In the wake of our report on links between atrial fibrillation and bisphosphonate drugs such as Fosamax and Reclast, Health Spectator performed a routine follow-up investigation of the health claims and side effects of this class of drugs. We discovered that, contrary to the majority of reports we had read when researching the initial story, other complications from treatment with bisphosphonates were already known.
Specifically, a condition known as osteonecrosis of the jaw (a condition in which the bone tissue of the jaw literally dies) had previously been linked to taking Fosamax. A check of the Merck website on May 6 showed no mention of this possible complication either under side effects or dosing information. Nevertheless, we found that no less prestigious a group than the New York Academy of Science is sponsoring a conference on bisphosphonates and osteonecrosis of the jaw (ONJ) later this month. In fact, that conference is partially funded by Merck & Co., Inc, Novartis, and Procter & Gamble Pharmaceuticals, the major manufacturers of bisphosphonates.
What’s more, it turns out that the bisphosphonates have been associated with cases of osteonecrosis of the jaw since 2003. That’s when reports surfaced of bisphosphonate-associated osteonecrosis of the jaw (BON) linked to use of Zometa (zolendronic acid) and Aredia (pamidronate). Novartis manufactures pamidronate, as well as zolendronic acid under the names Zometa and Reclast. Zometa is used to treat bone loss in cancer patients and others who are undergoing a more rapid form of bone disintegration than occurs in osteoporosis. Reclast has been approved by the FDA for Paget’s disease and is being considered for treating osteoporosis.
For the most part, early reports of BON were associated with dental work, especially dental work that directly affected the jaw, such as tooth extraction. But then it became apparent that some BON episodes were spontaneous and not the result of dental intervention. The odds of suffering from BON are much greater as a result of dental intervention, so patients who are about to undergo therapy with zolendronic acid (or any bisphosphonate, for that matter) are urged to take care of any essential dental work before beginning treatment.
At this point, the possible complications of treatment with bisphosphonates are unfamiliar to many medical professionals, hence the interest in symposia such as the NYAS educational conference on ONJ and bisphosphonates.