Fractured Sales?

It looks like the Journal of the American Medical Association (JAMA) chose fractures as the theme of its new issue. One study shows that taking a popular osteoporosis drug for 5 years and then going off of it for 5 years carries a residual beneficial effect almost as if the patient stayed on the drug for all 10 years.

Merck paid for the study of its #3-selling drug, Fosamax. The only exception was a 55% increased risk of fractures of the spine for those who stopped taking Fosamax. Doctors say that means patients who may have already had a spinal fracture should probably stay on the drug. But one leading geriatric researcher estimates 60%-70% of patients might be able to go off Fosamax or its smaller-selling competitor, Actonel, from Sanofi-Aventis and Procter & Gamble.

Both of the drugs, called bisphosphonates, are taken once a week. They're also quite cumbersome: patients have to fast, take the drug with a full glass of water (with no other pills) and stand up or sit upright for 30 minutes after swallowing.

Roche and GlaxoSmithKline make a newer, once-a-month drug called Boniva.

Merck says the results of the study are positive and bolster the long-term safety and efficacy of Fosamax. The company, which is set to lose the patent on the drug in 2008, had recently forecast 2007 Fosamax sales could fall as much as $500 million, but that was before these data came out.

Dr. Ken Lyles, a geriatric specialist at Duke University Medical Center, says people who quit taking Fosamax should get bone density scans once a year instead of once every other year and perhaps increase the frequency of blood and urine tests to detect bone formation.

JAMA also reported the results of a study showing the popular heartburn drugs (Nexium from AstraZeneca , Prevacid from a joint venture of Abbott and Takeda Pharmaceuticals and Prilosec from P & G) can increase the risk of hip fractures.

It's more than a $10 billion segment of the drug industry. The British study concluded that patients on those drugs for one year had a 44% higher risk of breaking their hips. The thinking is while the drugs help with stomach acid they might hinder calcium absorption.

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