HEALTHOsteonecrosis of the jaw linked to use of bisphosphonatesBone-building drugs remain important treatment options for patients at risk of debilitating fractures, but the impact on dental health figures into the equation.By Susan J. Landers, amednews staff. Aug. 7, 2006. Washington -- Physicians continually weigh the risks and benefits certain drugs pose to a particular patient. Bisphosphonates are no exception. Over the past few years, an apparent connection between these bone-building medications and osteonecrosis of the jaw has been making the calculation a touch trickier and patients a bit uneasy. Most of the jaw problems seem to occur with the drugs' intravenous forms, used primarily for cancer patients. A few cases have been seen in patients taking the drugs orally for osteoporosis. How great the risk is for either group and whether it is triggered by a dental procedure, as evidence suggests, has yet to be determined. The drugs' manufacturers were required last year to add safety information about ONJ to package inserts. Meanwhile, a lawsuit was filed recently against Merck, which manufactures Fosamax, and numerous Internet sites have been encouraging more such action. The resulting publicity has led to greater awareness of the condition and more calls to physicians' offices from worried patients. Bisphosphonates such as alendronate, marketed as Fosamax, and risedronate, or Actonel, have become the drugs of choice to help stop bone loss. Physicians who had prescribed estrogen to postmenopausal women turned to them as alternatives after the Women's Health Initiative determined that hormone replacement therapy increases a woman's risk of heart attack, stroke and cancer. The oral medications have been on the market for more than 10 years and have enjoyed a favorable safety profile despite having stringent requirements. For instance, the pill has to be taken with a full glass of water on an empty stomach, and the patient must remain upright and refrain from eating for a half-hour or more afterwards. Instances of esophageal irritation are the most frequent complaint. [...]Full text of American Medical News content is available to AMA members and paid subscribers.
Copyright 2006 American Medical Association. All rights reserved.
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The doctors are in the house
The AMA's House of Delegates is holding its Interim Meeting Nov. 7-10 in Houston, addressing issues such as health system reform and physician payment. Meeting coverage - Slideshow Feature articlesHealth reform review The Massachusetts experience Litigation stress Being sued is personal as well as professional Comprehensive coverage
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