What affect do these drugs have on existing bone spurs? It seems that a drug designed to increase bone mass wouldn't be able to avoid also stimulating unwanted osteophytes (bone spurs). The vertebral bone spurs are a major cause of low back pain in people with osteoarthritis. Could the widespread joint pain that some people experience on these drugs be related to stimulation of osteophyte bone cells? And are osteophyte cells and normal bone cells the same?
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Q: Does Fosamax/Actonel/Boniva cause bone spur growth?
Answers (1)
5/21/09 10:47am
Hi airy, welcome to the community and thanks for your question. Bisphosphonates maybe used for OA, because of the effect they have on bone and the remoldeling process. These drugs slow subchondral bone remodeling which is important in osteophyte production. Here's a link about it, from the Annals of the Rheumatic Diseases 2008. Also see the article: "The Effect of Alendronate on Progression of Spinal Osteophytes and Disc-Space Narrowing (T Neogi, et al)." referenced at the bottom of the page. You can read the abstract of it but not the entire article.
Good luck and if you have any other questions don't hesitate to ask.
5/21/09 4:49pm
Hi airy: First let's start with the words, maybe that will help? Osteophyte=Medical term for bone spur. Subchondral=layer of bone just below the cartilidge. Sclerosis=thickening; of the bone below the cartilidge.
In the article, they are saying that they found bisphosphonates help to delay the development or progress of "...subchondral bone remodelling, believed important by some in osteophyte formation and subchondral sclerosis." So, in their hypothesis, bisphosphonates (Fosamax, Actonel, Boniva and Reclast) help to delay the developement of osteophytes (bone spurs); so Bisphosphonates wouldn't cause bone spurs or make them worse, it should help to minimize them. In the second article they mention a second action that bisphosphonates have and that is to prevent or slow the DSN (disc space narrowing) within the spine that occurs from osteoarthritis. There was also a mention about pain reduction from bisphosphonates, but I don't have the exact wording in front of me.
Does this make sense? Simply put, no bisphosphonate shouldn't cause or make bone spurs worse. The added benefit is that bisphosphonates helped to prevent the disc space narrowing, of the spine, and the thickening of the bone below the cartilidge, seen in OA, and other disc related spinal problems.
Check all of this with your Dr. to be sure he or she agrees with this study.
Let me know if this clears it up.
5/21/09 8:52pm
Yes this does help very much! Thank you for taking the extra time to further explain these concepts. I think I now have enough info to talk more easily with my doctor about my situation. Thanks!
5/21/09 11:37pm
Hi airy, your very welcome!! Glad to help any time, just ask if you need to. It always helps to have a better understanding of our individual medical needs before we talk to our Drs., that way the appointment is much more productive, and you hopefully leave the office understanding the issues that you face, and if you don't understand something, politely but assertively ask for the explanation before you leave. This is what advocating for ourselves is all about.
Pam
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Thanks Pam. I couldn't read enough of either to really find out much. Let me rephrase my question: Will taking bisphosphonates for osteopenia (-1.1 t-score spine) cause an increase in growth of my lumbar vertebral bone spurs? It would be bad cure to increase my bone strength if the trade-off were that my arthritic bone spurs got worse...
I think you are saying that osteophytes are subchondral bone, and the bisphosphonates doon't target that type? Thanks for any further help you could provide.