Fastest Osteoporosis Drug: Actonel
Actonel Beats Fosamax in Fewest First-Year Fractures After Menopause
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
"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
All things being equal, Watts and Thacker would prescribe Actonel over
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.