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Osteoporosis drugs not taken by many who need them: reports

by Thomas Dworetzky , Contributing Reporter
Fear and a lack of awareness in many older adults that they have the bone-weakening disease osteoporosis has led to a growing public health concern by leading medical organizations.

In a joint statement, the American Society for Bone and Mineral Research, National Osteoporosis Foundation and National Bone Health Alliance, announced their concerns.

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“Untreated osteoporosis is a public health crisis. Many of us see firsthand the ravages of this disease every day - pain, fractures, loss of mobility and independence, and diminished quality of life,” said Dr. Douglas P. Kiel, ASBMR president and director of the Musculoskeletal Research Center and Senior Scientist for the Institute for Aging Research at Hebrew SeniorLife. “These results build on mounting evidence that identifying and treating patients after the first fracture is crucial to preventing suffering.”

Their statement highlighted recent findings in an Icelandic study that “the fracture risk jumps three-fold after the first fracture.”

“This new information makes it more important than ever that physicians and health care providers take immediate steps to evaluate and treat patients who have sustained an osteoporotic fracture,” said Dr. Robert F. Gagel, Professor of Medicine, MD Anderson Cancer Center, NOF President and NBHA Co-Chair. “At present, only 26 percent of patients who sustain their first osteoporotic fracture are evaluated and treated, putting large numbers of patients at risk for subsequent life altering and preventable fractures – a travesty we must work to fix.”

Several other recent reports highlight this looming health care issue.

One long-range study determined that there is an alarming drop in the number of people with osteoporosis taking medications that effectively combat the condition. “Oral bisphosphonate use declined by greater than 50 percent between 2008 and 2012 after increasing use for more than a decade,” according to a 2015 report in the Journal of Bone and Mineral Research (JBMR).

The main reason is fear. “Ninety percent of patients, when you talk to them about starting one of these drugs, won’t go on,” Dr. Paul D. Miller, medical director of the Colorado Center for Bone Research, a medical practice in Lakewood told the New York Times. “Ninety percent who are on the drugs want to come off. The fear factor is huge.”

This is despite the fact that the worst side-effects of the mainstay medications – such as alendronate, ibandronate, risedronate and zoledronate – are rare. Just 40 in every 100,000 patients have broken a thigh bone, one such complication. Only one in that number will experience necrosis in their jaw, another rare side-effect.
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