Bisphosphonates are approved to treat osteoporosis in both men and postmenopausal women, in osteoporosis caused by corticosteroids (but they should not be used for this purpose; see boxes above), and Paget’s disease. For women at risk of developing osteoporosis, Fosamax and Actonel are also approved to prevent osteoporosis.
Fosamax and Actonel belong to a class of drugs called bisphosphonates, which act on bone. They inhibit activity of the bone cells that resorb bone, and because resorption and synthesis are linked, they decrease bone turnover (synthesis and breakdown). Osteoporosis can develop in the elderly as well as in people who take corticosteroids such as prednisone (DELTASONE) or prednisolone (METICORTEN) for extended periods of time for conditions such as asthma, skin disorders, or arthritis.
Clinical Data (Fosamax)
Fosamax has been shown to reduce the risk of hip fracture by 1% in women who had previously experienced at least one vertebral fracture (2% of women on placebo had hip fractures versus 1% of women on Fosamax, a 50% relative reduction). We are still waiting for the results of a study evaluating the effects of Fosamax on hip fracture in postmenopausal women who have never experienced a vertebral fracture. Most women who took the placebo (over 85%) in the three-year clinical trials did not have a fracture of any type. Fewer studies have been done on men taking Fosamax.
