Drug for bone health reduces cancer, heart disease in older women
A drug used to treat osteoporosis and bone loss also appears to protect against heart disease and cancer, a major New
Zealand study has shown.
Researchers at the University of Auckland say the unexpected bonus benefits of the drug zoledronate, if confirmed by
further studies, could be as significant for older women’s health and wellbeing as the drug’s fracture-preventing
Fifty percent of women have a fracture between menopause and the time of death, and 80 percent of these fractures occur
in women with osteopenia, a less severe but more common form of bone loss than osteoporosis. One out of six women will
have osteopenia at age 55, jumping to half of all women by age 75.
Zoledronate, a long-acting bisphosphonate, is commonly prescribed for osteoporosis. It works on the cells that break
down bone called osteoclasts, which become overactive after menopause, causing an increased rate of bone loss.
Previous research had shown that zoledronate prevents factures in women with osteoporosis. But the University of
Auckland researchers wanted to see if it also prevented fractures in women with osteopenia.
Distinguished Professor Ian Reid and Dr Anne Horne carried out a six-year, double-blind clinical trial of 2000 women
aged 65 years and older with osteopenia. Half received four infusions of zoledronate at 18-month intervals, the other
half received inactive infusions.
The trial’s main findings, published late last year in the high-ranking New England Journal of Medicine, represent a game-changer for fracture prevention: giving zoledronate to older women with osteopenia reduced fractures
by between 35 and 50 per cent, depending on the type of fracture. It also ultimately halted the progression to
Already, this finding has prompted a global rethink in how to prevent fractures in older women.
Unexpectedly, analysis also revealed that taking zoledronate reduced women’s chances of having a heart attack, or
getting cancer by about a third. The researchers delved deeper into these findings and published a new paper in October
in the Journal of Bone and Mineral Research.
Says Dr Horne, a research fellow in the School of Medicine, “We know that some cancers spread to bone early in their
course, so having zoledronate coating the bones may prevent these cancer cells attaching to bone and establishing
themselves there. We also think that zoledronate may bind to the calcium in the walls of blood vessels, stabilising them
and preventing the progression of arterial wall damage so that people suffer less heart attacks.”
Distinguished Professor Reid says, “These extra effects of zoledronate, if borne out by future research, could have as
great – or even greater – impact on older women’s health as fracture prevention. We now need studies specifically
designed to test them.”
The Auckland clinical trial was funded by the New Zealand Health Research Council, which awarded the researchers its
prestigious Liley Medal this month for their significant medical breakthrough.