An article in the British Medical Journal (January 18, 2008) questioned whether the benefits of osteoporosis drugs have been overstated—especially when these drugs are prescribed to women with osteopenia, a milder condition than osteoporosis and one that affects nearly half of older women.

Drug manufacturers have promoted osteoporosis medications for women with osteopenia based on re-analyses of earlier clinical trials. These new analyses, funded by the drug companies, tend to overemphasize benefits while minimizing risks. For example, raloxifene has been linked with an increased risk of blood clots.

Risks Identified in Independent Research

A Canadian study by the University of British Columbia and the Vancouver Coastal Health Research Institute, published in the Journal of Rheumatology (online, January 16, 2008), reported that bisphosphonates—a major class of osteoporosis medications that includes drugs such as Fosamax—may triple the risk of bone necrosis.
Bone necrosis occurs when blood flow to part of the bone is compromised, causing the tissue to die and collapse. This condition is extremely painful and difficult to treat.

Additional concerns have been raised in other publications. A letter in the New England Journal of Medicine (March 20, 2003;348(12):1187–1188) reported that bisphosphonates may trigger inflammation of the eye in some individuals.

Are Osteoporosis Drugs Overused?

The BMJ authors argue that these medications are being prescribed unnecessarily to a relatively healthy population. They suggest this may represent a trend in which a risk factor is redefined as a disease, leading to increased testing and drug sales rather than meaningful improvements in patient outcomes.

One of the key issues highlighted is the difference between relative risk and absolute risk:

  • Drug companies often cite a 75% relative risk reduction in fracture risk.

  • But in real terms, this corresponds to less than a 1% absolute reduction.

  • To prevent a single fracture, approximately 270 women with osteopenia would need to take the drug for three years.

Because women with osteopenia already have a low likelihood of fracture, the absolute benefit of medication in this group appears minimal.

Educational only — not medical advice. Work with doctors trained in natural healthcare for individualized guidance.