Q: I’m taking Boniva for osteoporosis. Recently, I read information from an alleged women’s health expert who said that osteoporosis drugs like the one I’m taking actually make bones weaker by stopping the body from breaking down old bone, and causing disease of the jaw. Is that true?
A:What the “expert” said is misleading and largely untrue. Boniva (ibandronate) is a bisphosphonate drug, like alendronate. It’s true that a rare side effect of bisphosphonates is damage to the jawbone, but this has been seen mainly in patients with cancer who have been given high doses intravenously, not in people like you who are taking a bisphosphonate orally for osteoporosis.
It’s also true that one published report found nine cases in which alendronate “may” have weakened bones and caused unusual fractures. Even if these fractures were caused by alendronate, it’s a rare event when you consider the millions of women that take bisphosphonates.
To me, the main point is that many well-designed studies involving thousands of women have found that — at least for 10 years — the effect of bisphosphonates like ibandronate is to strengthen bone and prevent fractures.
So I think the expert is scaremongering and offering bad advice, based on an unproven side effect, which, even if it does occur, happens rarely.
Maybe someday we’ll be able to predict exactly who is going to have a side effect and give medications only to those who we know will benefit. But that’s in the future, and we certainly don’t know how to do that with bisphosphonates.
Every expert I know would agree that bisphosphonates are generally the first choice for treating osteoporosis and should be used unless there are side effects, usually an upset stomach.
Dr. Anthony L. Komaroff, editor in chief, Harvard Health Letter
