COVID-19 Vaccination and Osteoporosis Drug Therapy

Dr. Aliya Khan, Dr. Heather Frame, Dr. Claudia Gagnon, Dr. Rowena Ridout, Dr. Lianne Tile and Dr. Sandra Kim Recommendations from Osteoporosis Canada Rapid Response Team Osteoporosis is a chronic condition which requires consistent pharmacologic intervention. There is currently no evidence that osteoporosis therapy increases the risk or the severity of COVID-19 infections. With the [...]

Celiac Disease and Bone Health

Dr. Aliya Khan, Dr. Heather Frame,  Dr. Claudia Gagnon,  Dr. Rowena Ridout , Dr. Lianne Tile,  Professor Wendy Ward,  Dr. Sandra Kim Recently Duerksen and colleagues published on fracture risk assessment in celiac disease – a registry-based cohort study (1).  This study evaluated the incidence of major osteoporotic fractures (hip, spine, forearm and humerus) in [...]

Vitamin D and Potential Impact on the Severity of COVID

By Aliya Khan MD, FRCPC, FACP, FACE, Rowena Ridout MD FRCPC, Heather Frame MD FCFP, Claudia Gagnon MD, Lianne Tile MD MEd FRCPC, Wendy Ward M.Sc., Ph.D., David A. Hanley, MD, FRCPC, Sandra Kim MD, FRCPC Previously we have described the role of vitamin D in optimizing bone health and treatment strategies for osteoporosis. In [...]

New Study Associates Intake of Dairy Milk with Greater Risk of Breast Cancer

Dairy, soy, and risk of breast cancer: those confounded milks Dairy, soy, and risk of breast cancer: those confounded milks Gary E Fraser, Karen Jaceldo-Siegl, Michael Orlich, Andrew Mashchak, Rawiwan Sirirat, Synnove Knutsen International Journal of Epidemiology, 25 February 2020 Recent media headlines point to a study suggesting that women who drink as little as one cup /250 ml [...]

Eating for Bone Health with the New Canada’s Food Guide

The new Canada’s Food Guide was released on Tuesday Jan 22nd. It is a modern approach to promoting healthy eating, making healthier eating choices easier for all Canadians. This new food guide focuses on what to eat and how to eat. It also includes updated recommendations on saturated fat, sodium, and sugars. The food guide [...]

Increased Risk of Vertebral Fracture After Stopping Denosumab

Denosumab (Prolia) has been shown to reduce the risk of fracture in postmenopausal women and men ≥50 years old with osteoporosis. It has also been approved for steroid induced bone loss. Individuals who were in the FREEDOM study, which evaluated denosumab in comparison to placebo, were followed, and those who stopped denosumab had a subsequent [...]

Vitamin D and effects on Fractures, Falls and Bone Mineral Density

The recent study by Bolland and colleagues published in the Lancet Diabetes Endocrinology (Oct 4, 2018) is an updated meta-analysis that evaluated the effects of vitamin D supplementation on fractures, falls and bone mineral density (BMD) in adults. This study analyzed the pooled findings of 81 randomized control trials, collectively involving more than 50,000 participants. [...]

Long-term use of bisphosphonates increases the risk of fractures in older women

Bisphosphonate therapy - long term use Recently a study published by Drieling et al in JAGS 2017 described the results of a cohort study of 5120 older women with an average age of 80 yrs and at high fracture risk . This observational study from the Womens Health Initiative included 5120 women who had been [...]

Calcium and Cardiovascular Disease

The National Osteoporosis Foundation and the American Society for Preventive Cardiology formed an expert panel and completed a detailed review of all published research evaluating the effects of calcium intake from food sources and or supplements with or without vitamin D on the risk of heart attacks, strokes and death. The results of that review [...]

High dose vitamin D supplementation does not improve muscle function and may increase the risk of falls.

Vitamin D supplementation has recently been evaluated in Switzerland in a small 1 year randomized clinical trial by Bischoff-Ferrari and colleagues. This study compared the effects of two “high” doses of vitamin D (60,000 IU of vitamin D3 per month or 24,000 IU vitamin D3 plus 300 mg of calcifediol per month) to a standard [...]

Calcium Intake and Effect on Bone Health and Fracture Risk Reduction

Osteoporosis Canada continues to advise Canadians to meet the Institute of Medicine established daily calcium requirement of 1000 -1200 mg, from dietary sources preferably, and to use supplements if this is not possible (in the form of calcium carbonate or calcium citrate). Every cell in our body requires calcium in order to function normally and [...]

Swedish Milk Study

On Oct 28, 2014 a study on milk was published by Dr. Michaelsson of Uppsala University in Sweden. This study claims that high milk intake was associated with an increased rate of death. In this study, over 61,000 women (ages 39-74) and over 45,000 men (ages 45-79) were followed for just over 11 years during [...]

