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One in three women taking bisphosphonates remain at risk for fracture

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Around three million people in the UK are affected by osteoporosis, a condition that causes the bones to become fragile and prone to breaking.

Oral bisphosphonates are one of the most commonly prescribed osteoporosis treatments, but a new study has found that approximately one third of women who take these drugs still face an elevated risk for bone fracture.

The US study was based on a retrospective database analysis of 7,435 women age 50 or older taking bisphosphonates for at least two years between 2000 and 2012. The findings, published in the peer-reviewed journal Bone, show that 7% of the women had incident osteoporotic fractures and 35% had either fracture, decrease in bone mineral density, or persistent osteoporotic bone mineral density.

This represents a “substantial proportion” of treated patients remaining at risk for future for hip, spine and other major fractures, although the drug does improve bone density in the majority of patients, the researchers said.

“Not everyone responds the same way to oral bisphosphonates or any drug,” explained Dr Erik Imel, an Indiana University School of Medicine endocrinologist who led the research. “Various factors could convey continued risk of fracture in spite of bisphosphonate therapy, including other medical problems and risk factors for falling. Since we know that such a high percentage of women continue to have elevated fracture risk we — doctors and patients — need to focus on these factors.”

Dr. Imel advised medical practitioners and their patients to discuss additional measures to decrease fall risk and fracture risk, for example exercise, smoking cessation, use of assistive devices such as canes or walkers, modifying the home to avoid obstacles that might lead to falls, and taking appropriate amounts of vitamin D and calcium.

The researchers also recommended further studies to determine the best achievable goals for osteoporosis therapy, and which patients would benefit from alternate therapies.

http://news.medicine.iu.edu/releases/2016/06/imel-biphosphonates-fractures.shtml

http://www.thebonejournal.com/article/S8756-3282 (15)00422-6/abstract