No one osteoporosis drug better than another, says AHRQ report

Direct comparisons between osteoporosis therapies have not shown bisphosphonates to be superior to other therapies in preventing bone fractures, according to a new report from the Agency for Healthcare Research and Quality (AHRQ). In addition, not enough evidence exists to establish whether bisphosphonates are more effective than estrogen, raloxifene (Evista, Lilly), or calcitonin. However, some agents are associated with strokes, blood clots, or uterine bleeding. Calcitonin, parathyroid hormone, estrogen, and five bisphosphonates—alendronate (Fosamax, Merck), etidronate, ibandronate (Boniva, Roche), risedronate, and zoledronic acid (Zometa, Novartis)—were all found to be effective for preventing spinal fractures. Alendronate, risedronate, zoledronic acid, estrogen, and parathyroid hormone were efficacious at preventing hip and other non-spinal fractures. The report also found the efficacy of calcium and vitamin D varies according to dosing, how often they are taken, and whether the patient is at high risk for fracture. Comparative Effectiveness of Treatments to Prevent Fractures in Men and Women with Low Bone Density or Osteoporosis was based on evidence found in 101 published articles and can be accessed online at