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Question:

If I have osteoporosis and have never had a previous bone fracture, does taking a medication like Fosamax (alendronate) or Actonel (risedronate) really help reduce bone fractures in the future more than a placebo pill?

Answer:

No
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MedHead Message:

This is quite interesting. The benefits are much greater in women who have previously already had an fracture and are trying to prevent another one. For women taking medication to prevent a first fracture, only vertebral fractures were noted to be significantly reduced, not forearm fractures or hip fractures, but you would have to treat 50 women to prevent even that one fracture! Actonel (risedronate) seems to be a little better than Fosamax (alendronate), and there seem to be some potential side effects as well like osteonecrosis. Bottom line, medications like alendronate are frequently prescribed to prevent osteoporosis fractures, but the benefit is so slight, especially for women who have never had a previous fracture.

References:

1. Wells GA, Cranney A, Peterson J, Boucher M, Shea B, Welch V, Coyle D, Tugwell P. Alendronate for the primary and secondary prevention of osteoporotic fractures in postmenopausal women. Cochrane Database of Systematic Reviews 2008, Issue 1. Art. No.: CD001155. DOI: 10.1002/14651858.CD001155.pub2. 2. Wells GA, Cranney A, Peterson J, Boucher M, Shea B, Welch V, Coyle D, Tugwell P. Risedronate for the primary and secondary prevention of osteoporotic fractures in postmenopausal women. Cochrane Database of Systematic Reviews 2008, Issue 1. Art. No.: CD004523. DOI: 10.1002/14651858.CD004523.pub3.

 

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