July 2008

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Osteoporosis Drugs: Not What They Are Cracked Up To Be

According to the January 18, 2008, issue of the British Medical Journal, the benefits of osteoporosis drugs are exaggerated. The drugs are being prescribed to women with osteopenia, which is a less serious situation than osteoporosis and affects about half of all older women.

The drug companies are marketing their drugs to women with osteopenia, basing their actions on reanalyzing data from four earlier drug trials. The new analyses were funded by drug companies and tend to overstate the benefits of the drugs. They cite statistics in terms of “relative risk,” which presents a high percentage, making the drug look very effective. Analyzing the absolute risk reduction shows that the reduction in the number of fractures is actually a very low number.

The new analyses also tended to downplay the risks and side effects of these drugs. Raloxifene, for example, increases the risk of blood clots. A Canadian study performed by researchers at the University of British Columbia and Vancouver Coastal Health Research Institute found that a class of osteoporosis drugs can increase the risk of bone necrosis. Necrosis is a situation where there is not adequate blood supply to the bone, causing it to die and collapse. This is extremely painful. The study, published in the online Journal of Rheumatology (January 16, 2008) found that biophosphonates (including drugs like Fosomax) can triple the risk of bone collapse. Biophosphonates can also cause inflammation of the eye (published in a letter in the New England Journal

The authors of the British Medical Journal article believe that the osteoporosis drugs are being prescribed unnecessarily to a relatively healthy population. The calculation of the benefits of the drugs is presented in a way to make them look more effective than they actually are. For example, a 75 percent relative risk reduction for fracture is cited. In reality, this is actually less than a 1 percent reduction in absolute risk. This means that 270 women with pre-osteoporosis would have to be treated with drugs for three years to avoid a single fracture. They have such a low risk of fracture to begin with, that the drugs offer them almost no benefit. As usual, natural health care looks better when you start considering risk vs. benefit.

Dr. Paul G. Varnas graduated from National College of Chiropractic in 1983 and has been in private practice in the Chicago area for over 25 years. He is a Diplomate of the American Clinical Board of Nutrition and has written several books and hundreds of articles about health care. Dr. Varnas is the founder of Whole Health America, which is a resource for chiropractors and other health practitioners that provides Web sites, newsletters, marketing material and other practice development material. At www.thebetterhealthnews.com you will find free newsletters, patient education material, marketing information, health articles and more—all for free.

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