In the United states, an estimated 10 million people have osteoporosis. Another 34 million more are estimated to have low bone mass, placing them at increased risk for osteoporosis. The majority of those with the disease are women -- about 80 percent. Osteoporosis causes bones to lose mass and become brittle and easily broken. People can end up in wheelchairs after a hip fracture. Worse, 15 percent of hip fractures can end up being fatal. Risk factors that can be controlled include weight and physical activity. Researchers found women who are overweight or obese have lower rates of osteoporosis, suggesting excess body weight may protect against the disease. On the other hand, underweight women tend to have higher rates of osteoporosis. Research has shown that women who do not exercise or who exercise more than five days per week have an increased risk.
TREATMENT: There are several medications that can be used for the prevention and treatment of osteoporosis. Alendronate (Fosamax) and risedronate (Actonel) are medications that slow down bone loss and have been shown to decrease the risk of fractures. Calcitonin (Calcimar, Miacalcin) is a hormone made from the thyroid gland and is usually given as a nasal spray or as an injection under the skin. It may help prevent spine fractures. Estrogen therapy alone or in combination with another hormone, progestin, has been shown to decrease the risk of osteoporosis and osteoporosis-related fractures in women. However, the combination of estrogen with a progestin has been shown to increase the risk for breast cancer, strokes, heart attacks and blood clots. Selective estrogen receptor modulators mimic estrogens good effects on bones without some of the serious side effects such as breast cancer. Raloxifene (Evista) decreases spine fractures in women and is approved for use only in women at this time.
COMBINATION DRUGS: Researchers at the University of California, San Francisco experimented with combining two types of drugs to treat osteoporosis. Women took parathyroid hormone (PTH) therapy for one year. Then, they took Fosamax. The PTH works to restore bone mass. Fosamax is then taken to prevent loss of bone mass. In this sequence, Fosamax is more effective than if taken alone. The medications are not taken at the same time. In a study, women who took only Fosamax for two years had an 8 percent increase in spine bone density. Those who took PTH alone only had a 4 percent increase in spine bone density. Those who took the Fosamax after a year on PTH had a 30 percent increase in the density of spongy bone in the spine. This sequential combination proved to be the most effective way to increase spinal bone density than any drug regiment studied over this time period. Researchers say these results may encourage physicians to reconsider which drug regimens they prescribe to their patients.
FOR MORE INFORMATION, PLEASE CONTACT: Wallace Ravven
University of California, San Francisco