Take your medications to prevent fractures
Cur Med Res Opin. 2006 Sep;22(9):1757-64. Persistent bisphosphonate use and the risk of osteoporotic fractures in clinical practice: a database analysis study. van den Boogaard CH and others. PMID: 16968579. A recent Update on this Website mentioned three studies that show the very poor persistence that people with osteoporosis have concerning taking their medications after being prescribed FDA-approved osteoporosis medications. That is, people start taking their medications, then stop. This article by van den Boogaard CH and others shows the consequences of such behavior. The authors checked a database of 14,760 females who started taking either Fosamax or Actonel for a 3-year period and compared these women to controls. They were looking for hospitalization for fracture based upon how persistent the women were when taking their medications. They found that persistence increased from 33% to 48% in the first year when women went from taking once-daily to once-weekly medications. Persistent use of bisphosphonates for one year resulted in a statistically significant 26% lower fracture rate and two-year persistent use resulted in a 32% lower fracture rate. The authors conclude: “Persistent use of bisphosphonates decreases the risk of osteoporotic fractures in clinical practice.” Editor's comments: There is a tendency to disregard figures when they are given in percentages—after all these are just numbers. But remember these numbers refer to PEOPLE, and these people suffered a painful, often debilitating, and sometimes fatal fracture. In this study persistence for two years meant 32% lower fracture rate. For this one group of women that translates to 173 fewer people getting fractures because they took their medications. When I was diagnosed with osteoporosis, I had more than one compression fracture. I can tell you from experience they were painful and I wish I could have avoided them. There were no approved osteoporosis medications at that time, so I had no way to prevent them. We now have multiple FDA-approved osteoporosis medications: alendronate sodium (Fosamax); calcitonin-salmon (Miacalcin); estrogen therapy / hormone therapy; ibandronate sodium (Boniva); raloxifene hydrochloride (Evista); risedronate sodium (Actonel) and teriparatide (Forteo). My recommendation for those diagnosed with osteoporosis is to take one of those approved medications—and take it persistently. There is no cure for osteoporosis. So once you stop medications, your fracture risk increases and bone mineral density decreases. Persistent use of approved osteoporosis medications prevent fractures, and you don't want a fracture!