Concern over bisphosphonates microcracks study

A study published this month which suggested that drugs used to treat osteoporosis may, in fact, make bones weaker has caused considerable concern among patients.

Scientists at Imperial College London looked at the bone structure of hip-fracture patients who had been treated with bisphosphonates. The researchers reported they found microscopic cracks, making bones more fragile and prone to break.

Study on bisphosphonates

However, other scientists and osteoporosis experts have questioned the findings.

Professor Reid, Emeritus Professor of Rheumatology at the University of Aberdeen and a consultant at Twenty-five Harley Street Day Clinic commented: “There are specific scientific concerns about the interpretation of the study findings.

“The results are based on only a tiny number of subjects – only eight patients who had been using bisphosphonates for a variable length of time from one to eight years.

“Scientific reports based on small sample sizes and with study design issues can be over-interpreted in terms of risk of harm. Over-extrapolation of the data to alter clinical management algorithms at this stage are premature.”

Professor Reid also believes the structure of the study has led to misleading results as the bone samples were taken from the head of the femur. This is not a place where femoral fractures usually occur.

Drugs reduce fractures

National Osteoporosis Society Nurse Consultant Sarah Leyland said of the study: “There is plenty of good evidence to show that these drugs are effective at reducing fractures.

She added: “The study authors have emphasised that people should not be stopping their treatment based on the results of this study.”

Professor Reid said that the findings are being carefully looked at. “The forthcoming National Osteoporosis Guideline will advise that patients who have been on oral bisphosphonates for five years (or iv zoledronic acid for three years) should be reassessed to determine whether they should continue treatment or have a break for a period of time.”

Osteoporosis affects three million people in the UK. It’s estimated that one in two women and one in five men over the age of 50 will break a bone due to osteoporosis.

People are usually only diagnosed with osteoporosis when they have suffered a fracture.

However, osteoporosis can be prevented. A DEXA scan can measure bone density and predict the risk of fracture. This informs the patient and doctor of the best strategy to take when it comes to protecting bone health. 


If you have any worries about your medication, you are advised to contact your GP of your consultant rheumatologist and discuss. To make an appointment with Professor Reid, please contact Twenty-five Harley Street Day Clinic.

A class of drugs used in osteoporosis and other bone diseases to reduce loss of bone mass Full medical glossary
Relating to the area at the top of the thigh, near the top of the femur (thigh bone). Full medical glossary
The thigh bone. Full medical glossary
A condition resulting in brittle bones due to loss of bony tissue. Full medical glossary
Lying face-downwards. Full medical glossary
Liable to vary or change. Full medical glossary