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Bisphosphonates for Osteoporosis Treatment Linked to Jawbone Damage

Posted by Chrissie Cole
Monday, September 22, 2008 1:39 PM EST
Category: Major Medical
Tags: FDA & Prescription Drugs, Osteoporosis, Osteonecrosis, Bisphosphonates, Actonel, Aredia, Boniva, Didronel, Fosamax, Reclast, Skelid, Zometa


IMAGE SOURCE: © Fosamax for Osteoporosis Treatment

Osteoporosis drugs are not without possible adverse effects, including a condition in which jawbone tissue dies.

Bisphosphonate-related osteonecrosis of the jaw is a mouthful, pun intended,” says Dr. Thomas B. Dodson, an expert on oral and maxillofacial surgery a Massachusetts General Hospital.

An estimated 1 in 10 cancer patients who receive treatment with IV bisphosphonate drugs will develop the jaw problem. And now, some cases have been seen in women taking low doses of osteoporosis drugs.

Bisphosphonates, marketed as Actonel, Aredia, Boniva, Didronel, Fosamax and Fosamax PlusD, Reclast, Skelid and Zomeda - are a class of drugs that slow or stop reabsorption of bone. The drugs are also used to treat Paget's disease, metastasis and myeloma.

Many scientists believe the drugs may hinder the jaw’s ability to heal following a dental procedure such as an implant or tooth extraction.

The American Association of Oral and Maxillofacial Surgeons (AAOMS) recommends, women who plan to start taking osteoporosis drugs, plan dental work prior to starting treatment.

Researchers have a few theories as to why a drug that disperses through the body would result in a pharmaceutical punch directly to the jaw.

The bone in the jaw metabolizes at a faster rate than other areas of the body so more of the drug is deposited into that part of the body, says Dodson. Also, more bacteria in the teeth and mouth area can add more inflammation, causing the problem to worsen.

It may also be the drugs mechanism at work. Bisphosphonates work by inhibiting cells that dissolve bone, which is part of a healthy life cycle. The natural balance between new bone formation and dissolving bone is interrupted and bone producing cells take over. But, when they die off, fewer cells are left over to clean them out and they remain a dead mass.

The number of people who may experience the jaw problem is estimated between 1 in 2,000 to as many as 1 in 300 people who take drugs for osteoporosis.

According to a report in the journal Osteoporosis International in 2007, 55 million bisphosphonates prescriptions are written yearly in the U.S. each year.

In a recent study, two experimental osteoporosis drugs showed promise in clinical trials and increased bone mineral density in postmenopausal women with osteoporosis, according to researchers.

Denosumab made by Amgen and odanacatib made by Merck & Co., are a new class of a drug that may become the first biologic drugs to treat osteoporosis. #

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