Back

Latest Information on Drug Treatment for Osteoporosis

In this review, two doctors from the Virginia Commonwealth University School of Medicine in Richmond, Virginia give a summary of the latest findings on osteoporosis. In particular, they reviewed the current status of drug treatment for this condition.

Calcium, vitamin D, and bisphosphonates are the most commonly used agents to prevent and/or treat osteoporosis. It appears that using vitamin D along with calcium has the best results. Postmenopausal women who normally have a low (or no) intake of these supplements seem to have the best results.

Taking vitamin D alone is not as good as taking it along with calcium. By itself, it does reduce the risk of falls in healthy older adults. They must be taken daily to improve bone strength and reduce the risk of fracture. It's important to take enough of these supplements. How much you take depends on your age. For women, whether or not they are postmenopausal also determines how much to take.

A newer class of drugs called bisphosphonates is also available. This drug increases bone density. It also decreases the risk of fracture in adults who already have osteoporosis. Many people are familiar with Fosamax, a commonly prescribed bisphosphonate.

Newer bisphosphonates such as ibandronate and zolendrate are taken much less often. Ibandronate is given orally once a month. It can be given intravenously once every three months. A single dose of zolendrate has been shown to work for up to a year. It’s being tested further for its ability to prevent bone fractures.

There is a downside to these drugs. Studies show the benefit from taking these drugs goes away if the person stops taking it. Some patients have reported heartburn, stomach pain, and diarrhea with bisphosphonates. And recently, there's been an increase in the number of cases of jaw osteonecrosis with long-term use of bisphosphonate.

Scientists are studying the best way to use drugs to treat osteoporosis. Combining parathyroid hormone (PTH) with bisphosphonates is one option. Using PTH first for a year or two and then taking bisphosphonates is also under investigation. Another method being studied is called cyclical therapy. In this treatment, different drugs are taken in a pattern of three months on, then three months off.

So far, combining drugs in any pattern has not shown to be better than taking one drug long enough to let it do its job. The cost must be considered. Who is more likely to benefit remains to be determined by future studies.

References: Beth Rubenstein, MD, and Lenore Buckley, MD. Update on Osteoporosis Treatment: New and Better Approaches. In The Journal of Musculoskeletal Medicine. June 2007. Vol. 24. No. 6. Pp. 264-268.

Back