Boniva vs. Fosamax vs. Actonel

Discussion in 'Osteoporosis' started by Anonymous, Jul 18, 2007 at 11:33 AM.

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  1. Anonymous

    Anonymous Guest

    Anonymous Posts: n/a

    Re: Boniva vs. Fosamax vs. Actonel


    OK, let me straighten everyone out...

    Oral bisphosphonates (boniva, fosamax, actonel) are all extremely similar. Their ONLY function is to inhibit bone loss. This allows the body to then have a better balance on bone remodeling, which means it can naturally build bone, therefore improving bone health. Good bone health is what reduces fractures, & is dependent on much more than the drugs. You must have good levels of calcium & vitamin D as well, otherwise, the drugs will be of little benefit.

    Which is the best? The one each patient is most compliant with! We do know, however, that bisphosphonates are literally toxic to the esphogeal lining. This is why less exposure (less dosing) is safer, so my vote is clealy with once-monthly boniva. They all have similar numbers of pivotal trials. "Long term data" means nothing more than the length of time the drugs have been on the market. All have been on long enough to prove they are safe & effective. (Fosamax may be the most prescribed, but that's only because it has been on the market the longest, their company gives the highest rebates to the managed care companies, and because most doctors form habits & don't have osteoporosis high enough on their radar screen to care enough about changing their habits. Sad, I know).

    From a pure numbers perspective, fosamax & boniva are the best. Fosmax conducted a head-to-head trial with actonel & was proved statistically superior over actonel. Then, boniva conducted a head-to-head with fosamax & proved statistically equivalent to fosamax. Actonel is a good bisphosphonate, it's just that the mg strength is too low. Sorry actonel, the truth hurts.

    Regarding nonvertebral fracture's all VERY inconsistent & NOT required by the FDA for approval. Osteoporosis shows up first in the spine, therefore, the FDA requires drugs to prove efficacy in the spine ONLY. Fosamax was the only one to prove hip fracture reduction, but only by 1 fracture in 1 trial. In their other pivotal trial, they could not prove statistical significance. Actonel showed nonvertebral reductions in 1 trial, though not statistically significant hip data, and could not show nonvert in their 2nd trial. Boniva could not prove nonvert, but had a healthy patient population - they were not osteoporotic at the hip, so how do you show fracture protection when you're not at risk for fracture?) Even Forteo, strongly considered to be the best agent for osteoporosis therapy, could NOT show statistically significant hip fracture reduction!!!!

    Besides, all of the "fracture data" lies within the trials from the "daily doses" which are no longer used. The FDA allowed "bridging" studies based on bone mineral density ONLY, to prove "non-inferiority" to the new extended dose versions. So, fracture reduction cannot be claimed on the extended dose oral bisphosphonates, only implied fracture protection through improved bone health.

    Regarding IV bisphosphonates, reclast has best in class data, but also has significant safety issues. Boniva has an IV injection, which also has good bisphosphonate data, but with much fewer safety concerns, most importantly, NO cardiovascular side effects. So, to the 74 yo willing to accept possible don't have to worry about this with boniva injection. Did you have cardio issues before starting reclast? If you're "specialist" didn't give you boniva injection as an option, I would suggest getting a new specialist & then contacting a good lawyer if you develop cardio issues!

    Hope this clears things up out there! Dr Anonymous


    Check your data again. To say that the data backing Fosamax or Boniva is better than Actonel's data shows just how misguided you are about the facts.
    The first head-to-head trial, the so-called "FACT" trial was nothing more than a BMD study w/fractures measured only as a side affect. Guess what; there were more fractures in the alendronate group than the risedronate group. The second "FACT" trial was also a BMD study, only this time they set it up so that the side affect fracture total was fairly equal.

    Drugs that are supposed to prevent patients from fracturing should have FRACTURE PREVENTION as their primary endpoint, not some surrogate marker. Fosamax origionally had a wrist fracture indication but had it pulled because of lack of efficacy proved in FRACTURE PREVENTION.

    Then it gets even better. There have been studies showing that there are indeed differences among the bisphosphonates w/regard to the amount of time that the various drugs "stick to the bone". Some come off the bone quicker than others and spread to different sites compared to others. Their are also difference among the drugs concerning their affinity for certain receptors in the osteoclast and their ability to cause apoptosis.

    Check the headlines for current articles on long bone fractures w/Fosamax.
    Word is that Paul Miller, MD is close to publishing an article connecting long term (over five year) usage of alendronate(Fosamax) and non-traumatic radial fractures in the femurs of osteoporosis patients. Literature also has one case so far of this happening already in a Reclast patient.

