Giving 10mg per day of the bisphosphate drug alendronate to women after their menopause can help prevent loss of bone mass, reducing their risk of fractures, a Cochrane Review has found. This finding applies to women who have started to lose their bone mass but have no fractures (primary prevention), as well as those who have lost significant bone mass and/or have had fractures (secondary prevention).
Healthy bones constantly break down and rebuild their structure. The process is sensitive to hormones and once women have passed through the menopause the balance is disturbed; their bones tend to break down slightly more than they build. Over time this leads to a noticeable loss of bone mass, and weakening of the bones. Once the bones become too weak they are prone to fracture.
A team of Cochrane Researchers set out to evaluate the evidence behind the use of alendronate for primary and secondary prevention of bone fractures in these women. Alendronate works by inhibiting the bone break down process.
By studying the outcomes of eleven trials that involved a total of 12,068 women the researchers found significant evidence of both primary and secondary prevention against breaking bones in the back (vertebrae). In secondary prevention, there was also a statistically significant protection against fractures of other bones including those in the hip and wrist.
"This work revealed no increase in side effects in the women who were using the drugs, despite the fact that some studies outside clinical trials raise the possibility of stomach and jaw complaints," says lead author Dr George Wells, who works in the Department of Epidemiology and Community Medicine at the University of Ottawa.
"As a woman gets older, her risk of having on-going health problems or dying is significantly greater if she has reduced bone density and then breaks a bone such as a hip, so it is important to find effective preventative therapies with low or no side-effects," says Wells.