The attacks on Fosamax are beginning to mount. I personally think the fears are grossly unfounded. The risk of osteonecrosis is almost theoretically small. Although Fosamax has not been proven to improve mortality, there is strong data showing that it reduces fractures in those with osteoporosis.

Medicines like ibuprofen kill many more people with GI bleeding – but since Fosamax is made by Merck, it’s easy to kick a horse when it’s down.

Update -
Here is what UptoDate says about Fosamax and osteonecrosis:

Osteonecrosis of the jaw (ONJ, avascular necrosis of the jaw), often associated with dental extraction, local infection, and pathologic fracture of the jaw, has been described in patients receiving chronic bisphosphonate therapy. Although most cases have been in cancer patients treated with intravenous bisphosphonates, rare cases have also been noted in patients with postmenopausal osteoporosis taking oral bisphosphonates.

Fosamax continues to be the recommended treatment for osteoporosis.

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  • Greg P

    “almost theoretically small”
    Watch out, Kevin.

  • Anonymous

    He’s right. It wouldn’t cost a sodomite a dime to add the name “Kevin Pho” to a lawsuit against Merck. Then they would go back and look at all your comments…

  • SarahW

    A related USA today story: here

    Over a three-year period, the jaws of dozens of patients who had undergone oral surgery at his hospital had failed to heal properly. Part of the jawbone had died and become exposed.

    “We never saw this before in the jaw” except in patients who had received radiation therapy to that part of the face, says Ruggiero, chief of oral and maxillofacial surgery at Long Island Jewish Medical Center. “It just never existed.”

    Further investigation revealed one common thread: All of the patients had been treated with at least one of a class of drugs called bisphosphonates.

  • Anonymous

    I Love Merck and I love the Plaintiffs attorney’s. My Short on Merck is going to pay for a trip to Hawaii next year. Keep attacking Merck sodomites!

  • diora

    Is it a question of how small the risk is of whether Merck did anything wrong? Even if I believe that this side effect will be seen more often as more time passes and more women have dental surgeries, how could have Merck predicted it?

    This side effect wasn’t seen in clinical studies, and, correct me if I am wrong, but the fact that the effect was seen when in cancer patients getting it IV doesn’t imply that it would be seen in healthy women taking a much smaller dose in pill form. Aren’t there zillion examples of drugs that have serious side effects when given IV in huge doses but mild if any side effects when taken in smaller doses as pills?

    Fosamax has been on the market for about 10 years and the reports of this side effect is only just coming out. I find it a bit difficult to blame Merck. Even if I am annoyed at constant drug advertising on TV that seems to target more and more healthy people.

    One side that seems to be overlooked in all these lawsuits are Merck employees. These are not rich executives who often suffer, but average employees most of whom have no influence on major decisions. I work for a fortune 500 company, and whenever there is a lawsuit against my company I am always worried about my job. I hope Merck isn’t forced to lay off thousands.

    Now, I’ve got to decide if I want to short Merck. Anon at 10:55 do you think there is any risk in it? You don’t think all the bad news is already reflected in the price? (I promise not to sue you for wrong advice).

  • Anonymous

    There definitely is a Risk in shorting Merck. It’s already down to $33 from $50. One of the main problems is if you short it before the dividend date, you have to pay the dividend. I can tell you what I do: Merck stock goes lower every time it has bad news come out, ie when Mark Lanier hit the lottery 6 months ago. Then investors seem to ignore the 10,000 pending lawsuits and it creeps higher. Most recently it creeped to $36. I short it when it creeps higher, then when one of the sodomites hits the lottery, like 2 weeks ago in New Jersey, I cover my Short. Actually, a better SHort right now may be Bausch and Lomb. It should creep higher, short it when it hits $50 a share. then some scumbag Sodomite firm like Millberg Weiss will announce a lawsuit, it’ll dive lower, cover your short on the news. I would never own a healthcare stock in the current “Sodomania” climate, I just short them.

  • diora

    Anon at 4:15, thanks, this is very useful information.

  • Anonymous

    You know, it doesn’t seem very smart to me to refer to a large and respected law firm like Millberg Weiss as a “scumbag Sodomite firm”. If they were to become aware of this, they might well squash the author of that statement like a bug.

