Osteoporosis is a disease that weakens bones, reduces bone mass and makes them more porous. This condition is linked to a lack of calcium and is most often found in postmenopausal women. People who have osteoporosis are more likely to have bone fractures, most notably in the hip, forearm and vertebrae. According to the International Osteoporosis Foundation, drug therapy reduces vertebral fracture by 30 to 65 percent and fractures elsewhere in the body by 16 to 70 percent.
Bisphosphonates
Dr Kurt Kennel, MD, an endocrinologist at the Mayo Clinic, states that bisphosphonates like Fosamax, Actonel and Boniva are the most commonly prescribed medications used to treat osteoporosis. Fosamax, for example, having been on the market for more than 10 years, offers a proven safety record. Plus, bisphosphonates only affect bones, have few side effects and have few, if any, drug interactions. Patients who take these medications have also been shown to tolerate them well.
How They Work
Bisphosphonates work by reducing the degeneration of bones. After menopause, when estrogen levels in the body decrease, bone mass breaks down even more quickly, and bones become weak and porous. Bisphosphonates interfere with this process by maintaining the structure and density of bones.
Oral Bisphosphonates
Bisphosphonate medications differ only slightly. Some have different levels of potency, while others offer more protection against bone degeneration. All of them, claims Dr. Kennel, are effective in sustaining bone density and preventing fractures. How doctors determine which medication and dosing procedure is best for each individual is based on the specific patient. If you're not likely to remember to take a once-monthly pill, your doctor will prescribe a weekly medication. Taking these medications more than once a week seems to make no difference. Dr. Susan Ott, associate professor in the Department of Medicine at the University of Washington, reports that taking bisphosphonates once weekly is as effective as taking the medication once a day. It is an approach, she finds, that many patients prefer.
Injection Benefits
Studies have shown that after one year, many patients who take their medication orally either stop treatment or reduce the amount of medication they take---both of which increases the risk for fractures and advance bone degeneration. When an injection is administered at a doctor's appointment on a regular basis, those who suffer from osteoporosis maintain full protection.
Long-Term Effects
One study conducted by the American Society for Bone and Mineral Research shows that women who were taking medications in the bisphosphonate class of drugs for more than five years had no measurable benefits compared to women who had stopped after five years. In fact, patients who stayed on Fosamax for 10 years had the same number of fractures than patients who stayed on the drug for eight years. So how long should you stay on bisphosphonates? Can it hurt to continue using the drug? An article published in the Journal of the American Medical Association reported that women who discontinued drug therapy, or took a drug holiday, after five years were still protected from bone degeneration.
