Harvard Women's Health Watch

Do bone-building drugs really prevent hip fracture?

An international team of researchers has pored over scores of studies of bone density, osteoporosis, and hip fracture and has concluded that the number of hip fractures that have been prevented by bone-building drugs called bisphosphonates since 1995 doesn't justify the expense and potential side effects of the medication. Their findings were published online by the journal BMJ on May 26, 2015.

In their report, the researchers cited earlier studies to support their conclusion, including

  • several studies indicating that drug therapy doesn't prevent hip fracture in women over 75

  • a 2006 study that found that half of people who fracture a hip don't have osteoporosis

  • a 2013 analysis indicating that exercise training could prevent 60% of hip fractures.

The researchers suggested that older women should pursue lifestyle changes, including stopping smoking, increasing exercise, and following a healthy diet before resorting to bone-building drugs. They did not review research on the effect of the drugs in preventing vertebral fractures.

What should you do? If you're taking a bisphosphonate like alendronate (Fosamax) or zoledronate (Reclast), a SERM like raloxifene (Evista), or a newer drug like denosumab (Prolia), review this approach with your doctor. All have side effects, although most are uncommon. Whether you're taking osteoporosis medication or not, exercise, a healthy diet, and staying away from tobacco are still good for your bones.