| November 2006 · Vol. 18, No. 11 OSTEOPOROSIS UPDATE
New Developments that are Changing Patient Care
Real-life risks and benefits of fracture-reducing drugs
How do the high-profile studies of 2006 apply to our patients?
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Fast Track
There were no reports of ONJ in any of the controlled trials on use of bisphosphonates for osteoporosis
2 large trials cause me to believe that raloxifene reduces new onset breast cancer in virtually every group studied
Raloxifene was a good choice as the fracture reduction agent for a woman with atypical ductal hyperplasia
With transvaginal ultrasound monitoring, some women with a uterus can be managed on
estrogen only
High doses of bisphosphonates appeared to enhance bone accretion
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Steven
Goldstein,
MDProfessor 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 check bone mass: we want to prevent fragility fractures—not osteoporosis per se. Fracture incidence is greater in women with osteoporosis, but the absolute number of fragility fractures is far greater in the women who have not yet reached that threshold. That was my main message last year. It still is, although I had hoped we would by now have in our hands a fracture risk assessment tool due from the World Health Organization. It will use age, DXA score, history, and other factors to project 5- and 10-year risk of fracture. Then we will simply have to decide at what level of risk, for an individual patient, drug therapy is indicated. Watch this space!
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