    No wonder that many attorneys enjoy bringing arrogant members of the medical establishment before the bar of justice, demonstrating time and again the intellectual and moral inferiority of those “medical professionals”.

  • Anonymous

    “No wonder that many attorneys enjoy bringing arrogant members of the medical establishment before the bar of justice, demonstrating time and again the intellectual and moral inferiority of those “medical professionals”.”

    What an absolutely arrogant and asinine statement. The “bar of justice”? More like the travesty of justice. Seems to me that trial attornies who chase ambulances and scheme as to what the next class action lawsuit will be are the morally inferior scum of the earth.

  • Anonymous

    “a large and respected law firm like Millberg Weiss as a “scumbag Sodomite firm”.”

    Ha Ha Milberg Weiss a “respected firm”. Let us be honest on this. Milberg Weiss is nothing more than a giant class action ponzi scheme as follows:
    1: File a class action
    2: Get the defendent to pay
    3: Give a fraction of the monies to the class in form of coupons, life insurance, credit towards another purchase or another semi-worthless “benefit”.
    4: Keep the real money for themselves.
    5: Often the company doesn’t even have to change it’s behavior that resulted in the suit
    5: File another class action and repeat.

    I have seen this shitty slimey organization that masquerades as a law firm first hand. I was even part of their “class” when they didn’t send me the information in the first hand (Have you sodomite bastards ever heard of certified mail?). I recieved a three year “death benefit” (I would have to die to get anything), the company did not change their behavior in the least, and the scumbags at Milberg Weiss recieved millions. Now that make’s alot of sense (for Milberg Weiss). This had nothing to do with medicine.
    I will say it again. Milberg Weiss is nothing but a slimey unethical organization that pretends to be a law firm.

  • Anonymous

    So why didn’t you just opt out of the class if you didn’t like the settlement and pursue the case on your own?

    You had the right.

  • Anonymous

    I admit it: I have lost money when Millberg Weiss has sodomized stocks I’ve owned “on behalf of the stockholders.” Here’s one of their more infamous activities:

    New Indictments Loom in Milberg Case
    Justin Scheck
    The Recorder
    April 7, 2006

    After six years of wide-ranging inquiries, stop-and-go grand jury activity and peripheral indictments, L.A. federal prosecutors are close to charging two partners from the massive plaintiff firm Milberg Weiss Bershad & Schulman — and possibly the firm itself — with paying illegal kickbacks, said several lawyers connected to the case.

    Of course, the two partners aren’t the original targets of the investigation: Melvyn Weiss and former star partner William Lerach, who left Milberg Weiss Bershad Hynes & Lerach, along with almost all of the firm’s West Coast lawyers, to form San Diego’s Lerach Coughlin Stoia Geller Rudman & Robbins in 2004.

    After indicting a former Milberg client and his lawyer in June on charges of accepting kickbacks, prosecutors, in a well-publicized shift, have turned away from Weiss and Lerach in recent months. Instead, they’ve focused on two name partners at Milberg’s current iteration, Milberg Weiss Bershad & Schulman.

    Lawyers familiar with the investigation said Wednesday that David Bershad, partner Steven Schulman and perhaps their firm are likely to be indicted within the next month. They’re being looked at in connection with payments to Howard Vogel, a real estate broker and former lead plaintiff in several Milberg class actions.

    Schulman was the lead plaintiff lawyer in several cases in which Vogel was a client, the most recent filed in 2004, and Bershad is the partner who oversees cash flow at the firm.

    During the last two weeks, attorneys for Milberg Weiss and the two partners have traveled to Washington, D.C., in an effort to convince Alice Fisher, the Justice Department’s criminal chief, not to indict their clients, several lawyers said.

  • Anonymous

    Lots of maybes and possibilities in there – so far no one has indicted anyone at Milberg yet after 6 years.

    I wouldn’t hold my breath.

  • Anonymous

    Lots of maybes and possibilities in there – so far no one has indicted anyone at Milberg yet after 6 years.

    I wouldn’t hold my breath.

