The Clinical and Scientific Committee of the National Osteoporosis Society has said they are ‘disappointed’ by the coverage of a study which implied that bisphosphonate drugs - which are used to treat osteoporosis - may cause microscopic cracks.
Osteoporosis affects over three million people in the UK
Scientists at Imperial College London looked at the bone structure of 16 hip-fracture patients who had been treated with bisphosphonates. The researchers reported they found microscopic cracks in 6 of those studied.
The study, ‘Long-term effects of bisphosphonate therapy: perforations, microcracks and mechanical properties’ by Dr Richard Abel et al, was reported on The Today programme. It was also included on the BBC Health website and BBC Radio 4’s Inside Health.
Professor Neil Gittoes of The Clinical and Scientific Committee of the National Osteoporosis Society said: “We are extremely concerned that the findings of this study, highlighted purely because of the use of a new technology, were reported as having potentially harmful effects to patients already receiving bisphosphonate therapy to reduce their increased risk of osteoporosis-related fractures.”
He added: “Thousands of such patients were let down and misled by the way in which the story was reported.”
Should osteoporosis patients take bisphosphonates?
The National Osteoporosis Society’s Helpline was inundated with calls from worried patients wondering whether they should stop taking their medication.
The Scientific Committee said the reporting had been ‘sensational’, and lacking in context and balance.
There has been much research done into bisphosphonates. Over 20,000 patients have been involved in well-designed studies over the last 20 years. The research has consistently shown that that patients who took bisphosphonates gained protected from fractures and broke bones much less often than those given the placebo.
Professor Gittoes said: ”The overwhelming evidence is that these agents protect patients from fractures. From a technical standpoint, this is primarily due to in-filling of tiny cavities in the bone, so called resorption pits, a finding which was confirmed in the Abel study.”
Study too small to be significant
Another member of The Clinical and Scientific Committee, Professor David Reid of Twenty-five Harley Street Day Clinic said he believed the structure of the study has led to misleading results as the bone samples were taken from the head of the femur. This is not a place where femoral fractures usually occur.
He explained: “Scientific reports based on small sample sizes and with study design issues can be over-interpreted in terms of risk of harm. Over-extrapolation of the data to alter clinical management algorithms at this stage are premature.”
Dr Abel’s report that was based on small bone samples from only 16 people in a non-randomised study of which only 6 patients on bisphosphonate treatment were scanned.
The Clinical and Scientific Committee of the National Osteoporosis Society said the reporting ignored the overwhelming evidence and did not address the limitations of the Abel study.
DEXA scan reveals the bone fracture risk
Professor Gittoes commented: “The media reports did nothing to help those living on a day to day basis with the devastating effects of osteoporosis, particularly those patients at highest risk of fracture where the benefits of treatment with bisphosphonates far outweighs the risks.”
Most people with osteoporosis only discover they have the condition after suffering a fracture. However, a DEXA scan can reveal if a person is at risk.
Certain lifestyle changes – such as taking vitamin D and regular exercise - can help prevent the condition worsening, and allow the bones to be protected.
