Patients on bisphosphonates have no more GI problems than controls.

2002 NOV 14 - (NewsRx.com & NewsRx.net) -- In the Mayo Clinic Proceedings, researchers report that patients taking a common osteoporosis medication (bisphosphonate) showed no increase in upper gastrointestinal tract problems compared with groups taking placebos.

The findings are important as physicians seek therapies to increase or maintain bone density in women with osteoporosis.

In a study that reviewed published material and abstracts related to adverse gastrointestinal events, researchers found that clinical reports of esophagitis associated with bisphosphonate use appear to have declined after proper administration of the medicine was explained to physicians following early reports of complications.

Bisphosphonates are effective for reducing the risk of both vertebral and nonvertebral fractures, including hip fractures. The researchers said that early reports of esophagitis during bisphosphonate use were a result of capsules or pills becoming stuck in the esophagus or esophageal reflux. Since then, dosing instructions for oral bisphosphonates have been developed to minimize contact with the esophagus and ensure adequate absorption of the medicine into the body.

"The highest level of evidence comes from randomized controlled trials, and these data suggest that the risk of upper gastrointestinal tract problems can be minimized if bisphosphonates are administered properly," said Byron Cryer, MD, University of Texas, Southwestern Medical School in Dallas, and principal author of the study.

Cryer noted that upper gastrointestinal tract events must be interpreted in the context of consequences of osteoporosis, which currently accounts for more than 250,000 hip fractures and a much higher number of other fractures each year in the United States. Upper gastrointestinal tract events appear to occur in fewer than 1 per 100 patients treated with bisphosphonates for 3 years, so the risk appears to be relatively low when compared with the benefits, Cryer said.

Cryer and Douglas Bauer, MD, department of medicine, University of California-San Francisco, coauthored the ...