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Men Are New Target for Osteoporosis Treatment
Mar 23, 2015 | The Wall Street Journal
By Dana Wechsler Linden
...Bisphosphonates, sold under brand names such as Fosamax and Actonel, are highly effective. But because of some possible, rare side effects—an unusual type of fracture of the thigh bone and a deterioration of the jaw bone—the medication often isn’t prescribed for more than five years...
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Men Are New Target for Osteoporosis Treatment
Mar 23, 2015 | The Wall Street Journal
By Dana Wechsler Linden
Bone-health experts are making a new push to reduce rates of osteoporosis, with a particular focus on controlling the bone-wasting disease in men.
An important goal is to get greater numbers of men to be tested for osteoporosis when they come to a hospital or clinic with a fracture to the wrist, vertebrae or other bones that wasn’t from a major accident or trauma. Doctors call this a fragility fracture—one that results from a decrease in bone density.
A recent study of about 440 people over 50 years old found women were about three times as likely as men (53% versus 18%) to be tested using a bone-density scan after suffering a distal-radial fracture, or broken wrist, a common warning sign of early osteoporosis. The study, conducted by researchers at Beth Israel Deaconess Medical Center in Boston, was published in the Journal of Bone and Joint Surgery.
...When osteoporosis isn’t too severe or the patient is relatively young, doctors may recommend calcium or vitamin D supplements, diet changes or more weight-bearing exercise, which strengthens bones. People with a greater risk of future fractures may be put on medications called bisphosphonates, which slow bone breakdown and slightly increase bone mass. Bisphosphonates, sold under brand names such as Fosamax and Actonel, are highly effective. But because of some possible, rare side effects—an unusual type of fracture of the thigh bone and a deterioration of the jaw bone—the medication often isn’t prescribed for more than five years.
Many men “think they can’t get osteoporosis. A man will say, ‘Oh, it was a really bad fall’,” says Richard Dell, head of Kaiser Permanente Southern California’s fracture-liaison service until he retired last year. Care managers at Kaiser order a bone-density scan for everyone over 50 whose fracture results from a simple fall. A clinic sees patients who have abnormal scans, does lab tests and prescribes treatment if needed.
Since the service was launched in 1997, the rate of hip fractures at Kaiser is down 40%, says Dr. Dell, an improvement he attributes in large part to the fracture-liaison service. Dr. Dell currently advises the National Osteoporosis Foundation on its effort to get more hospitals to adopt the services.
A key goal of the hospital pilot project, which is funded by Merck & Co., the maker of Fosamax, is to find out if a fracture-liaison service can be effective in a non-managed-care environment. Among other things, the project has been testing systems to keep track of patients who might receive follow-up care from multiple providers. It eventually plans to make the systems available to hospitals launching such services.
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