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Bone health experts concerned over falling uptake of osteoporosis drugs

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The progress made over the past 30 years to reduce fractures and improve the quality of life for osteoporosis patients is rapidly being reversed, according to an article by two bone health experts in the Journal of Bone and Mineral Research (JBMR).

Dr Sundeep Khosla, a practising endocrinologist, research scientist, professor of medicine and director of the Clinical and Translational Science Award Program at the Mayo Clinic in Rochester, Minnesota, and Dr Elizabeth Shane, a practising endocrinologist, research scientist, professor of medicine and vice chair for clinical and epidemiological research at Columbia University in New York, claim that that too many patients at high risk for fractures are not being diagnosed or treated to prevent them.

The article, A Crisis in the Treatment of Osteoporosis, presents evidence showing that high-risk patients are not getting appropriate therapy despite research showing the effectiveness of several osteoporosis drugs in preventing fractures.

Drs Khosla and Shane also discuss how this situation came about, citing research analysing parallel trends in the media and public concern about rare side effects with a decline in the use of osteoporosis drug prescriptions and an increase in hip fractures.

The authors state: “While there are certainly controversies in the field of osteoporosis, there are also issues upon which there is complete or near-complete agreement: specifically, there is consensus that patients with hip fracture should receive pharmacological treatment to prevent additional fractures, as they are clearly at risk for recurrent hip or other osteoporotic fractures, and initiation of bisphosphonate therapy after hip fracture has been shown to reduce the risk of a second hip fracture.”

Currently available drugs can reduce fracture incidence by as much as 70%, yet many patients are either not being prescribed osteoporosis medications at all or, when prescribed, refuse to take them.

“We must find ways to ensure that patients who need appropriate treatment for osteoporosis are not only prescribed effective medications, but are also equipped with the information they need to make an informed choice on taking these medications,” the authors concluded.