Treatments that have been shown in rigidly controlled studies to reduce women’s risk of osteoporosis-related fractures are also working in the “real world,” according to Canadian research.
Osteoporosis, or brittle bones, puts people at increased risk for fractures, particularly of the hip, spine and wrist. According to Osteoporosis Canada, 1.4 million Canadians have the condition, including one in four women over the age of 50.
Treatments known as anti-resorptive agents have been shown to reduce the risk of fractures in clinical trials that randomly assign women to treatment and no-treatment groups. But women who enroll in these trials are usually healthier than average, and their compliance with the therapy is carefully monitored.
“It’s important to show that the efficacy of these medications, which has been shown in randomized trials, translates into effectiveness in real life,” says Dr. Suzanne Morin, an associate professor of medicine at McGill University in Montreal.
Morin and her colleagues studied more than 6,000 women age 50 and older who had been randomly selected from nine regions across the country. Over a seven-year period, 477 women reported they suffered an osteoporosis-related fracture. Fractures of the backbones, or vertebrae, were not included because they often cause no symptoms.
Thirty-seven per cent of the women were current users of anti-resorptive agents. These included the hormone estrogen, as well as the drugs alendronate, editronate, risedronate, raloxifene and calcitonin. In general, use of these treatments was associated with a 32 per cent reduction in the risk of nonvertebral osteoporosis-related fractures. However, the researchers were not able to compare the effectiveness of individual anti-resorptive agents.
Women with a low bone density or a history of previous osteoporotic fractures benefited more from the use of anti-resorptive agents, experiencing a 40 per cent reduction in fracture risk.
“It’s comforting that in the real world … what has been shown in randomized trials is actually happening as well,” Morin says.