Strong bones, weak risk

A new study should allay the fears of women who take osteoporosis drugs. The Swedish study, just published in The New England Journal of Medicine, found that the class of drugs known as bisphosphonates (including Fosamax, Boniva, Actonel, Atelvia, and Reclast) caused only one atypical femoral fracture for every 2,000 people who used them in a year. While the risk of such fractures is indeed increased, to put the increase in proper perspective, study co-author Per Aspenberg likens the risk to that of being struck by lightning: On a sunny day, he says, the risk of being hit by lightning is close to zero. On a rainy day, the risk might be 1,000 times higher, but it’s still very small.

The study’s findings are especially promising because of the size of the patient cohort, which included every Swedish woman aged 55 and up who’d had a femur (thighbone or hip) fracture in 2008. Within this group, researchers identified 59 whose fractures were atypical, 46 of whom had taken bisphosphonates — out of a total of over 83,000 Swedish women who took the drugs that year. The fracture rate, then, was less than one in a thousand within that group.

ACSH's Dr. Gilbert Ross was happy to hear about the study results. “These unusual complications are extremely rare compared to the benefits," he says. "Hip fractures in particular are all too common among older white women with osteoporosis, and the consequences are often debilitating, even life-threatening.”