Although these drugs are supposed to strengthen bone, some reports have raised the possibility that they actually may increase the likelihood of an unusual type of fracture for some women. For the most part, this story provides a thorough look at new research suggesting that these fractures are extremely rare and do not offset the drugs’ benefits. The story would have been better had it included some discussion of the other potentially serious harms associated with the use of these drugs.
Hip fractures are a common and often devastating result of osteoporosis. While bisphosphonates are proven to help prevent osteoporotic fractures, recent reports have raised concern about whether a rare type of thigh fracture might be more common in women taking these drugs.
Women need to know whether bisphosphonate drugs work as advertised, and whether the harms outweigh the benefits.
Treatment costs for both Fosamax and Reclast are provided.
The story characterizes the benefits of these drugs in a way that is accurate and easy for readers to understand. It notes that treating 1,000 osteoporotic women for three years would prevent 100 fractures at a possible cost of only one or fewer thigh bone fractures.
The major thrust of the story was the discussion of increased fracture risk associated with use of some bisphosphonates. While the story did an excellent job of discussing the evidence for this particular harm, it didn’t mention any of the other adverse effects that have been associated with the use of these drugs. These range from common but minor problems such as gastrointestinal upset to rare but potentially serious conditions such as chronic severe muscle pain and kidney damage.
The story provides enough detail for readers to make reasonable judgments about the quality of the evidence. It notes that the study included data from three controlled trials involving more than 14,000 women. It also discusses some limitations in the data, including the fact that many users hadn’t taken the drugs for very long or used a lower dose of the drug than is commonly used today. The story gives the appropriate impression that the study was strong but that it can’t definitively rule out increased risk of these fractures in bisphosphonate users.
The story quotes from an editorial by a researcher not affiliated with the study. It also does an excellent job of discussing the various financial conflicts that might complicate interpretation of the results. It notes that several authors of the study consult for the drugmakers who sponsored the research. It also notes that the editorial writer’s institution received research grants from drugmakers, even though she herself did not have any financial ties to these companies.
The story could have discussed the role of calcium, vitamin D, and weight-bearing exercise for preventing osteoporosis-related fractures. However, we thought it was acceptable for the article to focus exclusively on bisphosphonates, since its point was to discuss risks associated with these agents.
The story states that the drugs are taken by millions of American women, so readers can assume that they are widely available.
The story makes it clear that these drugs have been in use for some time and should not be considered "new."
It’s clear the story didn’t rely on a news release.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
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