Researchers evaluate long-term use of alendronate

A team of scientists from the University of California, San Francisco (UCSF), found that women at high risk for spine fractures may benefit from a long-term regimen of alendronate, which is sold under the trade name Fosamax. This study may have implications for the pharmaceutical marketing of bisphosphonates that are used to prevent fractures and other complications of osteoporosis.

More than 40 million Americans either have osteoporosis or are at risk for the bone-wasting condition, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases. An approximate 1.5 million resulting fractures cost the healthcare system $14 billion every year.

Between 1991 and 2004, researchers at UCSF evaluated the effects of alendronate on nearly 6,500 women, who took the drug for an average of five years. Results from this original study suggested that subjects who took the drug were less likely to experience fractures to their spines, hips and other major bones.

Prescriptions that last longer than five years remain controversial in light of evidence showing that alendronate may increase the risk of problems in the femur and jaw bones.

However, the scientists from UCSF wanted to see if such long-term regimens had any benefits. To that end, they conducted a follow-up study that included nearly 1,100 women from the original study. While some of these subjects were assigned to take placebos, the rest took alendronate for another five years, bringing the total of time spent on this drug to 10 years.

Results showed that the risk of spine fractures remained low for vulnerable women. However, this was not true for other types of broken bones.

"Each patient and her physician need to weigh the benefits versus the risks, but the purpose of our analysis was to try to give people a sense of what the benefits might be and in whom they would be highest," said researcher Dennis Black, Ph.D.



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