The Bone Rx - Cancer Link

Esophageal cancer linked to bisphosphonate use

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) A class of drugs known as bisphosphonates has received some bad press lately. These drugs, used to strengthen bones and treat bone metastasis, are linked with a number of health conditions. The association with cancer has expanded.

The link between bisphosphonates and esophageal cancer is greater than previously believed.

"Learn the side effects of all medications you're taking."

The first bisphosphonate - Fosamax (alendronate) - was approved by the U.S. Food & Drug Administration (FDA) in 2005. Four years later, the FDA reported 23 cases of esopohageal cancer in people who had been taking the drug for two years. 

To explore the association further, Beatrice J. Edwards, MD of the Northwestern University Feinberg School of Medicine, led a review of the FDA Adverse Event Reporting System (FDA AERS) between 1996-2010.

Investigators searched for esophageal cancer combined with all bisphosphonate drug names. They discovered 128 cases of bisphosphonate-associated esophageal cancer.

Fosamax was used in 96 of these cases.

Authors write, "Our analysis of FDA AERS identifies a larger number of cases of esophageal cancer than previously described, and a significant safety signal with alendronate use."

They conclude that oral forms of bisphosphonates are not recommended for patients who have what's known as mucosal abnormalities (inflammation of mucous membrane of the stomach).

Adam Brufsky, MD, PhD, professor of medicine at the University of Pittsburgh School of Medicine, told dailyRx, "This means we have to use even more care in deciding who should receive bisphosphonates and for how long."

It should be noted that millions of prescriptions have been written for bisphosphonates since 1995. That said, 123 cases makes the absolute risks of developing esophageal cancer extremely small.

Also included in this class, are medications sold under the brand names Actonel" data-scaytid="26">Actonel (risedronate), Boniva (ibandronate), Reclast (zoledronic acid), Zometa (zoledronic acid).

Other adverse effects of these drugs include mineral metaboloism disorders, stomach problems, including inflammation of the lining of the esophagus, kidney issues and jaw bone loss.

Findings from this current study were presented at the 48th Annual Meeting of the American Society of Clinical Oncology (ASCO).

Before publication in a peer-reviewed journal, research presented at conferences is considered preliminary.

Dr. Edwards disclosed a financial relationship with the following pharmaceutical companies: Amgen, Eli Lilly and Warner Chilcott

Reviewed by: 
Review Date: 
June 4, 2012
Last Updated:
June 5, 2012