Fosamax Can One Take It Again After Stopping

In women after menopause, osteoporosis is a sneaky disease that gradually weakens bone so that it is prone to fracture. Fosamax (alendronate) is used to care for osteoporosis. Fosamax is in a class of drugs that strengthen bone. Bone is in a constant state of remodeling, whereby old bone is removed by cells called osteoclasts, and new os is laid downward by cells chosen osteoblasts. Fosamax works to strengthen os past inhibiting the removal of bone past the osteoclasts.

What'south New: In a trial involving postmenopausal women with osteoporosis, Fosamax taken daily for 10 years produced increases in bone mineral density at the spine and hip. Prophylactic information suggest no loss of benefit in terms of the risk of fracture with prolonged treatment, though the discontinuation of Fosamax resulted in the gradual diminution of effects.

Bottom Line: Fosamax (alendronate) appears to have sustained and well-tolerated furnishings over a x-twelvemonth period.

Annotate: We disagree with the HealthDay title (below): "Osteo Drug Condom, Effective Over Long Haul."  It now looks like it'due south condom to take Fosamx for x years but that's not really the "long haul."  If a adult female starts taking the drug at menopause, she going to have hopefully a lot more ten years left to live. How long can you accept Fosamax?  This question volition take some very long-term studies to respond.

Barbara M. Hecht, Ph.D.
Frederick Hecht, M.D.
Medical Editors, MedicineNet.com

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• Fosamax (alendronate)

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Osteo Drug Prophylactic, Effective Over Long Haul

By Amanda Gardner
HealthDay Reporter

WEDNESDAY, March 16 (HealthDayNews) -- One of the longest controlled trials ever performed on the subject has found the osteoporosis drug alendronate worked well for a decade with no untoward side furnishings.

Once the drug was stopped, the benefits started dissipating, but but gradually.

"This is encouraging about the power to use this on a long-term basis and that there didn't seem to exist whatsoever impairment to continue," says Dr. Henry G. Bone, lead author of the written report appearing in the March eighteen consequence of the New England Journal of Medicine. "It also suggests that if somebody had to interrupt therapy, this isn't a crisis. The effect dissipates very slowly. Information technology makes information technology no longer a supposition. We have some information."

"It will give people confidence that alendronate is a drug you can use and expect good results for up to x years, and that is three years more than than the previous data had shown," adds Dr. Stephen Honig, director of the Osteoporosis Center at the Hospital for Joint Diseases in New York Metropolis. "That's of import because it allays some of the fears that people had about alendronate perhaps producing brittleness of os."

Because osteoporosis is a chronic condition that requires long-term treatment, information technology is helpful to have long-term data, Bone explains.

According to an accompanying perspective commodity, osteoporosis is fast condign an epidemic with the aging of the globe's population and the Westernization of much of the globe. A 50-year-old woman in the United States at present has a forty percent lifetime risk of suffering an osteoporotic fracture.

Osteoporosis is substantially the result of an imbalance in the pace of bone breakdown and os replacement.

"Bone is constantly being remodeled where you lot're constantly replacing your bones, lilliputian pockets at a time," says Bone, who is manager of the Michigan Bone and Mineral Clinic and head of endocrinology at St. John Hospital and Medical Center, both in Detroit. "There'southward supposed to be a residuum between the amount that'south removed and the amount replaced. If yous become an imbalance over time, you have osteoporosis. You're removing more than you put dorsum."

Alendronate, sold by Merck & Co. Inc. under the brand proper noun Fosamax, works by preventing bone resorption, which is essentially when os is beingness removed without being replaced.

"We are slowing down the breaking-downwardly process from likewise much to the normal premenopausal rate," Bone says. "That lets formation catch upward with resorption and helps stabilize the os."

The current report, which was supported by Merck Enquiry Laboratories, was extended so as to become results on 10 years of utilize in addition to 5 years of follow-up later on discontinuation of the drug. The current commodity reports results on 247 women who participated in all phases of the study, from the starting time. Early phases of the trial also reported increases in bone density and decreases in the risk of fracture.

Women who were treated with 10 milligrams of alendronate daily for 10 years produced mean increases in bone mineral density of 13.vii per centum at the lower spine, 10.iii per centum in the trochanter (the protrusion on the upper thigh), 5.4 percent at the cervix of the hip, and 6.7 percent for the total hip measurement. Women who took 5 milligrams daily had smaller gains.

Women who stopped taking the drug experienced a gradual loss of upshot as measured by os density.

"In the course of doing this, some of the drug gets cached in the bone and doesn't get dug up again until that particular place is remodeled, which is years afterward," Os says. "It's not surprising that if you stop taking the drug and at that place's still some of it, then to speak, buried in the bone, gradually some of that will be reabsorbed and released, and there will be some effect, but less than if you continue to accept the drug. We saw the measurements of bone remodeling activity increased afterwards the drug was stopped, simply not dorsum upward to the starting point. There was a residual benefit."

SLIDESHOW

Osteoporosis Super-Foods for Strong Bones With Pictures See Slideshow

"This gives us 10-year safety data and 10-year efficacy data and [a] petty fleck of information about what happens when someone stops it, and all of that is new," says Dr. Paula Rackoff, assistant chief of rheumatology and director of the Osteoporosis Center at Beth State of israel Medical Center in New York Metropolis.

While the study was a long-term one, it perhaps gives improve guidance on how to treat women who are 65 or older than women who are in their early 50s with deadline indications of osteoporosis and no evident fracture take a chance. "If someone's 52, y'all will have to treat her for 25 years, then ten years is a practiced beginning," Honig says.

SOURCES: Henry G. Os, Thousand.D., director, Michigan Bone and Mineral Clinic, and head, endocrinology segmentation, St. John Hospital and Medical Middle, Detroit; Stephen Honig, M.D., manager, Osteoporosis Center, Hospital for Joint Diseases, New York Urban center; Paula Rackoff, Yard.D., assistant chief, rheumatology, and director, Osteoporosis Center, Beth Israel Medical Center, New York Urban center; March 18, 2004, New England Journal of Medicine

Copyright © 2004 ScoutNews, LLC. All rights reserved.

SOURCES: John P. Neoptolemos, M.D., head, department of surgery, Royal Liverpool University Hospital, Liverpool, England; Michael Choti, Grand.D., acquaintance professor, section of surgery, Johns Hopkins Hospital, Baltimore; March 18, 2004, New England Periodical of Medicine

Copyright © 2004 ScoutNews, LLC. All rights reserved.

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