    Of course not. It’s like in professional wrestling when One of the Goons brings his goon friend in to referee the match.

  • Anonymous

    “So why didn’t you just opt out of the class if you didn’t like the settlement and pursue the case on your own?”

    Maybe you need to reread my post.

  • Anonymous

    “Maybe you need to reread my post.”

    Looks like you took the offer. If you didn’t receive notice, you’re not bound.

  • Anonymous

    “Of course not. It’s like in professional wrestling when One of the Goons brings his goon friend in to referee the match.”

    I thought that was when you conferred with a friend on a diagnosis?

  • Anonymous

    I thought that was when you conferred with a friend on a diagnosis?

    How dare you compare what we do in medicine with your greedy unethical sodomite behavior!

  • Anonymous

    “Looks like you took the offer. If you didn’t receive notice, you’re not bound”

    No that’s wrong. I was never sent anything on top of it. I was never sent any information about “accepting” the offer. No forms to sign, no infomation, no nothing. Of course I called the slime balls at Milberg Weiss. No help, no explanation. This is a very good reason for every memeber of the class to be sent CERTIFIED mail. That would make sense. Of course it affects the slime balls bottom line. Hence it does not happen. A sad day when an organization supposedly “helping the little guy” in reality acts like it is above the law itself. This class action machine is nothing but a giant vampire to suck out money out of anyone with the pockets.

  • Anonymous

    I agree with anon 11:50. I also recieved a benefit from Millberg Weiss from one of their class action suits. The problem was I never recieved anything from this firm before the judgement. The benefit was worth nothing to me. It amazes me that law firms can get away with flouting the very laws they are supposed to protect. What an amoral organization.

  • Anonymous

    You guys didn’t have to accept. You could have, and if the statute hasn’t run, still can, file your own individual suits.

    Just because you didn’t like what the members of their class settled for doesn’t mean others didn’t.

    Stop blaming other people for your own decisions or failure to read the information you were sent.

  • Anonymous

    Why do I have to send back a letter declining to become a part of the class action ? Shouldn’t they ask me first if I want to become a part of the class action suit ?

  • Anonymous

    Anon 16:54 are you a lawyer? If so you must be a lousy one because if you are part of a class action in which judgement has been made you CAN’T file an individual action (not that I would have, I avoid you parasites like a plague)

    “Just because you didn’t like what the members of their class settled for doesn’t mean others didn’t.”

    Yeah more JD BS. I am sure everybody “wants” death benefits, coupons, and other useless bullshit. Everyone is thrilled with class actions we here about it all the time.

    “Stop blaming other people for your own decisions or failure to read the information you were sent”

    What part of I NEVER RECIEVED THE INFORMATION DO YOU NOT UNDERSTAND. HOW MANY TIMES TO I HAVE TO SAY THIS…ARE YOU STUPID. Any good doc will mail important information by certified mail (or call them/schedule appt). You don’t rely on regular mail for important information…period. If you do I sure as heck would not want you for any of my business. The fact of the matter is EVERY member of a class should be sent certified letters and they should opt IN not out of the class. It will stop the nonsense suits and make sure those members of the class really want to be in. But since the law profession runs government we both know that will not happen. Milberg Weiss is nothing but a blood sucking outfit that screws all for it’s own benefit.
    My apology to kevin for digressing from fosamax but the fact is Milberg Weiss is a good example of what is wrong with the legal profession in this country.

  • Anonymous

    I think you should open the envelope, take a dump in it, and send that to Millberg Weiss. Then they can search through the fibers of your dump and figure out if it means you opted in or out.

  • Anonymous

    What was the class action about that wronged you so?

  • Anirban

    Is it the same Milberg Weiss where Bill Lerach works.Speaks for itself?

  • Anonymous

    Anon 9:50:
    You are wasting your time. Most people know that class actions are by and large little more than vehicles in which to enrich attornies. Those few exceptions include significantly changing corporate behavior. But as you said earlier, most class actions don’t even result in behavior modification by the defendents. Don’t expect a lawyer to do anything but defend the present system. It is their bottom line after all.

