Continuing Bisphosphonate Treatment for Osteoporosis — For Whom and for How Long? — NEJM

Continuing Bisphosphonate Treatment for Osteoporosis — For Whom and for How Long? — NEJM

Bisphosphonates for Osteoporosis — Where Do We Go from Here? — NEJM

Bisphosphonates for Osteoporosis — Where Do We Go from Here? — NEJM

Long-Term Use of Osteoporosis Medication May Reduce Bone Fracture Risk for Some Patients - U California

Long-Term Use of Osteoporosis Medication May Reduce Bone Fracture Risk for Some Patients:

"Continuing a popular but controversial treatment for osteoporosis could reduce spine fracture risk for a particular group of patients, but others could see little to no change if they discontinue it. Based on available evidence, a UCSF researcher reevaluated his 2006 finding from a randomized 10-year study of alendronate, a type of bisphosphonate - a class of drugs that prevent loss of bone mass.....

New Cautions About Bisphosphonates - NYTimes.com

New Cautions About Bisphosphonates - NYTimes.com

Clinical Oncology News - Zoledronic Acid Debate in Breast Cancer Continues

Clinical Oncology News - Zoledronic Acid Debate in Breast Cancer Continues

San Antonio—Long-term results of the ABCSG-12 trial and subanalyses of two recently presented Phase III trials provide further evidence that bisphosphonates can improve survival in breast cancer patients with low estrogen levels. The results of the studies, presented at the recent San Antonio Breast Cancer Symposium (SABCS), have convinced some doctors of the low estrogen hypothesis, but for others the water is still very murky.....


Weighing the Evidence
In recent years, some oncologists have been prescribing bisphosphonates off-label to treat breast cancer, and the new studies may sway more doctors to do so.
“The anticancer effects of adjuvant zoledronic acid are now well established in endocrine-responsive patients,” said Dr. Gnant.
Dr. Paterson added that “inhibition of osteoclast function with bisphosphonates has an effect on cancer growth in older women, and little effect in premenopausal women.”
For other doctors, however, the jury is still out. “Subanalyses are suspect,” said Dr. Vogl. “This is interesting, but we need to study it some more. But if they study it some more, Novartis will have lost its patent protection by the time that study comes out. Novartis has some interest in it [being approved] now.”

Dr. Paterson is a consultant for GlaxoSmithKline, Amgen, Roche and Nicomed and has received a grant for a clinical trial involving denosumab. Dr. Gnant disclosed relationships with AstraZeneca, Novartis, Pfizer, Sanofi, Roche, Schering and Amgen. Dr. Möbus disclosed relationships with Amgen, Novartis and Roche. Dr. de Boer disclosed a relationship with Novartis. Drs. Ingle and Dr. Vogl have no relevant disclosures.

Bisphosphonates in Oncology. [Bone. 2011]

UK Study Revives Theory That Osteoporosis Drugs Cause Esophageal Cancer - OncologySTAT

"A peer-reviewed study based on a massive British database has linked long-term use of oral bisphosphonate drugs to a higher risk of esophageal cancer, contrary to a separate study of the same database released a few weeks ago that found no evidence of increased risk. The competing conclusions have reopened the debate about a class-wide cancer risk, and a label change for the popular osteoporosis agents could be on the table..." cont'd

full access: The Role of Bisphosphonates in the Adjuvant Setting for Breast Cancer - Cancer Network

March 24th: No Link to Femur Fractures Found with Bisphosphonates - in Endocrinology, Osteoporosis

Action Points  

---

• Explain to interested patients that although this study did not find a link, some case reports have suggested that atypical fractures of the femur may be more common in patients treated with bisphosphonates, the most common drugs for treating osteoporosis.
• Explain that the FDA has begun a formal safety inquiry into this potential risk, but it has emphasized that it has not yet found evidence to suggest that physicians or patients should avoid these drugs.

Medical News: FDA Reassures on Osteoporosis Drugs - in Endocrinology, Osteoporosis (confused yet?)

FDA Reassures on Osteoporosis Drugs

By John Gever, Senior Editor, MedPage Today Published: March 10, 2010 Reviewed by Zalman S. Agus, MD; Emeritus Professor University of Pennsylvania School of Medicine.

"Bisphosphonate drugs for osteoporosis do not seem to increase the risk of femoral fractures, the FDA announced Wednesday, though the agency will continue to evaluate that possibility. Even as the FDA was making its announcement in Washington, orthopedic surgeons gathered in New Orleans were hearing news of a study showing an eventual decline in bone quality among patients who took bisphosphonates for more than four years. The FDA issued its statement as a result of case reports suggesting that "atypical" subtrochanteric femur fractures were occurring at higher-than-expected rates in women taking bisphosphonate drugs for osteoporosis....."