Value of drugs for pre-osteoporosis exaggerated

Jan 18, 2008

A series of recent scientific publications have exaggerated the benefits and underplayed the harms of drugs to treat pre-osteoporosis or “osteopenia” potentially encouraging treatment in millions of low risk women, warn experts in this week’s BMJ.

The authors believe that this represents a classic case of disease-mongering: a risk factor being transformed into a medical disease in order to sell tests and drugs to relatively healthy people.

Osteopenia or “pre-osteoporosis” is said to affect around half of all older women and, in at least one country, drug companies have already begun to market their drugs to women with osteopenia, based on re-analyses of four osteoporosis drug trials.

But the authors of this week’s BMJ paper argue that this move raises serious questions about the benefit-risk ratio for low risk individuals, and about the costs of medicalising and potentially treating an enormous group of healthy people.

These reanalyses tend to exaggerate the benefits of drug therapy, they say. For example, the authors of one reanalysis cite a 75% relative risk reduction, though this translates into only a 0.9% reduction in absolute risk.

In other words, up to 270 women with pre-osteoporosis might need to be treated with drugs for three years so that one of them could avoid a single vertebral fracture.

Most of the reanalyses also play down the harms of drug therapy, they add. For example, the reanalysis of data for the drug raloxifene focuses solely on the potential benefits, with no mention of an increased risk of blood clots.

Finally, like much of the published literature on osteoporosis, these analyses have potential conflicts of interest, they write. For instance, all of the original drug trials being re-analysed were funded by industry and, in three out of four cases, drug company employees were part of the team conducting the reanalyses.

The World Health Organisation is currently developing guidance on how to deal with women categorised as having osteopenia. Whether this will stop industry efforts to encourage treatment in low risk women is, however, questionable, they say.

“We need to ask whether the coming wave of marketing targeting those women with pre-osteoporosis will result in the sound effective prevention of fractures or the unnecessary and wasteful treatment of millions more healthy women,” they conclude.

Source: British Medical Journal

Explore further: No added benefit proven for umeclidinium/vilanterol in COPD

add to favorites email to friend print save as pdf

Related Stories

Drunk driving women treated differently than men

Sep 15, 2014

A study by Victoria University of Wellington's Health Services Research Centre explores attitudes and behaviours surrounding women and drink-driving, and the extent to which they have changed over the past decade.

Recommended for you

No added benefit proven for umeclidinium/vilanterol in COPD

13 minutes ago

The drug combination umeclidinium/vilanterol (trade name Anoro) has been approved since May 2014 for adults with chronic obstructive pulmonary disease (COPD). In an early benefit assessment pursuant to the Act on the Reform ...

Ebola vaccine not before late 2016: GSK researcher

Oct 17, 2014

An Ebola vaccine by British pharmaceuticals giant GlaxoSmithKline may not be ready for commercial use until late 2016 and should therefore not be seen as the "primary answer" to the current outbreak, a company researcher ...

Chimerix gets FDA OK to test drug for Ebola

Oct 17, 2014

(AP)—A North Carolina drugmaker plans to test its experimental antiviral drug in patients who have Ebola, after getting authorization from regulators at the Food and Drug Administration.

Esbriet, ofev approved to treat deadly lung disease

Oct 16, 2014

(HealthDay)—Two new drugs have been approved by the U.S. Food and Drug Administration to treat progressive lung scarring from an uncertain cause, medically called idiopathic pulmonary fibrosis (IPF).

FDA weighs removing bolded warning from Chantix

Oct 14, 2014

(AP)—The Food and Drug Administration will ask a panel of experts later this week whether a bold-letter warning on the anti-smoking drug Chantix should be removed based on company-supported evidence that the drug does not ...

User comments : 0