A review of clinical trials of therapies for osteoporosis using fracture as an end point

Citation
Rd. Blank et Rs. Bockman, A review of clinical trials of therapies for osteoporosis using fracture as an end point, J CLIN DENS, 2(4), 1999, pp. 435-452
Citations number
73
Categorie Soggetti
Endocrynology, Metabolism & Nutrition
Journal title
JOURNAL OF CLINICAL DENSITOMETRY
ISSN journal
10946950 → ACNP
Volume
2
Issue
4
Year of publication
1999
Pages
435 - 452
Database
ISI
SICI code
1094-6950(199924)2:4<435:AROCTO>2.0.ZU;2-V
Abstract
As the population ages, fragility fractures grow in importance as a public health problem. The principal goal of osteoporosis therapy is primary and s econdary fracture prevention. A growing choice of therapies is now availabl e for the treatment of osteoporosis. In this article, we review their effic acy using fracture prevention as an end point. The considerable heterogenei ty among studies with regard to patient age, past fracture history, fractur e site, and analytical methods precludes the possibility of performing a me aningful meta-analysis. Fracture outcomes have been reported in clinical tr ials with calcium supplementation, vitamin D supplementation, estrogen repl acement therapy (ERT), calcitonin, etidronate, alendronate, sodium fluoride (NaF), parathyroid hormone (PTH), and raloxifene. Compelling evidence for fracture prevention has been provided for calcium and vitamin D supplementa tion and alendronate treatment. Evidence of fracture prevention exists for ERT, raloxifene, calcitonin, etidronate, and PTH. Data on NaF are inconsist ent. Across agents, there is a trend toward greater efficacy for patients a t greatest risk of fracture.