Re: fosamax long term

Anne,

Most of the studies about the effectiveness of Fosamx have been for 4
years but in March of 2004, there was a study in New England Journal
of Medicine about that Fosamax for ten years.

Here are some details of report - direct quotes I found on Dr.SusanLove
web site. But note the dosages.....of course the once a week pill did
not exist for much of this study.

"The Fosamax study was initiated in 1991. At that time, 994
postmenopausal women with osteoporosis were randomized to receive 5 or
10 mg of Fosamax for three years, 20 mg of Fosamax for two years
followed by 5mg for one year, or a placebo daily for three years.

After the three years were over, the trial was extended for two more
years. During this time period the women who had started on 5 or 10 mgs
of Fosamax stayed on that dosage, the women who had been reduced from
20 mg to 5 mg stayed on 5 mg, and the women who had been on a placebo
began taking 5 mg of Fosamax.

After that two-year period, the trial was extended for two more years.
At this point, the women who had gone from 20 mg to 5 mg were put on a
placebo, the women on 5 or 10 mg continued their dosage, and the women
who had gone from a placebo to 10 mg of Fosamax ended their drug
treatment. When these two years ended, the trial was again extended for
two more years, with treatment remaining as it had been in the previous
two years.

Throughout the study all of the women received 500 mg of calcium a day.
They also could take vitamin D supplements, but it was not required.

When the trial ended, 247 women were still in the study. (About half of
the women in each group dropped out during the study.) Of these 247
women, 83 had been on Fosamax for five years and then on a placebo for
five years, 78 had been on 5 mg of Fosamax for 10 years, and 86 had
been on 10 mg of Fosamax for 10 years.

The researchers reported that the bone mineral density at the lumbar
spine continued to increase in the groups taking 5 or 10 mgs of Fosamax
during the second five-year period. And although the women who were on
Fosamax for five years and then on a placebo for five years did not
experience a significant decrease in bone mineral density at the lumbar
spine, they did show significant decreases in bone density at the hip,
neck, and forearm.

As Fosamax use became more widespread, some doctors began to express
concerns about whether long-term use might actually be bad for bones.
The potential for this problem first became apparent when animal
studies found that stopping bone resorption could lead to bones
becoming over-mineralized, which increases fracture risk. Although what
happens in animals doesn't always happen in women, the question was one
that could not be ignored.

Responding to this concern, the researchers reported that their
"observations do not suggest any association between prolonged use of
Fosamax and an excess risk of fracture." They also noted that the
fewest fractures and the least height loss occurred among the women who
had received the most Fosamax - 10 mg for ten years. However, this
difference was not statistically significant.

Based on these findings the researchers concluded "continuous treatment
with 10 mg of Fosamax daily for 10 years was associated with sustained
therapeutic effects on bone density and remodeling, with no indication
that the antifracture efficacy of the drug was diminished."

Note:
"Dr. Gordon Strewler, of Beth Israel Deaconess Medical Center and
Harvard Medical School, in Boston, notes that although this study's
findings are encouraging, more needs to be learned about how Fosamax
increases bone density and its impact on bone mineralization.

As Dr. Strewler explains, "By slowing bone turnover, Fosamax allows
secondary mineralization to progress, thereby increasing the tissue
mineral content. Thus, the increase in bone mineral density after
long-term Fosamax therapy reflects primarily not an increase in bone
mass but an increase in tissue mineral content. The measured increase
in mineralization after three years of Fosamax treatment did not exceed
the normal range, however.

"Is this increase in mineralization good or bad?" Dr. Strewler
continues. "It is good up to a point...But when bone is highly
mineralized and homogenous, it becomes brittle and less tough...We need
better long-term data on the prevention of factures during
bisphosphonate treatment and better data on the material properties of
bone after sustained bisphosphonate therapy."

That is the only long term study I have found in my research...I have
not found one on fracture risk long term with fosamx. If anyone knows
of such a study, I would be glad for it.

AS for other approaches [the rest of your post] - since the release of
Protelos [strontium ranelate] in the EU, I have been getting lots of
visitors to both the Protelos and the Natural Strontium pages of the
treatments sections of the web page.

Recently I found a source for strontium I trust and started taking it
about 2 weeks ago. My next dexa scan is some months off so I will not
know results but I like the idea of something that stimulates the
osteoblasts rather than inhibiting the work of osteoclasts.
Kate
http://www.osteopenia3.com


Those using Fosamx for 10 years showed an average increase of BMD of
13% - I am
Anne Brennan wrote:
> What do you consider long term?
>
> I am curious about these drugs being prescribed for osteoporosis.
> Assuming a patient is able to take any one of these drugs without any
> problem, is there a time limit, 3yrs, 5 years, 10 yrs, or can these
> drugs be taken indefinitely? Perhaps that too is an unknown factor.

.

Relevant Pages

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