Document Detail

Osteoporosis treatments and adverse events.
MedLine Citation:
PMID:  19412101     Owner:  NLM     Status:  MEDLINE    
PURPOSE OF REVIEW: Osteoporosis treatments will be used with increasing frequency as the population ages; however, relatively little is known about their long-term safety. Recent case reports cite a range of potential adverse events. We review data regarding atrial fibrillation, bone pain, osteonecrosis of the jaw (ONJ), atypical fractures, and osteosarcoma. RECENT FINDINGS: Incidence of bisphosphonate-related ONJ in osteoporosis patients is unclear, but several studies suggest rates may be higher than one in 100,000. Severe bone pain and esophageal cancer have been described among bisphosphonate users, but their relationship has not been carefully studied. The relationship between atrial fibrillation and bisphosphonates is unclear based on existing data, but the Food and Drug Administration's (FDA) analyses suggest no clear association. Although several case series discuss atypical fractures associated with bisphosphonate use, one epidemiologic study found no association. Finally, one case of osteosarcoma has been reported in a woman using teriparatide. One case in over 200,000 users suggests no increase in risk beyond background risk, but further evaluation is necessary. SUMMARY: Although case reports of adverse events with osteoporosis medications suggest potential links, epidemiological analyses have largely failed to illuminate a strong, clear link between osteoporosis therapies and many adverse events, with ONJ an exception. Until further data are available, providers should be aware of these potential side effects, and inform their patients accordingly.
Daniel H Solomon; Laura Rekedal; Suzanne M Cadarette
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.; Review    
Journal Detail:
Title:  Current opinion in rheumatology     Volume:  21     ISSN:  1531-6963     ISO Abbreviation:  Curr Opin Rheumatol     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-06-03     Completed Date:  2009-08-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9000851     Medline TA:  Curr Opin Rheumatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  363-8     Citation Subset:  IM    
Division of Rheumatology, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.
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MeSH Terms
Atrial Fibrillation / chemically induced
Bone Density Conservation Agents / adverse effects*
Diphosphonates / adverse effects*
Esophageal Neoplasms / chemically induced
Fractures, Bone / chemically induced,  pathology,  physiopathology
Jaw Diseases / chemically induced*,  pathology,  physiopathology
Osteonecrosis / chemically induced*,  pathology,  physiopathology
Osteoporosis / drug therapy*
Pain / chemically induced,  physiopathology
Reg. No./Substance:
0/Bone Density Conservation Agents; 0/Diphosphonates

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