May 11, 2005 07:00 ET

First Ranking of Big Cities Most at Risk for Osteoporosis

Pittsburgh Found to Be "America's Most Fragile City"

NEW YORK, NY -- (MARKET WIRE) -- May 11, 2005 -- Big cities where residents often pride themselves on being tough -- from New York to Chicago to Pittsburgh -- also rank high among the nation's most fragile, according to the Boniva® (ibandronate sodium) Fragile Cities Index that analyzed postmenopausal osteoporosis risk in the country's largest metropolitan areas.

This first city-by-city analysis was undertaken after a recent Surgeon General's Report on Bone Health elevated osteoporosis to a national health threat on par with smoking and obesity.(1) Despite the health threat, approximately one-half to two-thirds of patients quit taking their osteoporosis medication within a year, forgoing bone-strengthening benefits that build over time.(2)

According to the Boniva Fragile Cities Index, the "Steel City" of Pittsburgh ranked No. 1 for osteoporosis risk in women. Following closely behind were Tampa, Miami, Cleveland and New York, with Boston, Philadelphia, Baltimore, Orlando and Hartford rounding out the top ten.(3)

"Effective osteoporosis management is important for all patients -- for those living in the most Fragile Cities and in other areas of the country too," said Dr. John Sunyecz, a menopause specialist in Pittsburgh who sees many osteoporosis patients. "To minimize the risk of fractures due to osteoporosis, patients should get adequate calcium and vitamin D, exercise and stay on their medication, as directed by their healthcare provider."

The Boniva Fragile Cities Index was sponsored by Roche and GlaxoSmithKline, which co-promote once-monthly Boniva 150 mg Tablets, a recently approved prescription medicine for the treatment of osteoporosis. The Index found that the nation's most fragile big cities are:(3)

 1. Pittsburgh           11. Phoenix                  21. Indianapolis
 2. Tampa                12. St. Louis                22. Dallas
 3. Miami                13. Detroit                  23. San Diego
 4. Cleveland            14. Charlotte                24. Los Angeles
 5. New York             15. Washington, D.C.         25. Denver
 6. Boston               16. Sacramento               26. Raleigh-Durham
 7. Philadelphia         17. Chicago                  27. Houston
 8. Baltimore            18. San Francisco            28. Minneapolis
 9. Orlando              19. Portland, OR             29. Atlanta
10. Hartford             20. Seattle                  30. Salt Lake City
Pittsburgh's No. 1 ranking prompted support and encouragement from its mayor Tom Murphy, who declared Wednesday, May 11, 2005, Better Bone Health Day to fortify residents' resolve to keep on track with their bone-building treatment.

"We want women in Pittsburgh -- and other Fragile Cities -- to remain healthy and independent so they can enjoy all their city has to offer," said Mayor Murphy. "I applaud those citizens who are doing the right things to maintain their bone health."

Staying the Course

The Surgeon General recognizes that many patients stop taking their osteoporosis medications, and suggests numerous strategies for improvement, including simplifying and organizing treatment. Additionally, patients are encouraged to follow these simple tips:

1. Develop a support system. Friends and family can help motivate you to treat your osteoporosis the right way.

2. Know your options. Medical treatment choices have changed over the years and you should learn more about which medications slow bone loss, reduce fracture risk and increase bone density. For example, once-monthly oral Boniva, the first and only once-a-month medicine for the treatment of postmenopausal osteoporosis, is now available in pharmacies.

3. Talk to your doctor about treatment options. Since osteoporosis is a silent disease and your bones won't necessarily "feel" stronger, you may wonder if your medication is making a difference. Keep your doctor informed about your efforts to stay on treatment and ask for an update on your condition.

The Boniva® Fragile Cities Index

The Boniva Fragile Cities Index tracked the risk of osteoporosis based on the percentage of the metro area population that is female age 50 or older, doctor visits (for osteoporosis, osteopenia and fractures) for women age 50 or older, and data from the U.S. Census and the Centers for Disease Control and Prevention on factors that increase osteoporosis risk -- such as being Caucasian and a cigarette smoker. The Index was based on a weighted average of the above risk factors. Metro areas were selected based on population (minimum of 2.5 million population), and geographic borders were defined by DMA, or designated market area.(3) The Index was developed and administered for Roche and GlaxoSmithKline by Surveillance Data Inc., an independent research firm.

