Media reports about alendronate use and bone strength

01 Mar 2017

There have been reports in the media recently about a new study highlighting that patients taking drugs like alendronate for osteoporosis might weaken rather than strengthen bones.

The small study carried out by scientists at Imperial College London examined sugar cube sized bone samples from just 16 people who had broken their hip, 8 had taken alendronate and 8 hadn’t. Using very powerful techniques not used before, on six samples from the bisphosphonate-treated group, five from the untreated group and five from the healthy ageing non-fracture group, the researchers were able to show there was more bone tissue in the patients who had been on alendronate, but the small sample of bone from the patients had more cracks and was stiffer.

Dr. Kassim Javaid, Lecturer in Metabolic Bone Disease at the University of Oxford, said the way the study was reported had caused unnecessary confusion and worry to people taking alendronate and similar drugs to protect themselves against broken bones. 

“We have known that microcracks do happen with this type of treatment for many years. What really matters is whether or not taking a bisphosphonate means you are going to have more fractures or broken bones, and it doesn’t.

This was properly tested in 1996, by giving 1,022 people with osteoporosis alendronate and 1,005 placebo (a tablet that looks like a alendronate but does not contain it). This study showed that the people who took the drug had much better bones that broke much less often than those given the placebo.

Nearly all the studies since then have shown the same thing, that a person taking alendronate and similar drugs has stronger bones that are less likely to fracture or break. People taking drugs to reduce their fracture risk should continue to be confident that the stories from many other studies of bisphosphonates are all very positive,” he said. 

If you have had a broken bone after a fall and are aged 50 years or over, you should ask your doctor if you need to be checked for osteoporosis. This applies to men and women. We know many people are not. This is the real news story that not enough people are talking about

Juliet Compston, Emeritus Professor of Bone Medicine at the University of Cambridge and a member of the National Osteoporosis Society's Clinical & Scientific Committee said, although the study was interesting, it was a very small sample and the early findings need to be confirmed by further research . She emphasised anyone taking bisphosphonates should not stop taking their medication as a result of the study.

"While the data should stimulate further studies they do not provide sufficient evidence to change clinical practice and people at high risk of fracture should be reassured that the benefits of treatment, at least up to 5 years , and probably up to 10, outweigh the risks."

If people taking alendronate have any concerns they should get in touch with their doctor. Alternatively, they can get in touch with the National Osteoporosis Society Helpline on 0808 800 0035 or


Comments (1)

Dr David J Armstrong

Another example of mainstream media picking up small scientific study without understanding quality, validity or wider applicability of the work (or otherwise), and then making everything ten times worse with an over-simplified headline. Excellent measured response from Kassim. Don't forget - ultimate goal is fracture prevention. Bisphosphonates have been shown in dozens of large studies over 20 years to prevent fractures

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