Osteoporosis, a bone condition affecting, according to the International Osteoporosis Foundation, over seventy-five million people in the U.S., Europe, and Japan, has been dominating headlines.
Recently, the Canadian Medical Association Journal published a study stating that older people who break a hip have nearly a 25% chance of dying in the next five years, with a 16% five-year death rate for those who suffer a spinal fracture. Nearly eight thousand people aged fifty and older from all parts of Canada participated in the study, explained author George Ioannidis, a health research methodologist at McMaster University in Hamilton, Ontario, who found that a hip fracture increases the risk of death 3.2-fold and a spinal fracture increases the risk 2.7-fold.
“While a number of previous studies have outlined the dangers of fractures for older people, one aspect of this study that was of particular interest was the increased risk of death from spinal fracture, a far more common fracture than hip fractures,” notes bone expert, Warren Levy, Ph.D., CEO of Unigene Laboratories. One of every six women over fifty will sustain a hip fracture according to the study.
Dr. Levy adds that the 20-25% mortality rate associated with hip fractures is well known but perhaps not well enough appreciated. “In any event, it underscores the seriousness of osteoporosis for those who take it for granted,” Dr. Levy says. “If you can minimize fracture incidence you may live longer. Unfortunately, most people don’t consider osteoporosis to be a life-threatening illness.”
All estimates in the study appear to apply to U.S. residents as well as Canadians.
Eyes and Jaws on Merck Lawsuit
Osteoporosis patients might also want to monitor an ongoing lawsuit that could shed light on a commonly prescribed osteoporosis drug. Merck & Co is slated to fight the first of numerous U.S. lawsuits brought by patients who claim they suffered jaw damage from the company’s widely used osteoporosis treatment Fosamax.
Merck faced about 900 cases as of June 30, including suits with multiple patients, the company said in an Aug. 3 regulatory filing. Patients have alleged jaw problems due to the drug. Fosamax, approved in the United States in 1995, belongs to the bisphosphonate family of osteoporosis drugs that include Actonel and Boniva. The drugs reduce the risk of bone fractures — particularly in postmenopausal women — by reducing bone loss and helping to increase bone mineral density.
In 2003, reports first surfaced linking intravenous bisphosphonate treatments with jaw osteonecrosis, meaning death of jawbone tissue that can include symptoms such as pain, swelling, or infection of the gums and jaw, gums that don’t heal, and loose teeth. Oral versions of the class of drugs were initially thought to be safe until a report came out in May 2005 showing that seven of sixty-three bisphosphonate users who developed the condition had been using oral forms.
“Given the millions of osteoporosis patients who have taken or are taking drugs in the bisphosphonate category, including Fosamax, it is critically important to shed light on the possible long-term side effects of these drugs,” says Levy.
Levy warns, the focus of this trial is osteonecrosis, the most widely discussed possible side effect associated with Fosamax therapy, but unfortunately not the only one. Because of the additional bisphosphonate warning issued by the FDA for severe bone and joint pain, as well as publications suggesting that certain of these drugs may be associated with irregular heart rhythms, sudden severe leg fractures that do not heal normally, esophageal cancer and renal failure, it is imperative that patients and physicians become educated regarding all of the available data concerning bisphosphonate use he adds.
People should start thinking about the possible dangers of osteoporosis and also “bone up” on medications they will need to treat this condition as early as age fifty, Dr. Levy believes. “There are other classes of medications that are safe and effective including SERMs, parathyroid hormone and calcitonin. Importantly sufferers should also try to incorporate a variety of non-medical interventions to reduce the incidence of falls that cause fractures.”
Bone health can be maintained, Dr. Levy adds, by getting adequate calcium and vitamin D, performing weight-bearing exercises, eliminating smoking and avoiding excessive caffeine or alcohol consumption. Simple adjustments to one’s home such as having adequate lighting, fastening scatter rugs, and making sure there are handrails where necessary, can also go a long way toward preventing unnecessary bone breaks.