  • Anonymous

    There’s nothing more humorous than seeing physicians pontificate on complex litigation like class actions. Particularly when they are discussing the evils of them.

    Yet what do they do when nearly a million of them want to sue health insurers? Why, file a class action of course. That must be evidence of how bad class actions are. Maybe all those physicians just wanted to enrich attorneys?

    Damn facts getting in the way again, eh?

  • Anonymous

    “Is it the same Milberg Weiss where Bill Lerach works.Speaks for itself?”

    Sure. Anytime anyone working anywhere does something bad, it’s an indictment of everyone who works there. They all become bad people. And sometimes, it can even be used as an indictment of anyone with the same job, regardless of where they work.

    Didn’t you know?

  • Anonymous

    “Yet what do they do when nearly a million of them want to sue health insurers”

    Ha Ha Ha there aren’t even “nearly a million” doctors in this country. Look who doesn’t have their facts right.

    PS: I didn’t take part in that lawyer enrichment program.

  • Anonymous

    “And sometimes, it can even be used as an indictment of anyone with the same job, regardless of where they work.

    Yeah, I see you trying to “indict” the whole medical profession on this site regularly. Might want to look in the mirror pal.

  • Anonymous

    Hey, I get it now! If lawyers stick together, they’re scum. If doctors stick together, it’s called a ‘medical court.’ Doh!

  • Anonymous

    “Hey, I get it now! If lawyers stick together, they’re scum. If doctors stick together, it’s called a ‘medical court.’ Doh!”

    Gotta work on those critical reasoning skills pal. If you really think that your’s are severely lacking.

  • Anonymous

    “….If doctors stick together, it’s called a ‘medical court.’ Doh!”

    Sure it’s much better to have hired guns who tailor their testimony based on who’s paying their tab than impartial experts. Yeah that’s a better system…doh.

  • Anonymous

    “Ha Ha Ha there aren’t even “nearly a million” doctors in this country. Look who doesn’t have their facts right.”

    http://www.urologytimes.com/urologytimes/article/articleDetail.jsp?id=122608

    Do you ever get tired of me making you look silly?

  • Anonymous

    The article says 900,000 including retired. And with over a million sodomites destroying the healthcare system, more and more of us are falling into the retired category.

  • Anonymous

    “had systematically underpaid 900,000 active AND RETIRED physicians.”

    Read for comprehension CJD.

  • Anonymous

    Can you “read for comprehension” folks point me to where I said they were all practicing?

    Read for comprehension indeed. Heck, I just wish you guys could read and pick up a single fact.

    I think the guy with the sodomy obsession is funny. You know his wife hasn’t touched it in years.

  • Anonymous

    Well moron tell you what why don’t you get a “retired” doctor to write you a script. What part of retired are you unclear on? A retired doctor typically doesn’t practice medicine and surely shouldn’t be counted towards functioning docs in this country.

  • Anonymous

    The BLS reports that there were about 567,000 practicing physicians in the U.S. in 2004. That’s all doctors, all specialties. I find it hard to believe that there are nearly as many retired ones still living, especially since physicians have one of the oldest average retirement ages of any career, if not the oldest.

    The facts in your source document are very questionable.

  • Anonymous

    Why should CJDlite let the truth get in the way of his agenda.

  • Anonymous

    “What part of retired are you unclear on?”

    Seriously, can you read? I never made a claim as to whether they were retired. I simply said 900,000 physicians are members of this class. That is correct.

    As to how many there are, I don’t know. This figure comes in between both mine and Anonymous 7:39. It appears they’re a hard bunch to count.

    http://pn.psychiatryonline.org/cgi/content/full/39/24/23

  • Anonymous

    The important point is there ARE NOT close to a million practicing doc’s in this country, but hey why let the truth get in the way of your agenda.

  • Anonymous

    The important point is that apparently some of you can’t read, and if you’re physicians, that’s scary. The only thing that has been stated is that 900,000 physicians signed up for a class action against health insurers for improper reimbursement.

    No one made any claim as to their retired or active status. But hey, don’t let the truth get in the way of your nonsense.

