Osteoporosis risks and benefits of osteoporosis drugs rotates among
Dr. Susan Brown, Ph.D.
When it comes to osteoporosis, most patients and their practice is primarily associated with fractures. Pros bisphosphonates that if we could stop the destruction process of the bone and make bone more dense, we could prevent them from decay. Most of the ads you see you this case. But a closer look, the numbers DONT seem hot. Whats disappointment for me this way numbers of studies can be manipulated to exaggerate treatment benefits. Let me give you an example. When manufacturers say Fosamax, the drug can reduce fractures and 50% of women with a high risk that they have in mind are the results of research in 2004 shows
lower relative risk among women who, as a group, are very prone to fractures, before they even selected for the study. Most people do not have time to analyze the results of a study into details, but they show that with thousands of high-risk in postmenopausal women (with osteoporosis bone density and a history of fractures), about twice (2. 2 %) in the placebo group will break as those who take drugs (1. 1%). Because 1. 1%, in fact, half of 2. 2%, drug manufacturer may advertise that the drug reduces hip fractures by 50%, which is >> << lower relative risk (ie, comparing the number of people who fracture in both groups). But let's not forget that
both groups contain many more people who do not break at all, and if they turn over, you get called Whats >> << absolute risk reduction of unprofitable 1. 1% (2. 2 minus 1. 1) those who take Fosamax compared with those not taking anything. In 2008, the consideration of more than 40 years are data on more than 12,000 women using alendronate thats, many data show that in general it was just 1-2%
absolute risk reduction of its use. Co-optation that science that focuses directly on the consumer market continues to play to 45-50%
relative numbers of risk reduction. Thus, the relative risk reduction may be a useful tool for researchers, and value to the physician in determining the absolute risk reduction. But no good biostatistician will tell you that it does not seem useful measure for patients and families the choice of treatment! One more detail, we hear from pharmaceutical companies is that the fracture reduction benefit of these drugs is largely for secondary prevention, ie, when bone density is
and / or observed destruction of the existing. There is much less useful in
primary prevention lasix 40 mg daily, where bone density is osteoporosis and had no history of fractures. In women with osteopenia, some research even suggests
elevated levels of certain types of fractures in long-term use! In fact, these drugs are not recommended for primary prevention in general, but women are not at increased risk of fractures are among the largest target audience directly to consumer advertising of bone drugs. If the patient knew that the reality of these figures and dangerous side effects that come with taking bisphosphonates (see graph left), I'm sure they will review the merits taking prescription low bone density for the end of his days. This information is very hard to find, and many practitioners do not have time to analyze the statistics of each study that comes across your desktop. I would advise patients ask their suppliers to lower absolute risk for a drug before taking it. Or you can also ask about how to treat (NNT). This number gives you a sense of how many people have to take medicine for one person to receive benefits, and lower NNT, the more likely that drugs will benefit you. For example, the above information tells us that Fosamax reduces fracture risk by about 1% (absolute risk reduction), so that 100 people should be treated within one to benefit from the risk of fracture NNT 100, in this case. In fact, NNT tells us that for every person who drew benefits from these drugs, yet 99 receive no benefits at all! Unfortunately, the ads we see on television variety of drugs osteoporosis DONT note how little actually benefits or how serious side effects may be. As baby boomers begin to age, pharmaceutical companies have a bigger market than at any time by bisphosphonates, and they Arent dwelling on a lot to earn it. In fact, this is a great aging population is one reason it looks like osteoporosis was epidemic in this country. In fact, the rate of hip fracture in the U.S. went down to the end of the 1960s, women, and since the beginning of the 1990s in men, despite the aging population. A large number of aging baby boomers, the actual number of fractures may seem huge, but the speed is reduced. It is true that such a large group of people grows older, may crack and taking hospital beds will be a burden to society. This is partly because drug companies want to find a solution, but on the other hand, as I'm sure you can imagine related to income. In 2006 at least 2 billion dollars was spent on Fosamax alone. Pharmaceutical companies insist on direct consumer advertising to encourage women to get bone density tests, in the hope theyll treat low bone density. In the article on the use of market potential osteoporosis, write the editor
Medical Marketing & Media wrote that the United States, 95 100% of women who were diagnosed with osteoporosis test treated. He continues to advise pharmaceutical companies to manage the diagnosis rates sponsor travel DEXA scan in shopping centers, clubs for older people and social events. DEXA scanning was developed in the early 1980s as a way to quantify bone density, but, unfortunately, does not reveal much about the actual strength of bone. Patients given
T-score that compares their bones, and that healthy 20 - 30 years, then say they have osteopenia or osteoporosis!
Z-score that compares your bone density, as other men and women aged are more useful for monitoring bone density over time, but still not good at predicting risk. In fact there are many factors that are in predicting fracture risk and bone density is only part of the picture. He clearly is in the interests of pharmaceutical companies to compare their T-ball for young people, but you should know that while the machine can classify you as osteopenia or osteoporosis, even, you can never break bones in your life. And it is likely you most people do not break bones, even if they are at high risk. In a sense I agree with pharmaceutical companies: prevention is better. But I do not agree with their approach to prevention. Pharmaceuticals, in my opinion, do not work with your body. They work by inhibiting or deceive him in anything makes it Wouldnt do naturally. I know that under certain circumstances, bisphosphonates may be useful, but mostly they should be a last resort. In 2004, a doctor studying osteoporosis in the United States and wrote a report more than 330 pages of the best ways to promote healthy bones and prevent osteoporosis and fractures. His advice, in fact, is to work with nature. It is a pyramid of osteoporosis prevention and treatment that begins with diet, physical activity and prevention of falls in the base. The second level includes assessment and treatment of the root causes of threat to bone health. The very tip of the pyramid, and the last resort, is pharmacotherapy. The bottom line is that your bones are designed to last a lifetime. In most cases they do not need drugs to keep them strong and prevent deterioration. There are many, many natural ways to support the bones of the right >> << and many times, just >> << to prevent osteopenia, osteoporosis and fractures unnecessary. For more information on the topic of osteoporosis and bone loss, read additional articles here:
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. Original Publication Date: Last change: Main Author: Dr. Susan Brown, Ph.D.
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