Fosamax Femur Fracture - Fosamax Side Effects

Doctor Says Fosamax May Increase Risk Of Fractures

- clickondetroit.com
02/27/2010 - Nearly 40 million prescriptions have been written for the popular osteoporosis medication called Fosamax. It's part of a group of drugs called bisphosphonates that are supposed to make bones stronger, but now at least one doctor said there's mounting evidence that these medications could cause spontaneous fractures.

Sheridan Powell suffered a sudden break. "I was on my way to work, walking up the hill to catch the bus and I heard a snap. And I didn't realize that it was my leg until I fell," said Powell.

Powell said she didn't trip on anything. She didn't have an accident. Her leg just broke. "You don't just break your leg. You usually fall and break it. I said I felt I must have tripped over something, but there was nothing there," said Powell.

Powell was taken to the hospital, where doctors found she had a rare type of femur fracture. X-rays showed there was a clean break in the middle of her thigh bone. Doctors were left wondering -- what could have caused the largest bone in her body to suddenly snap in two?

"We think of the middle of the thigh bone as being a very strong bone. It's not a bone that typically an osteoporatic patient would fracture and in these patients they fracture with almost no trauma," said Dr. Robert Bunning, a rheumatologist at National Rehabilitation Hospital.

Bunning said he's seen this before, and once he learned Powell had been taking Fosamax for about eight years to treat osteoporosis, he had a pretty good idea what could have caused the break, a Fosamax femur fracture.

"The drugs are supposed to work by shutting down the cells that re-absorb the bone, the osteoclasts. The ones that make the bone, the osteoblasts, are supposed to keep working. However in biopsies of patients who have had the fracture, it shows that both are shut down," said Bunning.

Bunning called it "frozen bone," which is brittle and more susceptible to these types of clean fractures. He said in the United States, there have been 50 to 60 reported cases of this.
"Even thought it's rare, I think we're going to be seeing quite a few more cases," said Bunning.

Bunning said that in all of the reported cases, most patients had been taking Fosamax or another type of bisphosphonate for more than five years.

"The drugs clearly were designed to make the bones stronger and I think they do for the first few years. They make them denser," said Bunning.

The manufacturer of Fosamax, Merck, says there has been no "causal link" demonstrated between long-term use of Fosamax and fractures. Clinical studies have not shown any increased risk of fracture in any part of the body.

A spokeswoman for the Food and Drug Administration said the agency is "aware of this issue and are actively investigating it." Bunning said that Fosamax is safe to take for up to five years and it's been shown to benefit many patients with osteoporosis.

But for patients like Powell -- who had to undergo surgery plus weeks of rehabilitation just to be able to walk again -- she said she wishes she had known about the risks.

"It's kind of hard to believe that something that saves your bones can break the largest bone in your body," said Powell.
A big question is whether the osteoporosis itself can cause these fractures.

Bunning said typically, patients with that condition will suffer breaks in the hip area -- and that usually occurs after a fall. With all of these patients, the breaks are occurring in the thigh and without any sort of trauma.

Bunning said that in many of these patients they had experienced vague thigh pain before their femur broke, so he said if you or someone you know is taking one of these drugs, make sure to see your doctor right away if something doesn't feel right.