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A prestigious American medical organization has updated its recommendations on osteoporosis. She recommends bisphosphonates as the initial pharmacological treatment. The opinion of Dr Laurent Grange, rheumatologist at the University Hospital Center of Grenoble.
More common in women after menopause, osteoporosis is a skeletal disease that results in a decrease in bone density, bone mass and therefore bone strength. In fact, it can lead to fractures. “In France, osteoporosis affects one in three women and one in five men over the age of 50, i.e. around three to five million French people” says Dr. Grange, rheumatologist. The disease affects more than 10 million people over the age of 50 in the United States. The American College of Physicians (ACP), which has more than 160,000 doctors in the United States, has just reviewed its recommendations for care.
First-line bisphosphonates
To combat the risk of fractures in men and postmenopausal women with primary osteoporosis, the ACP publishes an update of its recommendations. It now recommends taking bisphosphonates as first-line treatment, following the diagnosis of osteoporosis.
“In postmenopausal women and men with primary osteoporosis, bisphosphonates had the most favorable balance of benefits, harms, patient values and preferences, and cost among the designated drug classes. In addition to the clear clinical benefits, bisphosphonates are much less expensive than other pharmacological treatments and are available in generic oral and injectable formulations“write the doctors in their press release.
Treatment limited to 5 years
This decision was made following a meta-analysis, the results of which are published in the journal Annals of Internal Medicine. This study demonstrates that duration of bisphosphonate treatment beyond 3 to 5 years increases the risk of new vertebral fractures, but not the risk of further fractures.
This is why doctors recommend “to stop bisphosphonates after five years of treatment, unless there is a strong indication to continue treatment“.
The opinion of Dr Laurent Grange, rheumatologist in Grenoble
“These recommendations go perfectly with the recommendations that exist in France on the subject. Bisphosphonates are safe, very effective drugs with few side effects that are well known and known to be controlled. What is important is to re-evaluate their need every two or three years, in order to measure the benefit-risk balance of prescribing them to a patient.“explains the specialist.
“The problem today in France is that 85% of people over 50 who leave hospital with a fracture do not have a treatment prescription afterwards. It is important to remember, that fragile bones must be treated and that falling from a height or from a bed, for example, must not lead to a fracture. If this is the case, the bone is weakened by osteoporosis, that must be dealt with” concludes the doctor.