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Quantity vs. quality: Long-term use of bone-building osteoporosis drugs
Date:3/10/2010

Bisphosphonate treatments, proven to enhance bone density and reduce fracture incidence in post-menopausal women, may adversely affect bone quality and increase risk of atypical fractures of the femur when used for four or more years, according to preliminary research presented today at the 2010 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS).

Bisphosphonates are designed to slow or stop the bone loss that occurs during the body's bone remodeling cycle, or the natural process that involves removal and replacement of bone tissue.

Two separate studies by researchers from Hospital for Special Surgery (HSS) and Columbia University Medical Center revealed data suggesting that long-term suppression of bone remodeling by bisphosphonate treatments may alter the material properties of bone, potentially affecting the bone's mechanical integrity and potentially contributing to the risk of atypical fractures.

"Although bisphosphonates have demonstrated an improvement in bone quantity, little if anything is known about the effects of these drugs on bone quality," said Brian Gladnick, BS, representing a team of investigators at HSS in New York.

Researchers at Columbia evaluated the bone structure of 111 postmenopausal women with primary osteoporosis, 61 of whom had been taking bisphosphonates for a minimum of four years and 50 controls taking calcium and vitamin D supplements.

This study found that bisphosphonate use improved structural integrity early in the course of treatment, but those gains were diminished with long-term treatment.

"In the early treatment period, patients using bisphosphonates experienced improvements in all parameters, including decreased buckling ratio and increased cross-sectional area," said Melvin Rosenwasser, MD, orthopaedic surgeon for Columbia University Medical Center. "However, after four years of use, these trends reversed, revealing an association between p
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Contact: Kristina K. Findlay
findlay@aaos.org
847-384-4034
American Academy of Orthopaedic Surgeons
Source:Eurekalert

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