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Fastest Osteoporosis Drug: Actonel
Nov. 27, 2006 -- Actonel and Fosamax both prevent bone loss after menopause. But Actonel works faster, a study by top osteoporosis experts suggests.
Actonel (made by Procter & Gamble) and Fosamax (made by Merck) are both effective treatments for age-related osteoporosis. This kind of bone loss is a particular problem for women after menopause.
The two drugs are members of a class of drugs known as bisphosphonates, as is a newer drug, Roche's Boniva.
There has been some evidence that Actonel may work more quickly to prevent fractures -- particularly the all-too-common hip and non-spine fractures that can greatly reduce a person's quality of life.
But is this really the case?
Nelson B. Watts, MD, director of the University of Cincinnati Bone Health and Osteoporosis Center, joined a team of internationally renowned experts in an effort to find out.
The researchers analyzed insurance records for 12,215 postmenopausal women who took Actonel and 21,615 women who took Fosamax for the first time. The women were 65 and older.
The result: After a year of treatment, women taking Actonel had 43% fewer hip fractures and 18% fewer non-spine fractures than women taking Fosamax.
"This adds to the suggestion from clinical trials that Actonel works faster than Fosamax," Watts tells WebMD. "We found a significantly lower rate of fracture at hip and non-vertebral sites for patients given Actonel vs. Fosamax at both six and 12 months.
"I am not saying one drug is better than the other -- only that Actonel works faster," Watts says.
The study -- sponsored by Procter & Gamble and Sanofi -- appears in the current online issue of the journal Osteoporosis International.
Procter & Gamble, Merck, Roche, and Sanofi are WebMD sponsors.
Slice of Life -- but Not Proof Positive
Watts is quick to point out that the study is not a clinical trial and therefore cannot be taken as conclusive proof.
But the study impresses Holly Thacker, MD, director of the Women's Health Center at The Cleveland Clinic.
Thacker, who was not involved in the study, notes that Watts and colleagues looked at the kind of women doctors see in real life. Moreover, they evaluated the endpoint that really matters to women suffering bone loss -- actual bone fractures.
"I tend to prescribe Actonel more often than Fosamax, so this study is reassuring," Thacker tells WebMD.
"We now have some excellent drugs for bone loss. In the bisphosphonate family, I rank Actonel No. 1, with Fosamax a close second," she says. "I rank Boniva a distant third, because it has not yet been shown to reduce hip fracture."
All things being equal, Watts and Thacker would prescribe Actonel over Fosamax.
But both of these top doctors point out that not all women are equal. Some women may tolerate one drug better than another. Or their insurance may pay more for one than the other.
In either case, women will get the most benefit from the drug that works best for them.
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VIVELLE-DOT (estradiol transdermal system) IS AVAILABLE BY PRESCRPTION ONLY.
INDICATION
Vivelle-Dot is used after menopause to: reduce moderate to severe hot flashes; treat moderate to severe dryness, itching and burning in or around the vagina; help reduce your chances of getting osteoporosis (thin weak bones); and treat certain conditions in which a young woman's ovaries do not produce enough estrogens naturally. Vivelle-Dot 0.025 mg/day is only used to prevent osteoporosis from menopause. If you use Vivelle-Dot only to treat your dryness, itching, and burning in and around your vagina or if you use Vivelle-Dot only to prevent osteoporosis from menopause, talk with your healthcare professional about whether a different treatment or medicine without estrogens might be better for you.
IMPORTANT SAFETY INFORMATION
Estrogens increase the chances of getting cancer of the uterus (womb). Report any unusual vaginal bleeding right away while you are taking estrogens. Vaginal bleeding after menopause may be a warning sign of cancer of the uterus (womb).
Do not use estrogens with or without progestins to prevent heart disease, heart attacks, or strokes. Using estrogens with or without progestins may increase your chances of getting heart attacks, strokes, breast cancer, and blood clots. Using estrogens with progestins may increase your risk of dementia (decline in memory and thinking skills).
Vivelle-Dot should not be used if you have unusual vaginal bleeding; currently have or have had certain cancers, including cancer of the breast or uterus; had a stroke or heart attack in the recent past (for example, in the past year); currently have or have had blood clots; currently have or have had liver problems; or think you may be, or know that you are, pregnant.
The most common side effects that may occur with Vivelle-Dot are headache, breast tenderness, and back pain.
You and your healthcare professional should talk regularly about whether you still need treatment with Vivelle-Dot.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
Please see Full Prescribing Information for Vivelle-Dot.
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