Zoledronate reduces risk of bone fracture in older women: shots

A large study has convincingly demonstrated that a drug commonly used to treat osteoporosis, a disease that causes bone loss, could prevent fractures in older women whose bones are not so fragile .

The study of 2,000 women aged 65 and older with early bone loss – a condition known as osteopenia – found that the drug zoledronate reduced by about one-third the risk of rupture.

"This is an extremely important document," said Dr. Ethel Siris, a professor of medicine at Columbia University, specializing in thinning bones and who does not have to worry about bones. did not participate in the study. "We now know that we have a therapy that has proven very effective."

The results were published Monday in the New England Journal of Medicine and presented at a meeting of the American Society for Bone and Mineral Research in Montreal.

"This could prevent many fractures," said Siris, who serves on the board of the National Osteoporosis Foundation. "The prevention of fractures in people of this age not only prevents a lot of suffering but also saves a lot of money."

The results indicate that physicians should consider millions of additional women as candidates for treatment. This treatment is now recommended only systematically for women whose bones have thinned to the point of officially being diagnosed with osteoporosis. According to the ASBMR, a zoledronate treatment costs between $ 300 and $ 500.

"I think it's a breakthrough," said Clifford Rosen, an endocrinologist and physician at the Maine Medical Center, who wrote an editorial accompanying the study. "At least we need to allow people to consider this as another option they might consider, perhaps the future in terms of treatment."

But others remain cautious.

The new findings are "suggestive and useful," says Robert McClean, a rheumatologist at the Yale School of Medicine and elected president of the American College of Physicians. But "a study, in itself, does not necessarily mean the truth," says McClean. "We will not meet and immediately change the guidelines."

As people get older, their bones tend to become diluted, exposing them to a risk of fracture. Fractures are a major problem in the elderly and increase with the age of the population. Hips, thorns and other broken bones often result in a cascade of increasingly serious health problems among the elderly.

A class of drugs called bisphosphonates has been used for a long time to reduce the risk of fractures in people with osteoporosis, a disease associated with relatively large bone thinning.

These drugs used to be much more used. But doctors and patients have begun to worry about reports of rare and sometimes serious complications, including hip fractures and jaw problems.

And while the National Osteoporosis Foundation's guidelines recommend drug treatment for women at risk of fractures, American College of Physicians guidelines indicate that current evidence of the benefit of drugs for osteopenia is " limited ".

In the new study, Reid and his colleagues gave women with osteopenia infusions of zoledronate or a placebo of 15 minutes every 18 months.

After six years, women victims of zoledronate were about 30% less likely to have suffered a fracture and about 50% less likely to have suffered a fractured spine, the researchers said.

"I think we have provided an important array of evidence that can guide our clinical practice in the future," Reid said.

Michael Econs, professor of medicine at the Indiana School of Medicine, who chairs the ASBMR, agrees.

"This document encourages us to think a little more about the treatment of people that we may not have treated before or that we thought we could be involved," says Econs. "We are extremely worried about the extremely rare side effects and common concerns such as the fracture.You must start looking at where the situation as a whole is."

There was no indication of serious side effects. In fact, women who took the drug seemed less likely to die than those who received the placebo, although this conclusion is not statistically significant. However, there was a statistically significant decrease in the number of heart attacks and cancers among women taking the drug.

"It's something for which we do not have a clear explanation," Reid says.

Although the study only concerns women, Reid says drugs can also benefit men.

It's not clear if other bisphosphonates would also be beneficial, although they may be, says Reid.