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Stories for Reprint
Weekly Osteoporosis Drugs Do Better
By Ferdous Al-Faruque, MARRTC Staff
A study by a group of pharmaceutical companies and the University of Alabama-Birmingham found women were more likely to take weekly rather than daily doses of bisphosphonate for osteoporosis.
Bones constantly lose old bone and add new. If the bone loss is too rapid or the new growth is too slow, it can lead to a condition called osteoporosis. Postmenopausal women are especially at risk for this condition. Healthcare professionals often prescribe bisphosphonates for postmenopausal women to reduce the risk of osteoporosis and bone fractures. Bisphosphonates slow bone loss, which can strengthen bones.
People on bisphosphonate therapy are required to take their medication early in the morning and are not allowed to eat, drink, or lie down for 30 minutes. They are also required to take their medicine with a full glass of water and are not allowed to take any other medication in conjunction. "That's a pain," says Jeffrey Curtis, principal investigator of the study. He suspects "the hassle factor" associated with taking the medication is an issue when people are faced with choosing to take the drugs on a daily or weekly basis and might explain why more women adhered to the weekly doses over the daily ones.
Another major concern with bisphosphonate therapy is the side effects of the drugs. "For most patients there are no side effects," says Curtis, a rheumatologist at the University of Alabama, Birmingham. But for those who do, side effects include upper gastrointestinal problems and, in some very rare cases, loss of blood flow to the jaw.
Though people are not to lie down after taking bisphosphonates to avoid pains in their gastrointestinal tract, for some people the stomach pains from the medication can be severe enough to incapacitate them. Curtis says that is unacceptable and people suffering from sever side effects should consult their doctors. "They need to be on a different osteoporosis medication," he says. "There are other bisphosphonates and a 30-second (intravenous push) that doesn't hurt your (gastrointestinal tract)." The 30-second intravenous push is given every three months and can be done in a physician's office.
Curtis says doctors need to ask patients on every visit if they are following the drug precautions and if they are taking them regularly. He also emphasizes that doctors need to educate patients on what the drugs do and what the benefit are.
Curtis and his colleagues monitored almost 33,000 women ages 45 and above for three years, to understand the effects of bisphosphonates on postmenopausal women. More than half the participants took weekly doses of bisphosphonates, 14 percent took daily doses and the rest shifted between daily and weekly doses. After three years, only a fifth of all the patients took their medication without missing doses. Those who took weekly doses tended to be much more consistent with their medication than those who took daily doses.
Anita Alspaw, a pharmacy technician at D&H Drugstore in Columbia, Missouri, says that she hardly ever fills daily doses of bisphosphonates anymore. In April, the pharmacy only sold one prescription of daily bisphosphonates. "I would say for at least the last year that's probably been the case," said Alspaw.
Besides weekly and daily bisphosphonate therapy, there is also a monthly dose. Regardless of whether it is a daily, weekly or monthly dose, the annual cost of the drugs is about the same.
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