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Osteoporosis drugs effective in women with bone fracture risk

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Auckland researchers have found osteoporosis drugs work to prevent fractures in women who are vulnerable to fractures but don't yet have the brittle bone disease. In a study of 2000 women over the age of 65, the osteoporosis drug zoledronate was tested against a placebo and found to be just as effective in those with weakened bones. The researchers say it means the drug could be used for fracture prevention across the older population before their bone density stooped to the osteoporosis threshold.

Journal/conference: New England Journal of Medicine

Organisation/s: University of Auckland

Media Release

From: University of Auckland

Treatment shown to reduce fractures in older women

Researchers from the University of Auckland have shown that a treatment known to reduce fractures in women with osteoporosis is equally effective in reducing fractures in women over the age of 65 who have only mild bone loss.

Distinguished Professor Ian Reid, Deputy Dean of the Faculty of Medical and Health Sciences, led the six-year study. It is being presented at the American Society of Bone and Mineral Research and simultaneously published in The New England Journal of Medicine on Monday 1 October (Eastern Standard Time).

“This is a highly significant finding, which I believe will have a substantial impact on how widely osteoporosis drugs are used for fracture prevention amongst older women worldwide,” says Professor Reid.

“Fractures are a major problem for older people, with half of all women having a fracture between menopause and the time they die. While there are a number of effective and well-tolerated medicines for preventing fractures, their effectiveness had been proven only for people with osteoporosis, who comprise only about 20 percent of the people who actually have fractures in that age group.”

“The majority of women over the age of 65 are osteopenic, which means they have a lowered bone density, but not the profoundly low density which is defined as osteoporotic.

The study tracked 2,000 women over 65 in a randomised trial to ascertain the effectiveness of a treatment called zoledronate in preventing fractures in women over 65 who are osteopenic.

Zoledronate had been proven to prevent fractures in women with osteoporosis when administered by injection once a year and in conjunction with calcium supplements.

In the trial, half the women received a placebo while the others received zoledronate, administered by injection every 18 months, with calcium supplements not used.

“The treatment was shown to be just as effective in this context as it is when administered once a year to those with osteoporosis,” says Professor Reid. “So we now have a treatment that can be used across the older population in those we believe have a significant risk of fracture, independently of what their bone density happens to be.”

The research also indicated a decrease in the number of heart attacks and the incidence of cancer in the group receiving active treatment, though this would require further research, says Professor Reid.

Professor Kath McPherson, Chief Executive of the Health Research Council of New Zealand, which provided funding for the research, says its findings are of enormous significance for the health of women everywhere.

"A number of us will have experienced, or had family members experience, such fractures and recognise the enormous burden that results. A fracture in our 60s, 70s and beyond can have permanent and devastating effects on health, wellbeing, doing our everyday activities - and on life itself. It's not only New Zealand women who stand to gain from this current study, and we should be enormously proud that New Zealand researchers are at the forefront of health research internationally."

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