Fastest Osteoporosis Drug: Actonel
Actonel Beats Fosamax in Fewest First-Year Fractures After Menopause
Slice of Life -- but Not Proof Positive continued...
"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.
Watts notes that bone-loss drugs should be taken for many years. But most patients stop taking them after six or seven months -- greatly reducing their potential benefit.
"When we start someone on osteoporosis treatment, we hope they will continue taking it for years," Watts says.
"But bone loss is a silent disease -- like high blood pressure or high cholesterol. Until something happens, the disease doesn't make them feel bad, and the drug doesn't make them feel better. That is sometimes hard for people to accept," he says.
Thacker, too, stresses the importance of long-term treatment. Unlike Watts, who usually begins drug treatment only when a woman has frank osteoporosis, Thacker begins as soon as she detects bone loss.
"Once you're starting to lose bone mass, you need to be on treatment," Thacker says.
"First, we make sure a woman is getting enough calcium and vitamin D," Thacker says. "But if she is, and she's still losing bone mass, we start treatment. It is a long-term commitment. The chances are, you will be on it for a long time."