Solid "Deep Dive" -- On Fosamax® -- Via National Public Radio

Do go read the whole article, and check out the graphical timeline side-bar, once there -- but NPR has done the nation a great service here, distilling into plain English all the disparate, and fractured (pardon the pun), current learnings on ostepopenia, and the $3 billlion a year drug:

. . . .Increasingly, bone scientists like Cummings say Fosamax^® — and drugs like it — are not a necessarily a win for most women with osteopenia [not full-blown osteoporosis].

Studies in women with osteopenia show that while Fosamax and similar drugs reduce spinal fractures, the drugs may not reduce other types of bone fractures that are more common in women who have osteopenia, say Cummings and Susan Ott, an associate professor in the department of medicine at the University of Washington.

"There was no difference in the number of [nonspine] fractures you had, whether you took the medicine or a placebo," says Ott. "It does make your bone density go up higher, but the number of fractures is what really matters, and that didn't really change."

And what about the long term?

There are no long-term studies that look at what happens to women with osteopenia who start Fosamax in their 50s and continue treatment long-term in the hopes of preventing old-age fractures. And none are planned.

So Cummings says treatment should start only when fracture risk is significant, bone density is low, or someone already has a spine fracture.

He says the WHO is promoting a new tool called the FRAX, which looks at a variety of factors that influence the risk of fracture. This allows women and their physicians to more accurately estimate their risk of experiencing a disabling bone break.

Ott agrees. And, she also worries that taking these medications long-term — over 10 years or more — might actually make bones brittle.

Ott points to a very small number of case reports about spontaneous breaks in the upper leg, which — though very rare — could be important, she says, given what's at stake. . . .

Indeed -- and, as we reported back in September 2009, that is exactly what some of these Fosamax suits are all about.