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Ineffective osteoporosis treatments still promoted

Ineffective osteoporosis treatments still promoted

Two Auckland clinical researchers have called for advocacy organisations and academics to abandon industry ties that promote the use of calcium and vitamin D supplements to prevent or treat osteoporosis.

In a paper just published in the British Medical Journal, the University of Auckland researchers, Associate Professors Andrew Grey and Mark Bolland, say that since 2002, evidence has emerged that these supplements do not reduce the risk of fracture and may result in harm.

By the end of 2010, 32 of 38 clinical trials of calcium and/or vitamin D had reported no benefit or harm.

“Despite this, many practice guidelines continue to recommend increasing calcium intake and/or the use of vitamin D supplements for managing osteoporosis,” says Dr Grey.

Calcium and Vitamin D supplements are very profitable, with global annual sales of calcium supplements in 2013 of about $6 billion, and of vitamin D in the USA alone in 2012 of $748 million.

“We investigated why these supplements are still being widely recommended, despite a substantial body of evidence that they are ineffective or harmful,” he says. “And we looked at the possibility that advocacy organisations, specialist societies and academics are part of the mechanism for resisting change.”

Drs Grey and Bolland found that, companies marketing calcium and vitamin D supplements (plus their lobby groups), companies marketing dairy products;, and companies selling kits for measuring vitamin D, all sponsor and influence the activities and policies of prominent osteoporosis advocacy organizations.

These include the Europe-based International Osteoporosis Foundation and the USA-based National Osteoporosis Foundation.

“Such companies also sponsor medical societies and groups of academic experts in the osteoporosis field. These conflicts of interest are often not declared,” says Dr Grey.

In the paper, the authors also discussed the likelihood that academic conflicts of interest influence recommendations for calcium and vitamin D use, given the professional advantages that can accrue from persistence of the belief that the supplements are beneficial to bone health.

Grey and Bolland called for greater transparency in the payments from the supplements and food industry to health practitioners and academics, and for advocacy organizations and medical societies to sever financial ties to industry, as “disentangling industry from academia might improve the translation of evidence into practice”.


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