Recent article supports Dr. Winnifred Cutler's findings on bone-building drugs
5/9/12 -- Health article "New Cautions About Long-Term Use of Bone Drugs" by Tara Parker-Pope features the FDA published analysis suggesting caution of extended use of drugs known as 'bisphosphonates'.
The article reported on the FDA review, published in the New England Journal of Medicine online, which analyzed the effectiveness of the drugs (i.e. Fosomax, Boniva, Reclast) after years of use.
While for many women with high-risk of fractures from osteoporosis the benefits of the drug still outweigh the rare complications -- for the women with moderate bone density "very little, if any benefit from the drugs after three to five years of use." (Pope, 5/9/12)
These 2012 FDA results, reflect the research and content Dr. Cutler presented in the "Protect Your Bones" chapter from her 2009 book for women; “Hormones and Your Health: The Smart Woman’s Guide to Hormonal and Alternative Therapies for Menopause” (John Wiley & Sons).
Excerpts below from Dr. Cutler's bone chapter, indicated some benefits, but also alerted readers to the potential risk of osteonecrosis (the dying of bone) of the jaw -- cited in the FDA analysis as a rare but documented occurrence.
Dr. Cutler also urges women to consider Hormone Replacement Therapy first, drugs second, in striving for healthy bones as they age.
From pp. 152 -153
Studying Hormone Regimens and Bone
The evidence has continued to confirm unequivocal benefits of hormonal therapies for the bones of women after their fertile hormone cycle has ended. Our bones are stronger when we're young and deserve more attention as we age.
What you should know: Hormones help bones. Scientific literature makes it clear that any sex hormone regimen will help bone density, whether estrogen alone,230, 294, 484, 563, 804- estrogen and a progesterone or a progestin,95, 122, 294, 542, 608, 820 or estrogen with an androgen, such as testosterone or DHEAS (dehydroepiandrosterone sulfate).187
It's never too late to start hormone therapy.54, 681 Frail women over age seventy-five who started estrogen and progestin experienced an increase in bone mineral density on the total body, the lumbar spine, the hip, and the trochanter region (the upper thigh-bone) joining the hip. They also showed better results on their bone metabolism: more building, less breakdown.804 Although the earlier you start, the better, your bones will always appreciate HRT.54, 681
From pp. 157
Bisphosphonates: Do They Help?
Drugs that work as antiresorptive agents appear to reduce the fracture risk by blocking (suppressing) bone resorption. Over-suppression, however, confers a potential risk because theoretically microdamage -micro cracks-would accumulate instead of being fixed.453
Bisphosphonates Work, but Long-Term Effects Are Unclear
Bisphosphonates definitely reduce the loss of bone mass and produce a significant 30 to 50 percent reduction in new vertebral fractures.89 In studies examining bone mineral density in the lower spine, the bisphosphonate alendronate maintained or increased bone mineral density better than raloxifene did.472 The molecules of alendronate attach themselves to the bone tissue, however, and accumulate in the bone.818 Because these are “foreign particles” not naturally produced by the human body, the long-term effects cannot be determined until the drugs have been consumed for many years, and the adverse effects are recognized and reported. Osteonecrosis (the dying of bone) of the jaw is one such recently discovered adverse effect.282
Compared to hormone therapies, bisphosphonates have significant gastrointestinal side effects. And they are not adequate substitutes for estrogen with regard to organ systems other than the bones.644
Click here to watch the recent video interview of Dr. Cutler
discussing her new book; Hormones and Your Health
Click here to read more on the topics from chapter excerpts of Dr. Cutler's new book; Hormones and Your Health
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