Posts Tagged ‘Osteoporosis’

Bisphosphonates are the most commonly prescribed Antiresorptive medications used to prevent or treat Ostoeporosis.  We know them as Fosamax (Alendronate), Boniva (Ibandronate), Actonel (Risendronate), Atelvia (enteric coated Risendronate), and IV Reclast (Zolendronate).  All but the last are pills taken weekly or monthly.

If your bone is strong enough that preserving it is sufficient to prevent fractures, then Antiresorptive medication is what you need.  If you are able to follow the protocol of taking the pill on an empty stomach, followed by one or more full glasses of plain water, and eating or drinking nothing else for at least 30 minutes (60 for Boniva) while remaining upright, Oral Bisphosphonates are the medication for you.

Atypical Fracture of the Femur (AFF) and OsteoNecrosis of the Jaw (ONJ) are rare complications of Untreated Osteoporosis.  They also occcur rarely in patients treated with long term Antiresorptives including: Fosamax, Boniva, Actonel, Allendronate, Ibandronate, Atelvia, Reclast, and Prolia, at a higher, but still very low, rate.  Neither has been reported in Evista.  Forteo is commonly used as a treatment for AFF and ONJ.

AFF and ONJ are rare even in patients treated for Osteoporosis with Antiresorptive medications.  Rates are estimated at between 1 in 1,000 and 1 in 10,000.  Let’s label AFF (X),  ONJ (Z), and patients with neither (O).  Here is a graphic representation, if the worst case estimate is correct:

OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO OOOOOOOOOOOOOOOOXOOOOOOOOOOOOOOOOOOOOOOOOOOO OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOZOOOOOOOOOOOOO OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO

These are very rare problems, even in patients on Antiresorptive Osteoporosis Medications for over 5 years.  Fractures from Osteoporosis in patients Not taking Medications are much more common.  That Graphic next time.

Jay Ginther, MD

“Baby-Boomers” Should Check Their Bones

June 6, 2014 @ 6:26 am
posted by Dr Ginther

A patient had no idea why her doc sent her to me for a Complete Bone Health Evaluation.  As a “baby-boomer”, she lives by the motto: “You are only as old as you choose to be.”  And she chooses to remain young.  If only it were possible…..

“I can’t have Osteoporosis.  I used to drink milk.  I am active and I plan to stay active!!!  So I just can’t have Osteoporosis!”  Unfortunately, she does have Osteoporosis by BMD on her DXA, by the multiple Vertebral Fractures on VFA, and by FRAX.  Still, there are simple steps to rescue her Bone Health before she Fractures.

Identify Fracture Risk – Prevent Fractures

April 23, 2014 @ 5:25 am
posted by Dr Ginther

Tomorrow I am at the 2014 National Osteoporosis Foundation meeting.  Actually the name “National Prevent Fractures Organization” would better explain our goals.  We don’t care about Osteoporosis as much as we care about Preventing Fractures.

DXA and T-score  test results of “osteoporosis” only identify about 15% of the persons who will fracture.  How can we identify those persons with “osteopenia” who will fracture?  We use FRAX and Vertebral Fracture Assessment (VFA).  My Poster # 18 tomorrow and Friday documents how adding VFA to DXA identifies additional persons at high risk for Fractures.