Yearly Injection Drops Fracture Risk
Elderly may find extra benefit in possibility of extending life

(HealthDay News) -- A drug injected once a year might not only help prevent the risk of hip fractures in older adults but might also reduce their risk of death as well.

"We changed the fracture rate, and, when we analyzed the data, we had a significant mortality reduction. We never dreamed we'd have that," Dr. Kenneth W. Lyles, a professor of medicine and vice chairman for clinical research in the Department of Medicine at Duke University Medical Center , told HealthDay .

Each year, about 345,000 people in the United States are hospitalized because of a broken hip, and as many as 36 percent of them will die within two years of the fracture, according to an editorial in the New England Journal of Medicine . Once a person has broken a hip, the risk of a subsequent break is five to 10 times higher. Many hip fractures are due to osteoporosis, which causes thin, fragile bones.

The drug examined in the study was Reclast, from a class of medications known as bisphosphonates, which work by slowing the body's reabsorption of bone. Other drugs in this class include Fosamax, Activa and Boniva.

"This is the first test of using this to prevent further fractures in elderly patients, and the reason that is a big deal is people weren't sure if zoledronic acid [Reclast] inhibited osteoclasts [cells] which are needed for repair" of the initial fracture, Paul Brandt, an associate professor of neuroscience and experimental therapeutics with Texas A&M Health Science Center College of Medicine, told HealthDay . "This study shows it doesn't interfere with that process and does give the beneficial effect of reducing further fracture rates."

More than 2,100 adults were randomly assigned to receive either an injection of Reclast or a placebo within 90 days of having hip fracture surgery. During the next two years, people who'd been given Reclast were 28 percent less likely to have died and 35 percent less likely to have had another fracture, the study found.

The study was funded by Novartis Pharma, the company that makes Reclast. Its findings were published in the New England Journal of Medicine .

"This appears to be the most potent of the bisphosphonates," Dr. Stephen Honig, director of the Osteoporosis Center at the New York University Hospital for Joint Diseases in New York City, told HealthDay . "It reduced bone turnover more and had a significant effect on fracture rate." He added that the once-a-year dose "obviously is attractive."

Preventing osteoporosis is an important step in preventing fractures, and the National Osteoporosis Foundation recommends taking adequate calcium and vitamin D to help keep bones strong. Adults younger than 50 should consume 1,000 milligrams daily of calcium, and those over 50 should boost their intake to 1,200 mg. The foundation advises those under 50 to consume 400 mg to 800 mg daily of vitamin D and those over 50 to take 800 mg to 1,000 mg a day. It also recommends regular, weight-bearing exercise for good bone health.

On the Web

To learn more about osteoporosis and risk factors for fractures, visit the National Institute of Arthritis and Musculoskeletal and Skin Diseases online.

SOURCES: HealthDay News ; Kenneth W. Lyles, M.D., professor of medicine and director of geriatrics research, Duke University School of Medicine and Duke Clinical Research Institute, Durham, N.C.; Paul Brandt, Ph.D., associate professor of neuroscience and experimental therapeutics, Texas A&M Health Science Center College of Medicine, College Station, Texas; Stephen Honig, M.D., director, Osteoporosis Center, New York University Hospital for Joint Diseases, New York City; Sept. 19, 2007, New England Journal of Medicine ; National Osteoporosis Foundation (www.nof.org)
Author: Serena Gordon
Publication Date: Sept. 30, 2008
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