebo for the first five years and were then switched to Actonel. These women went from having a 12.3 percent annual fracture rate while on a placebo to a 3.8 percent fracture rate while on the drug.
A second study concluded that Actonel's beneficial effects can't be measured solely by increases in bone mineral density (BMD), the traditional gauge of osteoporosis' debilitating effects.
In fact, the study authors state, increases in bone mineral density only accounted for 6 percent to 12 percent of the reduction in fracture risk at non-vertebrae sites -- such as the hip and wrist -- in postmenopausal women who were treated over three years.
Researchers had already discovered that increases in bone mineral density accounted for less than one-third of the reduction in vertebrae fracture risk.
"As your bone density becomes lower, your fracture risk becomes higher. But that data is kind of simplistic because it doesn't account for a lot of other factors that we know are important," says Dr. Stephen Honig, director of the Osteoporosis Center at the Hospital for Joint Diseases in New York City.
Bone density may not be a thorough measure of whether a drug is doing a good job. "The gains in bone density would not predict that you could reduce the fracture that significantly; so it's due to other factors besides bone density," Honig adds. "Improvements in bone density do not account for all of fracture improvement. It's also bone quality."
Adds Dr. Paula Rackoff, assistant chief of the division of rheumatology at Beth Israel Medical Center in New York City, "We define osteoporosis by bone density. It's the best predictor of fracture but it's not the only predictor. What's become clear is that bone quality is also very important. But bone quality is very hard to measure unless you get routine bone biopsies," she says.
A third study presented at ENDO tried to remove age from the equation when looking at bone loss.
Jane Lukacs, an assistant research scientist at the University of Michigan School of Nursing, looked at a small group of menopausal and premenopausal women of the same age, to determine whether menopause or age had the greater effect on bone loss.
"The metabolic bone changes in a woman who's having regular cycles is fairly minimal," Lukacs says.
More information
For more on bone loss and osteoporosis, visit the National Osteoporosis Foundation or the National Institutes of Health.
