美国国家公共电台 NPR Wider Use Of Osteoporosis Drug Could Prevent Bone Fractures In More Elderly Women

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AILSA CHANG, HOST:

A drug commonly used to treat the bone-thinning disease osteoporosis could protect many more older women against bone fractures. That's according to a big new study published today by the New England Journal of Medicine. NPR health correspondent Rob Stein has the details.

ROB STEIN, BYLINE¹: As we age, our bones tend to get thinner and thinner. And Ian Reid, of the University of Auckland, says millions of older people break a hip², a spine³ or some other bone. And it's often the beginning of the end.

IAN REID: In a frail⁴ older person, having a fracture can be the final straw that interferes⁵ with them being able to live independently and moves them into an institution.

STEIN: And the problem's just getting worse.

REID: What's happening at the present time is we are all living longer. Our population is progressively aging. And so fractures in older people is becoming a very major issue.

STEIN: People diagnosed with the bone-thinning disease osteoporosis can take drugs to prevent fractures. But there's been a big debate about people with less frail bones.

REID: In fact, most of the fractures that occur in older people occur in the much larger number of people who have moderate bone loss.

STEIN: So Reid and his colleagues tested a drug long used to treat osteoporosis on 2,000 women 65 and older with just the early stages of bone loss, a condition known as osteopenia. For six years, half got infusions⁶ of the drug. Half got a placebo⁷.

REID: We saw about a one-third reduction in total numbers of fractures and about a 50 percent reduction in spine fractures.

STEIN: And no sign of any serious side effects - in fact, the women getting the drug were less likely to suffer heart attacks, get cancer, maybe even die.

REID: So I think what this means is that we can broaden the group of people to whom we can offer these medications. And therefore, we can reduce the total number of fractures occurring across the community more effectively.

STEIN: Other experts agree.

ETHEL SIRIS: This is an extremely important paper.

STEIN: That's Ethel Siris at Columbia.

SIRIS: The reason this is so important is that we have been uncertain what to do with the great number of people, primarily women over the age of 60-65, who have osteopenia. You now know you have a drug that you can use that has been shown to work in such patients. It's a big deal.

STEIN: A lot of doctors and patients got scared away from these drugs because of reports they could actually cause hip fractures and unusual jaw⁸ problems. But Michael Econs, of the American Society for Bone and Mineral Research, says the new results should make people rethink that.

MICHAEL ECONS: We are overly worried about exceedingly rare side effects and under worried about common things like fractures. I think you have to start looking at where the big picture is.

STEIN: But others are more cautious.

ROBERT MCLEAN: This one study is helpful. And it's suggestive. But one study, in and of itself, does not necessarily mean truth.

STEIN: That's Robert McLean from Yale. He's president-elect of the American College of Physicians.

MCLEAN: We're not going to reconvene and immediately change the guidelines.

STEIN: But everyone agrees that older people should talk with their doctors about the new study to see if taking a drug to cut the risk of breaking a bone makes sense for them or not. Rob Stein, NPR News.

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