    Who would take Boniva when it has much less data on protecting against non-vertebral fractures (including HIP), patients have to wait an extra half hour before eating breakfast, it generally has a higher co-pay and the pill itself is twice as big as the 150mg OAM Actonel?

    Their are differences.

    Really clearing things up.
  2. Anonymous

    Anonymous Guest

    You are all so sick in your mind, this is unbelievable: Now all of you selling boniva I want you to go on this site:
    you are selling fosamax? Here we go:
    actonel is dito!

    Now speaking of efficacy:
    Read this!

    Speaking of safety! There is only one that is safe and this is miacalcin or fortical which is the generic.

    calcitonin helps by the way also with pain and increased the quality of life!

    The future will be in the calcitonin, believe it or not ..
  3. Anonymous

    Anonymous Guest

    All this information about Boniva vs. Fosamax vs. Actonel would be much more convincing if those who are offering it (supposedly doctors?) could spell!
  4. Anonymous

    Anonymous Guest

    My feelings exactly!
  5. Anonymous

    Anonymous Guest

    What about just good ol' Calcium with D?
  6. Anonymous

    Anonymous Guest

    Thanks for the very helpful links. Better diet and exercise is best. Stay away from end up taking other pills to counter the side effects of the first ones !

  7. Anonymous

    Anonymous Guest

    OK, folks, I set here & read all of the stuff about Boniva, Fosamax & Actonel...I've always been very active. Walking, acrobics, weight lifing, drank milk. I had a probelm with calcium tablets a few years ago. They put my stomach into turmoil. So said, "oops" can't do that. Gyno put me on HRT (Estrace) to protect my bones. Well, I cracked a vertebrae Christmas morning helping make up a bed. Yes, I was lifting one side of a mattress when it happened. A bone density scan was done & yep, high risk of fracture. I started 150mg of Actonel ton Saturday morn. No probelm @ all, but Sunday, every bone in my body ached. I have been running fever of 101. Went to the doctor, no flu. Must be the Actonel. Then on Monday afternoon, the stomach problem started..Man, I think my insides are eating each other!! Have any of you experienced this? I need som feedback before taking another one...
  8. Anonymous

    Anonymous Guest

    To anonymous of 2/23/1010:
    The day after my first dose of Actonel, I had the same achy-all-over feeling that you had. I thought I was coming down with the flu, but then remembered reading in the Actonel literature that this may happen. The next month the achy feeling was a lot less & since the 3rd month, I haven't notices any side effects at all. (I've been on Actonel for just over a year.)

    I did not experience any stomach problems & maybe just a slight fever that first month.

    You've got to decide for yourself, but I'd give it another shot & see if the side effects lessen this month. Good Luck!
  9. lyoga55

    lyoga55 Guest

  10. Anonymous

    Anonymous Guest

    My mother is 73 and has been taking Boniva for only a few months. She has spinal fractures, osteopenia. Her calcium and D levels are fine. She is in intense back pain every day and has been so for 5 months. The only recourse they say is surgery to fuse two of her vertebra.

    She has been asking meover and over again to do online research for her on what is better? Boniva or Actonel? it's driving me crazy!!!! they all seem the same....
    She heard that the Boniva can cause serious jaw/bone damage so if you are having dental work it can be detrimental?

    So from what i have been reading in all of the blogs is that Boniva is fine. RIGHT?????

    - Concerned daughter
  11. Anonymous

    Anonymous Guest


    Talk to her doctor about it.

    She is a candidate for it because she has had previous fractures

    God Bless
  12. Anonymous

    Anonymous Guest

  13. Anonymous

    Anonymous Guest

    Having taken most, if not all of the drugs mentioned including Reclast, imagine my surprise when I broke my right femur two weeks ago tomorrow! I was turning right on a sidewalk outside my church when all of a sudden, I was on the sidewalk face first. My Orthopedist, who had been trying to diagnose unexplained acute pain in my right thigh and groin area for two months, attends my church and was by my side in seconds after my fall and in the OR within hours. After studying the MRI that had been done just a week and a half prior to the fall and the x-rays directly afterwards and consulting his partners to see if he had missed something, he asked some in depth questions about my meds because, as he said that bone should not have broken in that location (just below my hip) unless I had fallen from a roof or a tall ladder. After doing much research on the different meds, he came to the conclusion that that genre of meds made the bone brittle. Apparently I am one of a small percentage of people so affected, but I'm just saying be careful and research, not only the differences between that class of meds, but if you are at risk in another way as well. ABC did an interesting study a few years ago on Fosamax. Google it.