|November 2005 · Vol. 17, No. 11
UPDATE on OSTEOPOROSIS
New Developments that are Changing Patient Care
Preventing fragility fractures:
Effective drugs and doses
The latest data from well-designed trials, including FACT, CORE, and MOBILE, have enlightened us on efficacy, tolerability, and patient-friendly dosing of antiresorptive drugs
Treatment success is the absence of bone loss, not extent of bone gain
The Fosamax Actonel Comparison Trial evaluated BMD and bone turnover, not fracture reduction
In the MOBILE study, the 150-mg monthly dose of ibandronate was superior to daily use in terms of lumbar spine bone density
Raloxifene has no time limit
Professor of Obstetrics and Gynecology,
New York University School of Medicine
New York City
It is all too easy to focus on T-scores and lose sight of why we are measuring women’s bone density. We are not trying to prevent osteoporosis; we are trying to prevent the fractures that result from osteoporosis.
The numbers tell why. The total number of fragility fractures in American women in a single year—1 million—out-numbers all heart attacks, strokes, breast cancers, and gynecologic cancers combined. A quality-of-life study by Toteson and Hammond found that 4 out of 10 Caucasian women over 50 will fracture a hip, spine, or wrist, sooner or later. One of every 5 who fracture a hip ends up in a nursing home. The direct care cost of osteoporotic fractures was $17 billion in 2001 dollars.