The chance of a rotting jawbone or a broken femur may be a rare side effect of osteoporosis drugs but they are legendary among the population that would benefit most from the drugs. So much so, that use of drugs to slow the bone deterioration have fallen so dramatically in recent years that three medical groups are now pleading with doctors to prescribe them more.
Between 2008 and 2012, years in which studies about and lawsuits over the unusual side effects were highly publicized, use of the most frequently prescribed osteoporosis drugs dropped by 50%, even though the drugs could help millions of Americans avoid some of the disfiguring bone breakage that comes from osteoporosis. And the trend has continued, The New York Times reported, citing a recent medical paper.
The problem is so pronounced, that the American Society for Bone and Mineral Research, the National Osteoporosis Foundation and the National Bone Health Alliance have called on their colleagues to step up the use of drugs to treat high-risk patients.
That would include drugs like Merck's ($MRK) Fosamax, Roche ($RHHBY) and GlaxoSmithKline's ($GSK) Boniva, and Warner Chilcott's Actonel. Some of the drugs have now gone generic and are cheaper, but that also has meant there is less aggressive advertising to promote them to patients, also feeding the problem.
The medical societies are urging patients to be more aware of the need to take the drugs but that is a very hard sell these days, Dr. Paul D. Miller, medical director of the Colorado Center for Bone Research, told the Times.
“Ninety percent of patients, when you talk to them about starting one of these drugs, won’t go on,” Dr. Miller said. “Ninety percent who are on the drugs want to come off. The fear factor is huge.”
Studies show that the drugs can reduce the risk of bone fractures by 50% in high risk patients, those whose bone density has fallen to a certain level. But reports on the side effects that the drugs can cause, like femurs to suddenly snap, that most patients who start taking the drugs, quit them within a year, the newspaper says.
While the feared side effects are infrequent, they became publicized when the FDA ordered that warnings of the side effects by added to labels in 2010. Then were also highly publicized lawsuits over drugs like Merck’s Fosamax. The drugmaker at one point faced about 3,000 lawsuits over claims the drugs caused serious femur fractures, charges the drugmaker said was theoretical. Merck won a so-called bellwether suit in 2013, but that has not changed the attitude of patients.
- read the NY Times story