Reclast: The Miracle Oral Bisphosphonate Alternative?
Let’s face it. When news breaks of an osteoporosis drug discovery that increases bone strength and reduces fractures in the hip, spine, wrist, leg, and rib, the medical establishment listens… and prescribes.1
Add to this the convenience of a once-yearly 15 minute intravenous infusion, and it seems like an osteoporosis treatment dream come true.
The drug I’m referring to is Reclast (zoledronic acid), marketed as Aclasta outside of the U.S.
Reclast is a recently approved bisphosphonate manufactured by pharmaceutical giant Novartis, and is portrayed as the magic osteoporosis and osteopenia solution.
It was developed as an alternative to oral bisphosphonates, such as Fosamax (alendronate), Boniva (ibandronate), and Actonel (risedronate), which have a long list of undesirable side-effects.
Persistent gastric disorders such as heartburn, nausea, and flatulence are the most common, making it difficult to follow the oral drug regimen. In fact, studies confirm a dismal and suboptimal rate of compliance for bisphosphonates.2 Based on a survey conducted by the International Osteoporosis Foundation, “up to 60% of patients who take a once-weekly bisphosphonate and nearly 80% who take a once-daily bisphosphonate discontinue treatment within a year.”3 So – at least in the eyes of Big Pharma – an intravenous infusion is a logical alternative to pills.
The “Solution” Brings New Problems
Unfortunately, the “solution” to circumvent undesirable side effects with the purpose of increasing compliance, brings about new problems – and they are quite undesirable, to say the least. In other words, in exchange for the often persistent and ultimately dangerous digestive problems caused by oral bisphosphonates, patients could be subject to other nasty symptoms after a Reclast infusion. (If you haven’t yet, check out my blog post titled “Alert: Bisphosphonates Double the Risk of Esophageal Cancer”.)
Here is a partial list of the most common side effects of Reclast:
- Muscle, joint, and bone pain
- Flu-like symptoms
The Devastation of Osteonecrosis of the Jaw
But none of the above compare to the most damaging negative consequence of Reclast: the dreaded and ultimately virtually incurable Osteonecrosis of the Jaw (ONJ). Also known as dead jaw, ONJ is characterized by the inability of the jaw to heal following dental trauma or surgery. The jawbone tissue becomes infected and eventually dies. It is a very painful condition, leading to exposed bone and disfigurement.
Unfortunately, the treatment of ONJ is most often an unsuccessful challenge. According to a study conducted by the Department of Oral and Maxillofacial Surgery at Sheba Medical Center in Israel, there is only an 18% chance that ONJ will completely heal and a 52% chance that it will only partially heal with long-term antibiotic therapy.4 And the researchers found “no association between ONJ and diabetes, steroid and antiangiogenic treatment, or underlying periodontal disease.” The author’s conclusion is that “solutions for decreasing morbidity and poor outcome of ONJ remain elusive.”
In all fairness, the majority of the reported ONJ cases involved the use of a larger dose of zoledronic acid for the treatment of various cancers. So the drug called Zometa, also by Novartis, seems to ranks first, with the most reported cases of ONJ. But some studies show numbers where intravenous osteoporosis treatment caught up with ONJ diagnosis for certain types of cancer therapies.
For example, in a review of 19 ONJ bisphosphonate-related cases, 11 patients were treated for breast cancer, four patients for multiple myeloma, and also four cases for osteoporosis.5 Study authors describe ONJ as a “rare, but morbid condition.” Indeed, its symptoms are quite catastrophic, and include:
- Pain, swelling, and/or infection of the gums
- Loosening of teeth
- Poor healing of gums
- Numbness or the feeling of heaviness in the jaw
- Partial or complete loss of the jaw bone
Risk vs. Reward
In view of these awful drug side effects, when you are faced with decisions about your bone health, it is critical you take a step back and look at all your options. A magical once-yearly infusion might sound tempting, but let’s not lose sight of the “What Ifs”.
In the end, Reclast is much like other bisphosphonates. It alters normal bone metabolism and sacrifices long-term results for temporary benefits. And worse yet, it does so by stopping the production of osteoclasts necessary for future osteoblast production and bone remodeling. For a more whimsical look at how bones renew themselves, be sure to check out: “How Your Bones Renew Themselves: An Inside Look”.
In light of this, that’s why I always recommend natural solutions that build your bones in harmony with your body.
Don’t go one more day without rebuilding your bones: If you haven’t yet, get the free Natural Bone Building Handbook as my gift to you and discover how simple it is to increase your bone density without dangerous side-effects. Then for detailed guidance every step of the way, try the Save Our Bones Program to accelerate your bone growth.
Stay natural and drug-free!
1Black D, Delmas, S, Eastell R et al for the HORIZON Pivotal Fracture Trial. Once-yearly Zoledronic Acid for treatment of postmenopausal osteoporosis. NEJM 2007; 356(18):1809-22.
2Cramer JA et al. A systematic review of persistence and compliance with bisphosphonates for osteoporosis. Osteoporosis International 2007. Volume 18, Number 8, 1023-1031.
3Navid D. The Adherence Gap: Why Osteoporosis Patients Don’t Continue With Treatment. International Osteoporosis Foundation April 2005.
4Lazarovici TS et al. Bisphosphonate-related osteonecrosis of the jaws: a single center study of 101 patients. J Oral Maxillofac Surg. 2009 Apr; 67(4):850-5.
5Gill SB, et al. Bisphosphonate-related osteonecrosis of the mandible and maxilla: clinical and imaging features. J Comput Assist Tomogr. 2009 May-Jun; 33(3): 449-54.