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The study was sponsored by Merck and Novartis. Several authors work for the companies, and others consult for them or other makers of osteoporosis treatments.
Other reasons the study cannot completely rule out risk is that not many participants took the drugs longer than three years and many took a lower dose of Fosamax than is commonly used now, Dr. Elizabeth Shane of Columbia University writes in an editorial in the journal.
Still, the results show that "many more common and equally devastating hip fractures are prevented by bisphosphonates than are potentially caused by the drugs," she concludes.
Shane is co-leader of an expert panel for the American Society for Bone and Mineral Research that is evaluating the risk of these unusual fractures. Her university has received research grants from drugmakers but she has no personal financial ties to any.
The safety of bisphosphonates may take on even more interest in the future: Two recent studies hint that these drugs might help prevent breast cancer. The cancer studies are not definitive -- better ones are under way now, and should give an answer in a year or two. Any safety concerns could dampen enthusiasm for wider use of this class of drugs.
On the Net:
New England Journal: http://www.nejm.org/
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