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Risk of fracture and treatment to prevent osteoporosis-related fracture in postmenopausal women. A review.
J Reprod Med. 2003 Jun; 48(6):425-34.JR

Abstract

OBJECTIVE

To review the antifracture efficacy of pharmacologic therapy approved by the U.S. Food and Drug Administration for the treatment of postmenopausal osteoporosis.

STUDY DESIGN

For this literature review, published trials of antiresorptive therapy with the bisphosphonates risedronate and alendronate, the selective estrogen receptor modulator raloxifene and calcitonin were reviewed; hormone replacement therapy was not included as this modality is not indicated for treatment of osteoporosis.

RESULTS

In controlled trials of postmenopausal women with osteoporosis, risedronate reduced the incidence of clinically evident vertebral fracture after 6 months of therapy and radiographically detected vertebral and nonvertebral fracture after 1 year. In similar trials, alendronate also reduced the risk of clinical vertebral fractures in 1 year. Risedronate and alendronate were both well tolerated, but some trials of alendronate were closed to women with recent upper gastrointestinal disease. In a large, controlled trial, raloxifene demonstrated a significant reduction in the risk of clinical vertebral fracture but not in the risk of nonvertebral fracture. Raloxifene is also associated with a 3-fold increased risk of thromboembolism. Calcitonin reduced the incidence of vertebral fracture, but there are no conclusive data on prevention of nonvertebral fracture.

CONCLUSION

Antiresorptive therapy can reduce the risk of osteoporotic vertebral fracture. The bisphosphonates are also effective in reducing the risk of hip fracture in women with osteoporosis.

Authors+Show Affiliations

Martens MG
Department of Gynecology and Obstetrics, University of Oklahoma, 1145 South Utica, Suite 600, Tulsa, OK 74104-4070, USA. mark-martens@ouhsc.edu

MeSH

AgedAlendronateCalcitoninClinical Trials as TopicDiphosphonatesEstrogen AntagonistsFemaleFractures, BoneHumansMiddle AgedOsteoporosisPostmenopauseRaloxifene HydrochlorideRisk Factors

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

12856513

Citation

Martens, Mark G.. "Risk of Fracture and Treatment to Prevent Osteoporosis-related Fracture in Postmenopausal Women. a Review." The Journal of Reproductive Medicine, vol. 48, no. 6, 2003, pp. 425-34.
Martens MG. Risk of fracture and treatment to prevent osteoporosis-related fracture in postmenopausal women. A review. J Reprod Med. 2003;48(6):425-34.
Martens, M. G. (2003). Risk of fracture and treatment to prevent osteoporosis-related fracture in postmenopausal women. A review. The Journal of Reproductive Medicine, 48(6), 425-34.
Martens MG. Risk of Fracture and Treatment to Prevent Osteoporosis-related Fracture in Postmenopausal Women. a Review. J Reprod Med. 2003;48(6):425-34. PubMed PMID: 12856513.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk of fracture and treatment to prevent osteoporosis-related fracture in postmenopausal women. A review. A1 - Martens,Mark G, PY - 2003/7/15/pubmed PY - 2003/10/18/medline PY - 2003/7/15/entrez SP - 425 EP - 34 JF - The Journal of reproductive medicine JO - J Reprod Med VL - 48 IS - 6 N2 - OBJECTIVE: To review the antifracture efficacy of pharmacologic therapy approved by the U.S. Food and Drug Administration for the treatment of postmenopausal osteoporosis. STUDY DESIGN: For this literature review, published trials of antiresorptive therapy with the bisphosphonates risedronate and alendronate, the selective estrogen receptor modulator raloxifene and calcitonin were reviewed; hormone replacement therapy was not included as this modality is not indicated for treatment of osteoporosis. RESULTS: In controlled trials of postmenopausal women with osteoporosis, risedronate reduced the incidence of clinically evident vertebral fracture after 6 months of therapy and radiographically detected vertebral and nonvertebral fracture after 1 year. In similar trials, alendronate also reduced the risk of clinical vertebral fractures in 1 year. Risedronate and alendronate were both well tolerated, but some trials of alendronate were closed to women with recent upper gastrointestinal disease. In a large, controlled trial, raloxifene demonstrated a significant reduction in the risk of clinical vertebral fracture but not in the risk of nonvertebral fracture. Raloxifene is also associated with a 3-fold increased risk of thromboembolism. Calcitonin reduced the incidence of vertebral fracture, but there are no conclusive data on prevention of nonvertebral fracture. CONCLUSION: Antiresorptive therapy can reduce the risk of osteoporotic vertebral fracture. The bisphosphonates are also effective in reducing the risk of hip fracture in women with osteoporosis. SN - 0024-7758 UR - https://www.unboundmedicine.com/medline/citation/12856513/Risk_of_fracture_and_treatment_to_prevent_osteoporosis_related_fracture_in_postmenopausal_women__A_review_ DB - PRIME DP - Unbound Medicine ER -