There is no evidence to show that any one group of osteoporosis drugs works better than other groups of drugs designed to fight the bone-thinning disease, US government researchers reported.
But some choices can cause severe side-effects such as blood clots, the Agency for Healthcare Research and Quality, which paid for the study, reported.
The team at the Rand Corporation in California compared six drugs in the class known as bisphosphonates. These drugs include alendronate; zoledronic acid; amidronate; etidronate, risedronate; and ibandronate.
The report also looked at oestrogen, a synthetic hormone called calcitonin, calcium, vitamin D, testosterone, parathyroid hormone and drugs in the selective oestrogen receptor modulators (SERM) class such as raloxifene.
Not enough evidence available
Reporting in the Annals of Internal Medicine, the researchers said they could not find enough evidence to show whether bisphosphonates prevent fractures better than oestrogen, calcitonin or raloxifene.
But oestrogen and raloxifene (Evista) can have serious side effects such as strokes, blood clots in the lungs or bleeding in the uterus.
The report also found that many osteoporosis patients stop taking their drugs, some because of side effects and others because they do not notice any osteoporosis symptoms. These patients have a higher risk of bone fractures, they noted.
Not enough evidence exists to determine how exercise or taking testosterone compares to medications in preventing osteoporosis-related fractures, the researchers said.
Osteoporosis affects many
"As more Americans live longer, osteoporosis will have a greater impact on health and quality of life," Dr Carolyn Clancy, director of the AHRQ, said.
"This report will help health care providers and patients understand what we really know, and don't know, about the array of available treatments."
Osteoporosis affects an estimated 44 million Americans. About half of women age 50 and older will have a bone break due to osteoporosis. – (Reuters Health)
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