Wednesday, July 05, 20063
Fosamax and jaw osteonecrosis
Dr. RW comments on this worsening hysteria:
Concerning my reference to a linked study showing that the major incidence of ONJ is with parenteral biphosphonates in patients with myeloma or metastatic bone disease she states: "That simply isn't true. Oral surgeons and dentists have been seeing patient after patient with jaw necrosis from Fosamax and other bisphosphonate drugs."
Wait a minute. Not so simply, please. According to the systematic review the oncology patients on parenteral therapy represent 94% of published cases despite much heavier use of oral biphosphonates such as Fosamax.
Comments
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Elizabeth
Here's the problem with the attitude that you and other doctors have: you ascribe women's concern over their health and well-being to "hysteria." You think thousands of women with rotting jaws is insignificant. In the L.A. Times, a doctor named Dr. David P Eisenman, Assistant professor at the David Geffen School of Medicine at UCLA has this to say about the issue when he was unhappy that the L.A. Times had made a big deal about this:
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Anonymous
It is true that Fosamax was prescribed to millions of women. But how many of these women needed dental surgeries? When it is prescribed to women in their 70s who already have osteoporosis (and likely don't have much teeth left, and if they do are not likely to do implants) it is one thing. These women have high risk of fructures and low risk of needing dental procedures.
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Tina
dpxjdwffI am of woman who just turned fifty.
Post a Comment »"Congratulations for unduly frightening hundreds of little old ladies."
Now, if that isn't the most chauvinistic, demeaning, and condescending comment I've ever read, I don't know what is. There are plenty of women taking Fosamax and other bisphosphonates who are not little old ladies. And so what if some of them are little and they are old? Does that mean they can't reason, that they can't ask questions about the medications they put in their bodies?
I am sickened by the attitudes of male doctors toward these "little old ladies" and indeed "ladies" in general.
If you wonder why the people are getting fed up with doctors this is a perfect example. Your flippant attitude about something as serious as jaw necrosis is horrifying.
So say the jaw necrosis is rare compared to the millions of women who take Fosamax. What about the bone pain that is not rare? I know one woman who has been on Fosamax for 10 years and now can hardly get out of bed because of severe bone pain.
Talk to women on this drug and you'll hear that complaint among many of them. So, doctor, if Fosamax is building strong bone as you say, why is it causing horrifying, debilitating bone pain in so many women? And would you put your wife on it? Your mother?
10:42 PM
But for how long has Fosamax been prescribed to women in their 50s or even 40s with osteopenia and/or risk factors for osteoporosis? The NNT for secondary prevention with Fosamax is pretty impressive, but is it so for primary prevention in 50-ish women? Anybody has the numbers?
These women still have all of their teeth and are very likely to need dental surgery some time in future. Many of them also have periodontal desease. What if the risk increases with length one is on Fosamax similar to risks of HRT? At least with HRT risks stop after one stops taking it, but Fosamax stays in bones for a very long time so if tomorrow there is a study that shows that the risk is high after 10 years of taking Fosamax there is very little a woman can do.
I have to tell that if I had been a 70-something woman with osteoporosis and high risk of a fructure, I'd say benefits for me outweigh the risk. But if I were a 50-something woman with risk factors and osteopenia I'd probably say no, thanks, not yet. Call me paranoid, but there is something exceedingly scary of this particular side effect, more so than any other. More so than the risk of a heart attack or death. This side effect is excruciatingly painful, untreatable and potentially disfiguring. Yes the probability is small but it is just too scary.
10:41 AM
Unfortunatley I had to have extensive bone grafting in my mouth.
at the same time my Gyno said after a bone density test that I must take Actonel.
After asking my doctor if there wer any concerns I should have with this medication, he assured me that as far as he knew there were no major factors( he knew about my oral surgery).
When I had the prescription filled again I asked my pharmacist about any adverse effects. He repeated what my doctor told me.
Thankfully I decided to search the net before I started the medication and found out about this jaw necrosis. I was stunned and called my doctor. He told me he never heard of this complication as did my pharmacist.
I called Procter and Gamble and their reply is that the risks were low unless you had dental work!
My question is why didn't the doctor know or the pharmacist.
Had I not done the research myself I might have been put myself in a very dangerous situation.
Most people especially in the 40's and plus have some kind of dental work done. You would think that this risk would be brought to people's attention by Someone.
I have learned from this experience,
I learned that you must take control of your own health by researching and asking alot of questions.
Do not leave all the decision making to the medical proffesion.
Your best interest is not always a priotiy.
1:03 AM