What is Osteoporosis
Osteoporosis is a disease of bone in which bone mineral density (BMD) is reduced, bone microarchitecture is disrupted, and the amount and variety of non-collagenous proteins in bon...
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5 vs 10 years of Alendronate (Fosamax)
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Many of you may have heard results of this study published in JAMA Dec 2006 (Vol 296. No.24)
This is important because many of us doing Womens Health have been waiting for studies to address the ? of how long we treat women with bisphosphonates for to get the fracture reduction benefits? 1) 1099 Women who had been taking Fosamax for 5 years were randomized to EITHER continue taking 5 MORE years of Fosamax OR take placebo 2) Women who stopped Fosamax after 5 years did have a moderate decline in bone mineraly density 3) HOWEVER WOMEN WHO DISCONTINUED FOSAMAX AFTER 5 YEARS DID NOT HAVE A HIGHER RISK OF NONVERTEBRAL FRACTURES OR OF XRAY DETECTED VERTEBRAL FRACTURES 4) This study suggests that discontinuation of Fosamax after taking it for 5 years does not appear to be associated with an increased fracture risk even 5 years after discontinuing it... Thoughts? Questions? Dr O. Posted on 01/12/07, 07:01 pm |
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Hi, Orange-
Is there any data on males regarding Fosamax? I have had 5 vertebral compression fractures ( all in the thoracic region) and have been taking Fosamax for 2.5 years and was concerned, as time passes, what the effects of this drug may be having-good or bad. I have read a little about necrosis of the jaw, but am not sure I am at risk. My doctor now renews my prescription for 3 months at a time, rather than yearly as he used to, so I am wondering if he is thinking I am getting to the end of efficacy of this drug. Thanks for any input you may have. Best, Fred 
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Hey Fred
Glad you brought up the issue of men and osteoporosis treatment. Unfortunately the above study was done only in women and its hard to say whether the results can be applied to men. 1) Here is the rundown: Bisphosphonates (fosamax, boniva, actonel) are the first-line drugs for the treatment of osteoporosis in men 2) A randomized, controlled trial evaluated the effects of fosamax compared with calcium alone on bone density in 241 men with osteoporosis. 3) After two years, the men treated with fosamax had significantly greater increases in lumbar spine density (7.1 versus 1.8 percent with placebo) and femoral neck density (2.5 versus 0.1 percent) and a significant reduction in the risk of new vertebral fractures. 4) There are no studies comparing 5 vs 10 years of therapy in men...as you asked...so we dont know the answer to your ? 5) see previous posts on the jaw osteonecrosis...i dont think you have anything to worry about there Dr O.
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Fred, my MD,(male) has been on it 3 yrs since c spine fractures. Since no further #s while on it, he plans to stay on it indefinitely. If that's any help, its an MDs mindset!
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