Bad news on biphosphonates for longer than four years use...
 

http://www1.voanews.com/english/news...-87614397.html


"Dr. Robert Bunning, of the National Rehabilitation Hospital in Washington, co-authored a study of about 50 patients who have been on the drugs. His research shows that those taking the medications for more than four years have a higher risk of a fracture than people taking the drugs for a short period of time."

http://www.businessweek.com/lifestyl...ay/636826.html

http://www.modernmedicine.com/modern...tegoryId=40137
http://www.fda.gov/Drugs/DrugSafety/.../ucm203891.htm

Re: Bad news on biphosphonates for longer than four years use...
 

I saw my onc last week and was surprised when he told me that the 4 treatments I had received of Zometa would be enough, and that I would not need more infusions. But this article explains why.

Earlier, my onc had planned for more than four injections of Zometa (I received one infusion every 6 months), but I never knew exactly how many.

Re: Bad news on biphosphonates for longer than four years use...
 

I would suppose that would also happen to me as I did not get my last IV in Nov 09 due to my dexa being normal. It never was throughout until I significantly upped my vitamin d3 intake to 4000iu - 5000iu per day. After a year of that, normal bones and no Zometa. I would be shocked if I got an IV of it in May when I next see my onc.

Re: Bad news on biphosphonates for longer than four years use...
 

"They found that long-term use of the drugs -- at least four years -- was associated with an increase in the buckling ratio, reflecting a higher risk for fracture."

Ok...how much higher? Makes a difference in cancer world where benefit A is weighed against risk B.


"They looked at bone biopsies taken from the thigh bones of 21 women, all past menopause, who had suffered fractures at the site. Nine had not taken the drugs, while 12 had, for an average of 8.5 years."

So half had fractures w/o bisphosphonates? Same type of fractures? Same amount of osteoporosis at diagnosis? I suspect those who were on bisphosphonates had higher levels of osteoporosis to start with.

And it's unclear whether those on drugs took supplements or not.

Re: Bad news on biphosphonates for longer than four years use...
 

Rich, great questions.From what I gather from what I have read elsewhere on this topic, the fractures from high accumulative dosages or prolonged biphosphonates therapy ( risk appears to be associated with 5 or more years of oral use) have a characteristics unlike other fractures of the femur as they are:
-nonstress related
-preceeded by a period of thigh pain prior to fracture
-transverse fracture with lateral pattern
-may heal more slowly, especially if still on biphos.

It seems at least with biphos. therapy, shorter duration ( less than 4-5 years) and concentration may be safest to prevent over-suppression of bone building matrix as the wash out of the drug is very prolonged with an EXPODENTIAL HALF LIFE, where half of the drug is only cleared at ten years.


Some other interesting stats :

http://www.orthosupersite.com/view.aspx?rid=41933