July 1, 2015
Bisphosphonate Use Drops With Negative Media Coverage

Bethesda, MD—Media reports on safety concerns about bisphosphonates appear to be responsible for a dramatic decline in use of the drugs to treat osteoporosis, according to new research.

Following a decade of steady growth, use of bisphosphonates dropped more than 50% from 2008 to 2012, according to the report published recently in Journal of Bone and Mineral Research.

The study team, led by researchers from the National Institutes of Health, suggests that
the sudden descent occurred after media reports of adverse effects, such as the development of certain fractures that occurred rarely in long-term users. Yet, the authors note, neither the FDA nor the American Society of Bone and Mineral Research recommended any specific safety restrictions on bisphosphonates.

“Our study documents a dramatic drop in osteoporosis medication use by patients. Whether it will impact the long-term bone health of the nation remains to be seen,” said senior author Timothy Bhattacharyya, MD, an orthopedic surgeon.

For the study, the researchers conducted an ecological analysis from 1996 to 2012 of relevant media reports, oral bisphosphonate use, and fracture outcomes in the United States. Google Trends was used to track themes in media reports and public interest in bisphosphonates, while data from the Medical Expenditure Panel Survey (MEPS) and the National Inpatient Sample (NIS) were used to estimate the trends in oral bisphosphonate use among patients aged 55 and older and hospitalizations for intertrochanteric and subtrochanteric fractures, respectively.

The report notes a series of spikes in Internet search activity for Fosamax that occurred between 2006 and 2010 immediately following media reports of safety concerns. They also identified a decline in use of oral bisphosphonate by greater than 50% between 2008 and 2012, after use had increased for more than a decade.

Results indicate that the decline was more common in patients with lower education levels.

Over the first part of the study period, from 1996 through 2006, intertrochanteric hip fractures declined and continued to decline from 2008 to 2012, according to the study. Subtrochanteric and diaphysis fractures, however, showed a steady and significant increase from 2002 to 2011. The incidence decreased from a peak of 30.5 per 100,000 in 2011 to 26.7 per 100,000 in 2012.

“The plateauing and subsequent decline in oral bisphosphonate use since 2006 coincided with reports of safety concerns of bisphosphonates, despite the fact that Food and Drug Administration (FDA) and American Society of Bone and Mineral Research (ASBMR) reports did not recommend any safety restrictions on their use,” the authors conclude. “This decline in oral bisphosphonate use was followed by the decline in the incidence of sub trochanteric and diaphysis fractures.”

U.S. Pharmacist Social Connect