  • Anonymous

    Your quote CJD:

    “Yet what do they do when nearly a million of them want to sue health insurers? Why, file a class action of course. That must be evidence of how bad class actions are. Maybe all those physicians just wanted to enrich attorneys”

    Quit the word games and nonsense.

  • Anonymous

    Again, learn to read. Where in that quote do you see anything about their current employment status? Or are retired physicians not physicians?

    Here’s another article, which specifically denotes active and retired:

    http://www.urologytimes.com/urologytimes/article/articleDetail.jsp?id=122608

    What’s more, the original point remains. Physicians, like most people, have no problem filing a lawsuit when it’s them doing the filing and they have been wronged. They believe people should be held responsible for their torts and breaches of contract. Unless the physician is the one at fault, that is.

  • Anonymous

    Um, most docs don’t get sued over torts and breach of contract.

  • Anonymous

    A more analogous comparison would be to see what pecentage of the physician population has filed a medical malpractice suit against another provider in regards to treatment for themselves or family, compared to the percentage for the whole population. I’ll admit I’m too lazy to research it, but I’d bet my life it is lower.

  • Anonymous

    “Again, learn to read. Where in that quote do you see anything about their current employment status? Or are retired physicians not physicians?”

    So let us get it right there are NOT nearly one million practicing doctor’s in this country. So I guess one million of us couldn’t have been in the suit…period.

  • Anonymous

    I have AVN of both knees, presumed to be a result of taking both IV and PO corticosteroids on several occasions for another condition. A year ago, I had core decompression drilling to try to offset the pain in my knees. I’m not yet a candidate for replacement because of my age and the fact that my joints haven’t yet started to collapse. I’m also on my feet for 8-12 hours a day, and the replacements may not last as long as they would in someone who isn’t very active, so we’re trying to hold off as long as possible.

    However, the same steroids also gave me osteopenia, but I’m not being treated for it right now. My internal med doc recently sent me to get a repeat DEXA scan to see where we’re at now, and we had a lengthy chat about the bisphosphonates and AVN. I told her that I understand the incidence of ON/AVN is rare with these meds, but it was also very unlikely that I would develop AVN in the way that I did from the steroids, too! I was one of only 3 patients my orthopod (who specialises in AVN) has ever seen that had AVN in both knees and none in the hips. So – just because a negative effect is rare doesn’t do it for me….I’ve fallen into the rare category on more than one occasion!

    That being said, my int med doc told me that she understands the concern and feels it is legitimate, but that these cases were always around invasive dental procedures. She said that if I were to have something of that nature done, she’d have me stop the med a month before and a month after the procedure. She said that sometimes dentists and oral surgeons look at her like she’s nuts, but she would rather be safe than sorry.

    I have to say that I really appreciated that!! AVN is a hard thing to live with at age 25. I’m just finishing up 5 months of physical therapy – round 2. This time for severe back pain caused by the way I walk. I can’t even imagine having AVN of the jaw. My orthopedic said I’d always be at a higher risk than normal for getting AVN in other joints, particularly the hips and shoulders. Since diagnosis almost 2 years ago, I’ve only taken steroids 3 times – once an injection in my back, IV one time for an allergic reaction, and one taper for an autoimmune flare up. I had to seriously weigh the benefits vs. risks for all 3 times, and I wasn’t all that comfortable with it, but I knew it had to be done.

    I like the tactic being used by my internal med doc in order to try to protect her patients from getting AVN by stopping the med around invasive dental procedures. I don’t think she does it based on fear of lawsuit – she does it because she cares about her patients and doesn’t want to see them suffer further. I really commend her for that – she’s top notch. Even though I understand that I would probably never get AVN of the jaw due to the nature of cases for people who did develop it, I still very much appreciate that she understood my concerns and had a solution. Ultimately it would allow me to take the Fosamax if needed so that I didn’t break a bone, but it still would decrease my risk of getting AVN of the jaw from it.

  • Anonymous

    I took Fosamax for 6 years and was just diagnosed with osteonecrosis in my jaw. I am in my mid 50s and other than taking Foxamax for osteoporosis, I never take drugs, smoke or drink. I now have exposed bones in my gums and face an uncertain future. I find it hard to believe that my situation is a “one-in-a-million”.