Some Life Enhancing Drugs May Weaken Bones
Common treatments for asthma and prostate cancer could affect bone health, according to two new studies published in the New England Journal of Medicine (NEJM).
“Based on these findings in NEJM, we have further scientific evidence that some medical therapies promote bone loss,” said Bess Dawson-Hughes, MD, in a press release. Dawson-Hughes wrote an editorial about the subject in the September 27 issue of NEJM. She is a professor and an expert in bone metabolism at Tufts University School of Medicine in Boston.
One of the studies found that young, asthmatic women who used inhaled glucocorticoids lost more bone mass than women who did not undergo such therapy. The other study found that prostate cancer patients who used hormone therapy (leuprolide) suffered bone loss, but not as much if they were also treated with pamidronate (an oral bisphosphonate).
Experts say the popularity of drugs such as leuprolide and inhaled glucocorticoids prompt the need for research looking into the consequences of such therapies.
Bone loss among prostate cancer patients is an important problem that requires attention, says study author Matthew Smith, MD, PhD, assistant professor of medicine at Massachusetts General Hospital in Boston. “This year in the United States, about 200,000 men will be diagnosed with prostate cancer. Many of these men will receive hormonal therapy at some time during the course of their treatment. We’re talking about tens of thousands of men per year who will begin hormonal therapy for prostate cancer.”
Most men who undergo hormone therapy suffer serious skeletal complications because the drug leuprolide encourages the breakdown of bone, according to Smith and his co-authors. They say, however, that use of pamidronate protects against such bone loss. In their study, men treated with hormone therapy alone experienced a 3.3% loss in bone density, whereas men treated with hormone therapy plus pamidronate experienced no changes.
Smith encourages patients to consult with their doctors about the best treatment options for them.
Dawson-Hughes offers suggestions for patients who are concerned about bone loss. “Although substantial research has shown that some medical therapies, like leuprolide and both inhaled and oral glucocorticoids, accelerate bone loss, there are protective measures that can be taken in conjunction with these treatments in order to minimize such bone loss,” she said. Her recommendations include:
* Oral bisphosphonates, such as alendronate and risendronate, which reduce corticosteroid-induced bone loss. This option, however, is not recommended for pregnant or young women.
* Weight-bearing exercise, calcium, and vitamin D.
* Oral contraceptives.
Women who are interested in finding out about other options for asthma care are encouraged to visit the Web site of the National Heart, Lung, and Blood Institute at www.nhlbi.nih.gov.
Article By: Dulce Zamora, Medical Writer
Publication Date: September 2001
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