February 07, 2011
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Additional 5 years of life found as an unexpected benefit of bisphosphonate use

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Osteoporosis patients taking bisphosphonates have not only displayed an ability to survive – they also appear to gain an extra 5 years of life, according to Australian investigators.

The findings were published online in the Journal of Clinical Endocrinology and Metabolism, and based on data from the long-running Dubbo Osteoporosis Epidemiology Study.

Jackie R. Center, PhD
Jacqueline R. Center

“In a group of women with osteoporotic fractures over the age of 75, you would expect 50% to die over a period of 5 years,” researcher Jacqueline R. Center, PhD, stated in a press release. “Among women in that age group who took bisphosphonates, the death rate dropped to 10%. Similarly, in a group of younger women, where you would expect 20% to 25% to die over 5 years, there were no deaths.”

“The data were consistent with about 5-year survival advantage for people on bisphosphonates,” she added.

A prospective cohort study

The investigators examined data for 1,223 women and 819 men in the Dubbo Osteoporosis Epidemiology Study from April 1989 to May 2007. Of those patients, 325 women and 37 men were on osteoporosis treatment. The study aimed to identify the effect of treatment – bisphosphonates, hormone therapy, and calcium with or without vitamin D only (CaD) – on mortality risk.

In women, mortality rates were found to be lower with bisphosphonates and hormone therapy, but not CaD, when compared to no treatment. Accounting for age, fracture occurrence, comorbidities, quadriceps strength and bone mineral density, the authors reported that mortality risk remained lower for women on bisphosphonates but not hormone therapy.

The study added that in men, lower mortality rates were observed with bisphosphonates — but not CaD —when compared to the no treatment group. After adjustment, mortality was noted as similar but not significant.

“Marked and clear”

When compared to other sub-groups taking other forms of treatment, the longer life associated with bisphosphonates was reportedly “marked and clear.”

John A. Eisman, PhD
John A. Eisman

“We speculate that it may have something to do with the fact that bone acts as a repository for toxic heavy metals such as lead and cadmium,” researcher John A. Eisman, PhD, stated in the release. “So when people get older, they lose bone. When this happens, these toxic materials are released back into the body and may adversely affect health. By preventing bone loss, bisphosphonates prevent some of this toxic metal release. While we know this is the case, we don’t yet have evidence that this produces the survival benefit.”

“Only about 30% of women and 10% of men with osteoporosis receive treatment, which is unacceptable when you consider that people could be helped, and death could be delayed by several years,” he added. “There is good evidence – even without this study – that treating osteoporosis reduces fractures and reduces mortality.”

Reference:

  • Center JR, et al. Osteoporosis medication and reduced mortality risk in elderly women and men. J Clin Endocrinol Metab. Rapid Electronic Publication first published on Feb. 2, 2011. doi:10.1210/jc.2010-2730

Disclosure: No financial disclosure was reported.

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