Unexpected Benefit Found for Osteoporosis Treatment

A new study has uncovered an extraordinary and unexpected benefit of osteoporosis treatment; people taking bisphosphonates not only survive better than people without osteoporosis, they appear to be gaining an extra five years of life.

Researchers at the Garvan Institute of Medical Research (Sydney, Australia), conducted a prospective cohort study between April 1989 and May 2007 of 1,223 women and 819 men participating in the Dubbo (Australia) osteoporosis epidemiology study to examine the effect of osteoporosis treatment (including bisphosphonates (BP), hormone therapy (HT), calcium and vitamin D (CaD)) on mortality risk; there were a total of 325 women and 37 men on treatment. The main outcome measure was mortality according to treatment group.

The results showed that in women, mortality rates were lower with BP and HT, compared to no treatment; in men, lower mortality rates were observed with BP but not CaD. When accounting for age, fracture occurrence, comorbidities, quadriceps strength, and bone mineral density, mortality risk remained lower for women. For 429 women with fractures, mortality risk was still reduced in the BP group, not accounted for by a reduction in subsequent fractures. When comparing among the other sub-groups, the longer life associated with bisphosphonate treatment was marked and clear. The study was published ahead of print on February 2, 2011, in the Journal of Clinical Endocrinology and Metabolism.

"In a group of women with osteoporotic fractures over the age of 75, you would expect 50% to die over a period of five years. Among women in that age group who took bisphosphonates, the death rate dropped to 10%,” said lead author associate professor Jacqueline Center, MD. "Similarly, in a group of younger women, where you would expect 20% - 25% to die over 5 years, there were no deaths. The data were consistent with about a 5 year survival advantage for people on bisphosphonates.”

"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. When people get older, they lose bone; when this happens, these toxic materials are released back into the body and may adversely affect health,” added coauthor Prof. John Eisman, PhD. "By preventing bone loss, bisphosphonates prevent some of this toxic metal release. While we know that this is the case, we don't yet have evidence that this produces the survival benefit.”

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Garvan Institute of Medical Research