The Plus Side of Bisphosphonates

The pros and cons of bisphosphonate medications for osteoporosis have been in the news a lot lately. A new study adds a point to the "pro" column. 

In a study published in the Journal of Clinical Endocrinology & Metabolism, people who took a specific type of osteoporosis medication known as bisphosphonates lived an average of five years longer than those who didn't take them. Scientists are surprised at these findings, but further investigation has been unable to disprove the results. They couldn't find any reason other than this specific type of osteoporosis treatment for why their study participants lived longer. 

The study was conducted at the Garvan Institute of Medical Research in Sydney, Australia where researchers analyzed results from 2,000 people in an ongoing osteoporosis study. Of this larger group, they found 121 women and men who had been taking bisphosphonates like alendronate (Fosamax) and risedronate (Actone) for an average of three years. Upon further analysis, they discovered that the death rate among women who were older than 75 when they took bisphosphonates was 69 percent lower than expected. There were fewer men in this group so researchers can't be certain, but results were similar. 

Why is this surprising? Initially, researchers wondered if the reason why these participants lived longer was because they were healthier overall than other participants and were receiving health care.  It turned out, however, that people in this group were actually sicker than other participants. They were more fragile, had lower bone density, more fractures, and weighed less, which are all factors that are associated with increased mortality. 

Did they live longer because they had fewer fractures?  Researchers don't think that's the answer because there weren't enough fractures expected, and therefore prevented in the study group to validate that theory. 

So what is it about bisphosphonates that add years to one's life?  It may be that by preventing bone loss, bisphosphonates also stop bones from releasing toxins from bones. The skeleton acts as the body's storage locker for many substances we absorb throughout life including heavy metals and toxic materials.  As we grow older and bones become porous (osteoporosis), they release these substances into the bloodstream and may potentially cause disease.  Bisphosphonates may prevent that from happening.

What's on the "con" list for bisphosphonates?  Some patients who received these medications developed a serious disorder called Bisphosphonate-related osteonecrosis of the jaw. There have also been findings of unusual and severe bone fractures (usually the tibia) in some patients taking bisphosphonates for a long period of time.

To find out with if bisphosphonates are right for you, make an appointment to talk with your doctor.



National Library of Medicine of the National Institutes of Health
Atypical insufficiency fracture of the tibia associated with long-term bisphosphonate therapy.
Breglia MD, Carter JD.

Arthritis Today
A Bonus for Bisphosphonates
Jennifer Davis

Journal of Clinical Endocrinology and Metabolism
Osteoporosis Medication and Reduced Mortality Risk in Elderly Women and Men
Jacqueline R. Center, Dana Bliuc, Nguyen D. Nguyen, Tuan V. Nguyen and John A. Eisman