About Osteoporosis

Osteoporosis (porous bones) is a disease in which bones become brittle and more likely to break. In the U.S. today, ten million individuals, eight million of whom are women, are estimated to already have osteoporosis, and almost 34 million more are estimated to have low bone mass (osteopenia)(4), placing them at increased risk for osteoporosis. Unfortunately, the prevalence of osteoporosis is growing, especially as the number of postmenopausal women in the population continues to rise. Together, osteoporosis and osteopenia are expected to affect an estimated 52 million women and men age 50 and older by 2010, and 61 million by 2020.(4) Direct medical costs of osteoporosis total nearly $18 billion in the U.S. each year.(4)

About Once-Monthly Oral Boniva

With once-monthly Boniva, an effective bisphosphonate, patients take 12 tablets a year versus 52 required with current weekly bisphosphonate treatments. Boniva is indicated for the treatment and prevention of osteoporosis in postmenopausal women. Once-monthly Boniva is a small, film-coated, easy-to-swallow tablet dosed at 150 mg. Patients should take once-monthly Boniva with plain water on an empty stomach upon rising in the morning. They should remain upright and avoid food, drink and other medications for at least 60 minutes.

Patients who take Boniva are eligible to sign up for MyBONIVA, a patient relationship program designed to help enhance compliance (taking therapy as directed) and persistence (staying on therapy) with this unique once-monthly regimen. For more information on this program call 1-800-4BONIVA.

Important Safety Information

Boniva is contraindicated in patients unable to stand or sit upright for at least 60 minutes or with uncorrected hypocalcemia. Boniva is contraindicated in patients with known hypersensitivity to Boniva or any of its components. Hypocalcemia and other disturbances of bone and mineral metabolism should be effectively treated before starting therapy. Adequate intake of calcium and vitamin D is important in all patients. Boniva is not recommended for use in patients with severe renal impairment (creatinine clearance < 30 mL/min). Rarely, patients have reported severe bone, joint and/or muscle pain after taking bisphosphonate therapy for osteoporosis. Additionally, osteonecrosis of the jaw has rarely been reported in patients treated with bisphosphonates; most cases have been in cancer patients undergoing dental procedures.

Boniva, like other bisphosphonates administered orally, may cause upper gastrointestinal disorders such as dysphagia, esophagitis, and esophageal or gastric ulcer. As aspirin, NSAIDs, and bisphosphonates are associated with GI irritation, caution should be exercised when used concomitantly. The overall adverse events profile of Boniva 2.5 mg daily was similar to that of placebo. In a 1-year study comparing Boniva 150 mg once-monthly and Boniva 2.5 mg daily, the overall incidence of adverse events with the 2 dosing regimens was similar. The most commonly reported adverse events regardless of causality were abdominal pain (Boniva 150 mg 7.8% vs Boniva 2.5 mg 5.3%), hypertension (6.3% vs 7.3%), dyspepsia (5.6% vs 7.1%), arthralgia (5.6% vs 3.5%), nausea (5.1% vs 4.8%) and diarrhea (5.1% vs 4.1%).

For more information about Fragile Cities and for complete prescribing information for Boniva, go to

2. Data on file. (Ref. 161-011), Hoffman-La Roche, Inc., Nutley, NJ.
3. Surveillance data Inc., Fragile Cities Index: Ranking of Top 30 Big
   Cities.  Plymouth, PA: March 2005.
4. America's Bone Health: The State of Osteoporosis and Low Bone Mass in
   Our Nation.  The National Osteoporosis Foundation: February 2002.

Contact Information

  • Contacts:

    Barbara Goldberg
    (212) 229-8419

    Terry Hurley
    (973) 562-2882

    Veronica Grosshandler
    (919) 483-2839