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Dr. Joseph Lane on the Joan Hamburg Show

WOR710 (New York, NY) —March 12, 2010

Two studies have proved that some post-menopausal women who take popular drugs to ward off osteoporosis actually show a reversal in bone strength and may experience a rare hip fracture. Dr. Joseph Lane, chief of metabolic bone disease at Hospital for Special Surgery in New York, discusses these findings.

“Basically, the bottom line is that these drugs are eminently successful in limiting bone fractures and fractures of the spine. So, if you take those drugs, you will decrease your fracture rate by 50-70 percent, which is huge - the rate of fractures in the United States per age is actually going down, ” Lane said. “The difficulty is once you start taking these drugs for a lifetime. If you take blood pressure medication, your doctor is going to monitor your blood pressure and adjust the drug with the blood pressure and go up or down. Some people end up taking these drugs for 5, 10, 15 years and the doctors keep renewing their prescriptions. In this population, there has been the appearance of an unusual fracture that appears after a minor trauma to the hip. This is still a very unusual occurrence, but it does occur. We are working to identify these patients ahead of time so the drugs remain safe and secure, so that we would know to make a judgment before a problem occurs. ”

“The study shows that normally your bone is constantly being repaired, but these individuals seem to have a problem in repairing their bone. That appears to be the material that came out of both Columbia and our study at HSS. So that raised some concern – that maybe we should not allow the bone to get that old. And that’s where we currently stand.”

What does that mean for the average woman?

“Nobody gets these fractures within the first five years of treatment. After five years, I think patients should go to their doctors and ask them to take a good look and ask, do I really need to take this medication? The doctor can make that judgment in several ways, ” said Lane. They can take a look at bone density. If it’s going up, then stay on the drug. If the bone density remains flat and has been that way for two to three years, then it may be time to take a little breather.”

“There are things called bone markers that determine the rapidity that you are replacing your bone, and if these are repressed then your bone has lost the ability to repair itself.  Your doctor will give you a yearlong rest period and then revisit the situation. That’s what I do with my patients, and then I look at their markers and then maybe use a much lower dose to maintain my gains without activating the bone suppressor. If you do that you won’t get these fractures.”

So what is the bottom line?

“One, these drugs are fabulous, two you should have no fear in taking them, but I’m not sure they’re drugs you take for a lifetime.”

 

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