Strontium Ranelate (Protelos) and Osteoporosis

Strontium ranelate (Protelos) is a drug approved for the treatment of osteoporosis in Europe, but not in Canada. It is effective in reducing fractures . Recently the European Medicines Agency has completed their review regarding the safety of this drug and recommend that strontium ranelate not be taken by patients with heart or circulatory problems. [...]

Vitamin D and Effects on BMD

In 15 of the studies the mean baseline vitamin D level was over 50 nmol/l which is higher than values seen in a significant number of Canadian men and women particularly during the winter months. In 1 study of adult Canadians who were not using vitamin D supplements, 34% had evidence of vitamin D insufficiency [...]

The Potential Link Between BioSil ™ (Orthosilicic Acid) and Bone Health

In 2008 the results of a small study were published reporting on the use of choline stabilized orthosilicic acid a form of silicon, or placebo in 184 women with low bone density. The women also received 1,000 mg of calcium in addition to vitamin D3 supplements. At 12 months 136 women had completed the study. [...]

The Potential Cancer Risk with Long-Term Use of Calcitonin-containing Drugs

Prepared and reviewed by members of the Scientific Advisory Council of Osteoporosis Canada – Updated August 6, 2013 Calcitonin is a hormone found naturally in our bodies. A synthetic form of calcitonin (Miacalcin NS® or generic calcitonin) is used in a nasal spray It decreases the function of the osteoclast (bone-eroding cells) and can decrease [...]

Calcium Supplements and Risk of Heart Disease

Prepared and reviewed by members of the Scientific Advisory Council of Osteoporosis Canada Calcium is essential for the achievement and maintenance of normal bone health. The current daily requirements for elemental calcium are approximately 1200 mg daily preferably from dietary sources and if this is not possible then supplements are recommended ideally in the form [...]

Prolia and Atypical Fractures

An atypical femoral fracture is an uncommon type of hip fracture which has been associated with long term use of certain osteoporosis medications. This type of hip fracture affects the shaft of the femur bone and is often preceded by thigh or groin pain which may occur for several weeks or months before the fracture. [...]

Bisphosphonates and atypical fractures

We are aware of recent media reports that long-term use of bisphosphonates for osteoporosis (sold under the names of Fosamax [alendronate] and Actonel [risedronate]) may be associated with the occurrence of unusual fractures, most commonly reported to affect the thigh bone. It is a fact that all medications have risks associated with them. Osteoporosis medications [...]

New Study Confirms that Potential Side Effect of Bisphosphonate Therapy on the Eyes is Very Rare

A recently released Canadian research study confirms what has been shown in past preliminary studies; - inflammation of the eye as a possible side effect of bisphosphonate therapy is very rare. Bisphosphonates include Alendronate (Fosamax), Risedronate (Actonel), Etidronate (Didrocal) and Zoledronic Acid (Aclasta). In this new study to evaluate the risk of inflammation of the [...]

Osteoporosis Canada statement on esophageal cancer and bisphosphonate use

No link between the use of bisphosphonates and the risk of cancer of the esophagus or stomach has also been noted in a recent large study from the UK. This study evaluated the risk of cancer in 41,826 people using bisphosphonates and a similar number not on therapy. An increase in the risk of cancer [...]

High-dose oral vitamin D and falls and fractures

A recent study, Annual High-Dose Oral Vitamin D and Falls and Fractures in Older Women, published in the Journal of the American Medical Association (JAMA), showed that a single large dose of vitamin D, given once yearly to a group of elderly patients, actually increased their risk of falls and fractures. The study recruited 2258 [...]

The reported association between use of zoledronic acid (Aclasta) and renal impairment

We are aware of a recent Food and Drug Administration (FDA) publication that reports on the association between use of zoledronic acid (Aclasta) and renal impairment. 1 We recognize that you might find this report concerning and it may raise questions about your care. Osteoporosis Canada takes your concerns seriously and we will continue to [...]

Fosamax and atrial fibrillation: Osteoporosis Canada responds

We are aware of recent press reports concerning the link between two drugs for osteoporosis (alendronate and zoledronate) and the occurrence of a heart condition characterized by an irregular heart beat (atrial fibrillation). We recognize that you might find these reports concerning. Osteoporosis Canada takes your concerns seriously and we will continue to be vigilant [...]

Osteonecrosis & Bisphosphonate position statement

Prepared and reviewed by members of the Scientific Advisory Council of Osteoporosis Canada • Dr. Rick Adachi, Rheumatologist, McMaster University • Dr. Robert Josse, Endocrinologist, University of Toronto • Dr. Aliya Khan, MD, FRCPC, FACP, FACE, McMaster University • Dr. Heather McDonald-Blumer, Rheumatologist, University of Toronto • Dr. Suzanne Morin, Internal Medicine, McGill University • [...]

Osteonecrosis of the Jaw

A number of recent medical reports have linked high doses of intravenous bisphosphonates given to patients for the treatment of multiple myeloma, breast cancer or other cancers, to a condition known as Osteonecrosis of the Jaw (ONJ). Osteonecrosis of the Jaw typically appears as an area of exposed bone in the upper and/or lower jaw [...]