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Bone Therapy May Not Always Need Monitoring

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Bone Therapy May Not Always Need Monitoring
In older women, annual measurements are unnecessary, study finds

HealthDay

By Robert Preidt

Wednesday, June 24, 2009


WEDNESDAY, June 24 (HealthDay News) -- Monitoring bone density in older women after they've started taking drugs to prevent osteoporosis is unnecessary and could be potentially misleading, researchers say.

In the study, Australian researchers analyzed data from a large randomized trial that compared the effects of the drug alendronate (a widely used bisphosphonate) in more than 6,000 postmenopausal women with low bone mineral density, which is a risk factor for fractures.

The women's bone density was measured at the start of the study and again one, two and three years later. After three years of treatment, 97.5 percent of the women who took the drug showed at least a modest increase in bone density, and there was little variation in the treatment effect between individuals, the researchers found.

The findings, which appear online June 24 in BMJ, suggest that monitoring a person's response during the first three years of the treatment is unnecessary and, because of the potential to mislead, should not be done, concluded the researchers, from the School of Public Health at the University of Sydney.

The results support the case against routine monitoring during the early years of treatment, according to an accompanying editorial by Juliet Compston, professor of bone medicine at the University of Cambridge, in England. She said that when changes in bone mineral density are used to monitor treatment, people may be given inappropriate advice.

"Routine monitoring of bone mineral density during the first few years of antiresorptive treatment cannot be justified because it may mislead patients, lead to inappropriate management decisions and waste scarce health care resources," she concluded.



SOURCE: BMJ, news release, June 23, 2009

HealthDay

Explore topics in this discussion:

Forteo Fractures Osteoporosis Alendronate

3 replies

I can't imagine why it would be better NOT to have information on how your body is reacting to a drug. If the drug is helping, it provides motivation to continue despite possible risks and side effects. If the drug is not helping, it lets you weigh that information in deciding whether to continue with it, despite possible risks and side effects, to see if another year will make a difference. In neither case does the information hurt. Sounds to me like this study was funded by insurance companies who don't want to pay for testing!

catwoman: More information about the study is at
http://www.webmd.com/osteoporosis/news/20090624/bone-test-not-helpful-durin g-treatment

[begin extract]
...there was quite a lot of variability in the measurements from year to year among individuals, Irwig says, suggesting that the test is not very accurate and could be misleading...

"A test may show a decline in bone density when this isn't the case," he says. "This would give the patient the impression that the drug is not working when it is."

Even if the test were completely accurate, bone mineral density testing is not a particularly good measure of fracture risk, says Juliet Compston, MD, University of Oxford professor of bone medicine.

"Monitoring treatment using bone mineral density assumes that any increase in bone density means a reduction in fracture risk," she says. "But the studies show that people on treatment who show decreases in bone mineral density still have a reduced fracture risk."...
[end extract]

My gyn and my rheumatologist told me a bone density test was only needed every 2 years. That will be the end of my forteo treatments, maybe. I'll find out soon. The bones in my jaw (around my tooth sockets) Is better though. Not that TMJ stuff either. My dentists was amazed as I have had bone loss in my mouth since my 30's and nothing has helped until now. I'm hoping this is a good sneak preview of sorts.

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