New Orleans - the benefits of bisphosphonates results in the structural integrity of the femoral decay over time in postmenopausal women suffering from osteoporosis, the researchers found. In women taking oral bisphosphonates for four or five years, bending ratio, a measure of structural integrity, improved significantly in the proximal femur in comparison with the original, according to Anthony Dean, a student of medical faculty at Columbia University College of Physicians and Surgeons in New York. However, these improvements began to break down and crawl back to previous levels when using bisphosphonates lasted more than five years, he said at the American Academy of orthopedic surgeons meeting here. This effect can give an explanation of the latest messages in connection with long-term use of bisphosphonates atypical podvertelnyh transverse fractures, Dean said. These fractures do not behave like typical podvertelnyh fractures, he said, tend to occur with little or no injury, slow healing, and is associated with long-term disability, he said. Although some cases reports showed an obvious link between prolonged use of bisphosphonates and these atypical fractures, FDA announced today that does not really seem to be good evidence of such connection. (See
agency said that will continue to explore opportunities lasix 50 mg iv. Endocrine Society on the side of FDA. "Although these data messages have caused concern among patients and health professionals, there is currently no convincing evidence to suggest that the reason This rare type of fracture bisphosphonates "statement. organizations recommended for patients to discuss the risks and benefits of continuing treatment bisophosphonate and continue to use drugs if their doctor sends them to stop." For most patients, "the statement reads" The benefits of therapy leads to a reduction in osteoporosis fractures outweigh the potential risk of this rare type of hip fracture. "
At least one orthopedic surgeon, however, believe that the risk is real. Lisa Cannada, MD, University of St. Louis, said that Dean and other studies coming to similar conclusions, "argue that bone architecture affects [the long-term use]."
She said that the risk is probably the result, because bisphosphonates interfere with normal bone reconstruction of everyday wear. "If women can not respond to stress or adapt to them, because their bones can not tip is when you have a problem, "she said. short-term benefits of bisphosphonates are well known, she added, but future strategies may include the inclusion of women in supplements of calcium and vitamin D or other agent after about four or five years of use of osteoporosis medications. "bisphosphonates clearly have a place in the short term, but, as is evident from this, not in the long run" she said. Dean and his co-author, Melvin Rosenwasser, MD, and Columbia, would investigate the structural effects of bisphosphonates treatment and determine whether the difference between short and long term. use They conducted a retrospective cohort study of 111 postmenopausal women who suffer osteoporosis - 61. taking oral bisphosphonates for at least four years and 50 of which took calcium and vitamin D supplements only women with concomitant diseases that affect bone metabolism and those with secondary causes of osteoporosis were excluded. All women serial dual X-ray densitometry (DRA) scans of the proximal femur were analyzed using the hip structural analysis program approved instrument despite the mineral distribution scanning. section modulus, a measure of bending strength was improved in comparison with the original, both in the short-and long-term Members bisphosphonates. There was no difference between groups (
P = 0. 63). Results were similar measures axial force, without any distinction based on duration of treatment bisphosphonates. However, for loss of stability ratio, which measures the likelihood that the cortex will fall and there was a lot more improvements in the short group (
P = 0. 02). In the short term band bending ratio improved 3. 8% of the initial level, while in long-term group benefits poslablyuvalysya only 1. 3% from baseline (
P = 0. 02). "Interestingly, the phase in which it splits meets all these reports, when these [atypical] fractures are" said Dean.
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