Bisphosphonate drugs to prevent osteoporosis double the risk of esophageal
series of television commercials, actress Sally Fields has long promoted
the drug Boniva as a wonderful and super easy way to treat and prevent the
bone robbing disease known as osteoporosis. Just pop a pill once a month
and stay strong, youthful and energetic like Sally, the ads imply. The trouble
is, Boniva and other drugs in the class of medications known as oral bisphosphonates
not only have a host of side effects, including heartburn and diarrhea and
constipation, now scientists have found out these medications can be deadly.
Research just published in the British Medical Journal (BMJ) shows the drugs
double the risk of esophageal cancer.
(which, along with Boniva, include Fosamax, Actonel and Didronel), are the
most commonly recommended and prescribed Big Pharma drugs for post-menopausal
bone loss. And as they've grown in widespread use, troublesome case reports
have mounted suggesting people who take oral bisphosphonates for osteoporosis
are developing esophageal cancer far more often than would be expected.
In fact, a letter to the editor by an FDA official published last year in
The New England Journal of Medicine warned that these drugs might be linked
to esophageal cancer -- and, in some cases, the drugs were suspected of
causing deaths from bisphosphonate-linked malignancies.
despite the huge numbers of people, mostly women, taking the drugs, no large
study looking specifically at the potential cancer-causing risk of bisphosphonates
has been conducted until now. Researchers from the University of Oxford's
Cancer Epidemiology Unit and the Medicines and Healthcare products Regulatory
Agency in the United Kingdom (UK) have carried out large-scale research
to finally investigate whether bisphosphonates are a cancer risk.
research team analyzed data from the UK General Practice Research Database
on men and women over aged 40 years -- 2,954 with esophageal cancer; 2,018
with stomach cancer and 10,641 with colorectal (bowel) cancer diagnosed
between 1995 and 2005. Then each case was compared with five controls who
were matched for age, sex, and other factors.
results showed that those who had taken 10 or more prescriptions of bisphosphonate
drugs -- or who had taken the medications for about five years -- had about
double the risk of esophageal cancer compared with people who had not taken
bisphosphonates. Usually, esophageal cancer develops in one per 1000 people
between the ages of 60 and 79 over five years. But based on their findings,
the UK scientists estimated that when oral bisphosphonates are taken for
five years, the rate of esophageal cancer increases to two cases per 1000
study found no increased risk of esophageal cancer with oral bisphosphonate
drugs, but the new report tracked patients for nearly twice as long and
is considered far more statistically significant than the earlier research.
are being increasingly prescribed to prevent fractures, and what is lacking
is reliable information on the benefits and risks of their use in the long
term," the study's lead author, Dr Jane Green, said in a statement
to the media.
accompanying editorial, Dr Diane Wysowski, a FDA epidemiologist wrote: "The
possibility of adverse effects on the esophagus should prompt doctors who
prescribe these drugs to consider risks versus benefits." She also
urged doctors to "tell patients to report difficulty in swallowing
and throat, chest, or digestive discomfort so that they can be promptly
evaluated and possibly advised to discontinue the drug."