Do Biphosphonate Drugs Cause Fractures Rather than Prevent Them?

Drugs such as Fosamox and Boneva are commonly prescribed to prevent fractures in patients with osteopenia and osteoporosis. Randomized trials have shown that long-term use (> 5 years) of these drugs can reduce the usual fractures that occur in old age. However, a large study reported in JAMA also showed that unusual fractures below the hip are increased somewhat with minimal trauma in patients who have used these drugs long-term. The authors suggest that long-term use of these drugs should be re-evaluated. In my experience, the more vigorous use of vitamin D, magnesium along with lower doses of calcium, natural progesterone, exercise, and sometimes strontium is often a better approach than reaching for the prescription pad for such patients.

See Park-Wyllie, et.al., JAMA, Feb. 23, 2011, p. 783-789.