Efficacy and Safety of a Bone Loss Treatment

Often recognized as an aging disorder, bone loss can affect a variety of age groups, and is not to be considered a hopeless part of aging.

Medical conditions like eating disorders and menopause and lifestyle factors like a lack of exercise and a poor diet can cause a loss of bone mass or increase the rate of risk.^1,2,3

This loss of bone mass can lead to severe concerns if left unaddressed and is particularly problematic with age. Testing the efficacy and safety of a bone loss treatment is critical.

Bone density testing

Medical imaging tests showing a bone mass density that’s lower than the average for a person’s age is called osteopenia.

Osteopenia is the preliminary stage of bone loss where the tissue begins to weaken. Osteopenia can progress into osteoporosis, a more severe condition where the bones, including the spine, become highly porous and at risk for fractures.³

If there is a bone density concern, bisphosphonates may be the new option to prevent or manage osteoporosis.

Are bisphosphonates effective and safe?

There is a natural balance between bone tissue breakdown (osteoclastic activity) and bone tissue rebuilding (osteoblastic activity) that must occur.

These activities require a specific amount of minerals like calcium.

Bisphosphonates are drugs that reduce natural bone reabsorption that occurs when we age and helps the body retain calcium in the bones.⁴ This is why bisphosphonates are currently used for osteopenia treatment and osteoporosis management.

A study reviewed 14 randomized clinical trials to see whether taking bisphosphonates as a bone loss treatment was effective.⁴ The average age of the participants was 67 and the majority were female.

According to the researchers, this could be the first meta-analysis that reviewed the effectiveness of bisphosphonate osteoporosis treatment in individuals 45 and older.⁴

Bisphosphonate effectiveness

To measure bisphosphonates’ effectiveness, researchers focused on the level of bone mineral density change in the lumbar spine.

An increase in bone mineral density meant that the treatment was effective.

The researchers also looked at how often fractures occurred, including clinical fractures (all fractures that were brought to the attention of a medical professional), vertebral fractures, and non-vertebral fractures.

In order of effectiveness, the bisphosphonates tested were:

• alendronate,
• risedronate,
• and zoledronate.⁴

Differences in effectiveness were not statistically significant between the bisphosphonates tests but this may be due to the age and gender variety.

Bisphosphonate safety

The safety of bisphosphonates for treating bone loss associated with aging disorders is particularly a concern.

If a patient does not follow their treatment plan as directed, taking bisphosphonates can actually increase their risk of fracture.⁴ The bisphosphonate that bestowed the lowest non-vertebral and vertebral fracture risk was zoledronate.⁴ 

Serious bone loss can be prevented

Depending on the source and level of bone loss, there is hope.

With lifestyle modifications including a healthy diet, regular weight-bearing exercise like resistance training, quitting smoking, and getting early treatment, severe bone loss is not inevitable. 

Prescriptions like bisphosphonates may also be an option for you. If you are looking for osteopenia or osteoporosis treatment options, speak with your doctor to see if it would be a good match for you.

References 

1. Did you know that weak bones are not a normal part of aging? Bone Health & Osteoporosis Foundation. November 9, 2018. https://www.bonehealthandosteoporosis.org/news/did-you-know-that-weak-bones-are-not-a-normal-part-of-aging/
2. Varacallo M, Seaman TJ, Jandu JS, et al. Osteopenia. [Updated 2022 Oct 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan. https://www.ncbi.nlm.nih.gov/books/NBK499878/
3. Aging changes in the bones – muscles – joints: Medlineplus medical encyclopedia. MedlinePlus. July 21, 2022. https://medlineplus.gov/ency/article/004015.htm 
4. Hu Q et al. Comparative efficacy and safety of bisphosphonate therapy for bone loss in individuals after middle age: A systematic review and network meta-analysis. Nano TransMed. 2022;1(1):e91300003. https://doi.org/10.26599/NTM.2022.9130003.