BMJ  2008;336:126-129 (19 January), doi:10.1136/bmj.39435.656250.AD

Analysis

Drugs for pre-osteoporosis: prevention or disease mongering?

¹ Iberoamerican Cochrane Center, Department of Clinical Epidemiology and Public Health, Hospital de Sant Pau (Universidad Autónoma de Barcelona), 08041, Barcelona, Spain, ² Servicio Madrileño de Salud, Madrid, Spain, ³ Department of Clinical Epidemiology and Biostatistics and Department of Medicine, McMaster University Faculty of Health Sciences, Hamilton, ON, Canada, ⁴ Faculty of Health, University of Newcastle, Callaghan, New South Wales, Australia

After looking at data used to support treatment of women with slightly lowered bone mineral density, Pablo Alonso-Coello and colleagues argue thatproponents have overstated the benefits and underplayed the harms

The first 150 words of the full text of this article appear below.

Osteoporosis is a controversial condition. An informal global alliance of drug companies, doctors, and sponsored advocacy groups portray and promote osteoporosis as a silent but deadly epidemic bringing misery to tens of millions of postmenopausal women.¹ For others, less entwined with the drug industry, that promotion represents a classic case of disease mongering—a risk factor has been transformed into a medical disease in order to sell tests and drugs to relatively healthy women.² Now the size of the osteoporosis market seems set to greatly expand, as the push begins to treat women with pre-osteoporosis. These are women who are apparently at risk of being at risk, a condition known as osteopenia that is claimed to affect more than half of all white postmenopausal women in the United States.³ We examine the evidence from four post-hoc analyses of trials of osteoporosis drugs that is claimed to support this move.

Expanding an already controversial condition

In 1994 . . . [Full text of this article]

Treating those at risk of being at risk?

Reanalysis: science in the service of marketing?

Exaggerating benefits

Playing down side effects

Potential conflicts of interest

Where to from here?

Summary points

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Related Articles

Absolute risk please

Fiona Godlee
BMJ 2008 336: 0. [Extract] [Full Text]

Shifting the focus in fracture prevention from osteoporosis to falls

Teppo L N Järvinen, Harri Sievänen, Karim M Khan, Ari Heinonen, and Pekka Kannus
BMJ 2008 336: 124-126. [Extract] [Full Text] [PDF]

Multifactorial assessment and targeted intervention for preventing falls and injuries among older people in community and emergency care settings: systematic review and meta-analysis

S Gates, J D Fisher, M W Cooke, Y H Carter, and S E Lamb
BMJ 2008 336: 130-133. [Abstract] [Full Text] [PDF]

Selling sickness: the pharmaceutical industry and disease mongering • Commentary: Medicalisation of risk factors

Ray Moynihan, Iona Heath, David Henry, and Peter C Gøtzsche
BMJ 2002 324: 886-891. [Extract] [Full Text] [PDF]

Meta-analysis of how well measures of bone mineral density predict occurrence of osteoporotic fractures

Deborah Marshall, Olof Johnell, and Hans Wedel
BMJ 1996 312: 1254-1259. [Abstract] [Full Text]

This article has been cited by other articles:

• Brown, S. (2008). Combined hormone therapy 'increases risk of lobular breast cancer after just three years of use'. Menopause Int 14: 2-4 [Full text]  

Rapid Responses:

Read all Rapid Responses

Drugs for pre-osteoporosis: an example of prejudice-based medicine?

Juliet E Compston, et al.
bmj.com, 10 Feb 2008 [Full text]

Osteoporosis is not a controversial condition

Ego Seeman, et al.
bmj.com, 15 Feb 2008 [Full text]

More disease mongering?

Onisillos Sekkides
bmj.com, 20 Feb 2008 [Full text]

Osteoporosis is a disease which can be treated

Rene RIZZOLI, et al.
bmj.com, 28 Feb 2008 [Full text]

Drugs for pre-osteoporosis: prevention or disease mongering?

Pablo Alonso-Coello, et al.
bmj.com, 6 Mar 2008 [Full text]

Drugs for pre-osteoporosis: prevention or disease mongering?

Ray Moynihan
bmj.com, 6 Mar 2008 [Full text]

Excellent Paper

Robert Marx, et al.
bmj.com, 7 Mar 2008 [Full text]