Worth a Read – Fosamax Article in More Magazine

June 7th, 2010. By AbiK

Finally got to catch up on some reading this weekend and found myself flipping through the latest More magazine. The one with Sharon Stone on the cover—looking great at 52 (not to take away from Stone’s smarts or her three adopted children, but my response to any “hot body over 40” (or 50) press is, ok, but has she gone through childbirth?—and sans plastic surgery? if so, then let’s talk; otherwise, get real.) But I digress.

What I really want to talk about is the article by Katharine Davis Fishman that’s a bit further back in the June issue. Page 119, to be exact. Title: Boning Up on Bone Drugs. It’s about Fosamax and femur fractures.

And it’s worth a read—particularly if you’re a woman, of a certain age—or nearing that age, or one who’s been taking bisphosphonates—either as a result of a diagnosis of osteoporosis, or as a preventative measure against such bone degeneration.

Fishman presents her own incredible journey through osteoporosis, Fosamax prescriptions, and then a seemingly out-of-the-blue femur fracture after tripping on a rug. Her description of the incident is enough to bring on a palpable wince in the reader. Heck, I got up mid-article and popped a Caltrate D.

The part of the article I found most interesting was the delineation of what Fosamax (and others of its ilk like Actonel, Didronel, Boniva, Aredia, Reclast, Zometa, Skelid) was initially intended to treat, and where it’s evolved to. Bisphosphonates are prescribed to help prevent the breakdown of bone—to help prevent hip fractures—which according to Fishman’s article have a harrowing statistic associated with them: Around 24 percent of elderly men and women who suffer a hip fracture die within a year of the fracture; another quarter wind up incapacitated in nursing homes; and the remainder typically never walk “right” again.

With that kind of prognosis, if I hear the word “osteoporosis” uttered in any examination room I’m in, I’m asking for a Fosamax scrip right then and there.

But wait a minute—that’s the problem. Apparently, Fosamax has been prescribed more and more as a preventative measure—it was approved for such in 1997, two years after its initial approval by the FDA. Of note is that, according to an FDA statistician in 1998, the data Merck had submitted to the FDA prior to receiving the approval for Fosamax for preventative purposes may have shown distorted results—the data had been based on two studies with “different time spans, populations and goals”. Hmm.

You can read plenty about subsequent lawsuits that have been filed against Fosamax (Merck) since that time, but the bigger question that remains is what does a woman who shows signs of bone loss, but has not yet been diagnosed with osteoporosis, then do? Studies done on patients who suffered a femur fracture and had been taking Fosamax seem to indicate a correlation between the fractures and longer-term use of the drug. And yet, doesn’t it seem that if you were to take Fosamax as a preventative measure that you’d probably be taking it for the long-haul—ie, from the first point at which any loss in bone density became apparent?

So it appears to be a question of weighing the risks: would you be better off, given a diagnosis of osteoporosis (not just lower bone density) and a prognosis of hip fractures (via tests like the newer FRAX scoring), to take a bisphosphonate like Fosamax and possibly risk femur fracture—or not take it and risk the hip fracture?

Get a copy of the June More and read Fishman’s article—she’s done an incredible job delving into a controversial topic that she unwittingly found herself right smack in the middle of.

Tags: femur fracture, Fishman, Fosamax, Fosamax femur fracture, Merck, More

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