(Reuters Health)—Media reports raising safety concerns about osteoporosis drugs known as bisphosphonates may have contributed to a sharp drop in their use—even though U.S. doctors and drug regulators haven’t recommended against taking them, a study suggests.
Fosamax (alendronate sodium) won U.S. marketing approval in 1995. Widespread use of the drug and others like it over the next two decades coincided with a dramatic drop in hip fractures, the researchers note in the Journal of Bone and Mineral Research.
Starting in 2006, a series of media reports highlighted research linking the drugs to rare but serious side effects, including unusual fractures of the thigh bone, death of bone tissue in the jaw and esophageal cancer.
After that, use of the drugs plunged by more than 50% between 2008 and 2012.
Even though a decline makes sense, given the negative publicity, “the magnitude of the decrease was surprising,” said senior study author Timothy Bhattacharyya, a researcher at the National Institutes of Health.
“Osteoporosis remains a huge problem and I see people with preventable fractures every day,” he said by email. “Bisphosphonates are effective, and the safety risks are low.”
Each year, one in three adults over age 65 experiences a fall, the leading cause of fatal and nonfatal injuries among the elderly, according to the U.S. Centers for Disease Control and Prevention.
For older women, the risk of fall-related injuries is compounded by osteoporosis, or thinning bones, which occurs when production of the hormone estrogen declines after menopause.
Fosamax, as well as similar drugs such as Actonel (risedronate sodium) and Boniva (ibandronate sodium), work by slowing down the process by which the body removes old bone, which allows time to rebuild normal bone. The drugs can help prevent bone loss and also regrow bone to make fractures less likely.
Using data from Google, Bhattacharyya and colleagues looked at patterns in online searches for Fosamax and other bisphosphonates, and found a series of spikes from 2006 to 2010 that lined up with heavy media coverage of side effects associated with the drugs.
The first prominent spike in the Google data lined up with media reports about the first lawsuit filed against Fosamax maker Merck & Co. over the death of jaw tissue.
Another surge in Google searches occurred in 2008 after a study in the Archives of Internal Medicine linked the drug to an increased risk of an arrhythmia called atrial fibrillation.
There was also a sharp increase in 2010, when ABC World News aired a segment highlighting studies being presented at the American Academy of Orthopedic Surgeons linking Fosamax to atypical fractures of the femur, or thigh bone.