Osteoporosis Drugs: Risk to the Heart?
Fosamax, Other Bisphosphonate Drugs Studied; No Reason to Stop Use, Experts Say
WebMD News Archive
Atrial Fibrillation Study continued...
The study doesn't prove that Fosamax caused atrial fibrillation. The study
was observational, meaning that patients weren't randomly assigned to take
The results held when the researchers weighed other heart rhythm risk
factors. "It was a robust finding," says Heckbert, cautioning that
observational studies can't address
every possible influence on the data.
Heckbert and colleagues did the study after other researchers last year
reported an increased rate of atrial fibrillation associated with the
osteoporosis drug Reclast, which, like Fosamax, is a bisphosphonate.
But in another recent study, Danish researchers found no evidence of
increased risk of atrial fibrillation in women taking bisphosphonates.
"Medicine is like that," Heckbert says. "We don't always
find the same things."
Real Risk or Fluke?
WebMD asked two independent experts to review Heckbert's study.
"The evidence here is interesting, but I'm not going to put this at a
high level of confidence at this point," Edward Puzas, MD, tells WebMD.
Puzas is a professor of orthopaedics, director of the Osteoporosis Center, and
director of orthopaedic research at the University of Rochester School of
Medicine in Rochester, N.Y.
"I think you're going to see articles coming out on both sides of this
right now, and my prediction is that in the end, it's going to sort itself out
that there's little if any risk associated with cardiovascular issues and these
bisphosphonates," Puzas says.
"I'm not ready to believe that the bisphosphonates, certainly as a
class, have got any real potential serious adverse event with regard to atrial
fibrillation," Puzas says. "Sometimes, where there's smoke there's
fire, but many times, when you retrospectively ... look at these articles, they
really do amount to statistical fluke or a statistical fluctuation, and it's
not until other people demonstrate them in other trials in a more prospective,
rigorous fashion that you can actually believe the evidence.
"If I were treating a new patient and about to put them on a
bisphosphonate, I would evaluate their cardiac status with an extra eye toward
looking at atrial fibrillation," says Puzas, adding that he wouldn't rule
out bisphosphonates based only on cardiovascular risk factors.