What's New

• Males with Osteoporosis
  1. Screen for medical diseases causing osteoporosis (multiple myeloma, thyroid disease, steroids, etc.). Treat underlying problem if possible.
  2. Check for hypogonadism. If present, treat with testosterone and/or alendronate depending on severity or presence of contra-indications to testosterone.
  3. Alendronate (Fosamax) or Risedronate ( Actonel) is useful therapy for those that are not hypogonadal or any patient on chronic steroids.
  4. All osteoporotic patients need supplemental calcium (1000 to 1500 mg/day).
  5. Follow DEXA yearly at earliest.
• PTH is the major cause of bone mineral density loss in women 13+ years postmenopause. (JSBMR 13: 303-9 1998)
• Heart and Estrogen/progestin Replacement Study:
  Prospective, randomized, placebo-controlled study to determine whether HRT is effective in the prevention of recurrent cardiac events. There was no overall benefit of HRT in the prevention of coronary artery disease or mortality over 4.1 years. There was an increase in venous thrombosis and gall stone disease in the HRT population. (JAMA 280: 650-652, 1998) There was no decrease in fractures.
• Raloxifene (Evista) reduces the incidence of spinal fractures by 50percent.
  The MORE study of the effect of Raloxifene on vertebral fracture rate is a double blind placebo controlled study of 7705 osteoporotic women given raloxifene, 500mg calcium and 400IU vitamin D. Both women with and without fractures received benefit. This was a 24-month interim analysis. There was no difference in nonspinal fractures at this point in the 36-month study. (European Congress on Osteoporosis as per Lilly information service)

For more information, please send mail to vpiziak@swmail.sw.org.

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