Osteoporotic Women at Risk of Fractures despite Oral Bisphosphonates Use

 Bisphosphonates are the most commonly prescribed drugs for osteoporosis treatment in women. A recent study has revealed that the risk of osteoporotic fractures persists even after the use of oral bisphosphonates. 

Osteoporosis is a disease affecting nearly 53 million American women at or above the age of 50 years. Since the density of the bones is dramatically reduced in this disease, bone fractures are the most common complication associated with osteoporosis. 

Bisphosphonates are one the primary drugs given for osteoporosis and have been demonstrated to lower the risk of osteoporosis related fractures in women, if not completely eliminate it. Recent evidence suggests that the effectiveness of medications may be different when tested during trials than that of the clinical scenarios. 

A research was recently carried out by researchers under the supervision of Erik Imel, M.D., the Indiana University School of Medicine endocrinologist and Regenstrief Institute-affiliated scientist, through collaboration of Regenstrief Institute-Merck. The investigators were able to demonstrate that even after regular medication, most of the women carry the risk of osteoporosis-related fractures. 

During this cross-sectional retrospective study, the data of 7,435 women at or above the age of 50 was collected. The data, mainly figures about bone density and fractures, was collected from the Indiana Network for Patient Care and represented a wide scope of real-life clinical practices from a diverse background of patient and physician behaviors. These women had been on oral bisphosphonates for an interval of at least 2 years from 2000 to 2002. The results of the study were later published in the journal Bone. 

High Risk of Fractures Found In Women Taking Bisphosphonates 

According to Erik Imel, the lead researcher, it was found that most of the women who had been placed on oral bisphosphonates remained at high risk of hip, spine, and other fractures despite the fact that bisphosphonates strengthen the bones by increasing the bone density. Even then, bisphosphonates should remain a part of the first-line osteoporosis treatment regime. 

The study included only those women who were known to take bisphosphonates regularly. In women who were less compliant to their therapy, the efficacy of bisphosphonates was assumed to decline even further. According to the researchers, the efficacy of the drug can be enhanced only by adhering to the medication and through vigilance of both the doctor and the patient. 

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How to Reduce the Risk of Fractures? 

This study has raised some serious questions like the advantages of prescribing bisphosphonates to osteoporotic women and what to do when the anticipated benefits of taking bisphosphonates fail to manifest. The scientists, however, do agree on the fact that the risk of fractures is significantly lower in women taking bisphosphonates as compared to those not using them. 

Since the study has effectively established that only sticking to the medications is not enough, other factors and lifestyle modifications should also be heeded in order to minimize the risk of falls and the resultant fractures. The various lifestyle modifications that can be easily adopted include the use of walking aids, smoking cessation, regular exercise and removal of the obstacles that may result in falls. 

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This study has highlighted the importance of lifestyle changes in addition to taking medicines in order to reduce the obvious complication of fractures resulting from osteoporosis.