Involutional Osteoporosis. Critical Evaluation of Medical Treatments

  • C. Anderson
Conference paper

Abstract

A review of the published reports on the medical treatment for involutional osteoporosis leaves the skeptical reader with a number of questions. This presentation will only deal with four of these: 1) the statistical acceptability of results obtained from these studies when the measured end- point is a reduction in fracture rates; 2) the interpretation of results obtained from the application of indirect measurements to individuals at risk of losing bone or who have lost bone; 3) incomplete knowledge concerning the physiopathology of bone loss or the cellular response to pharmacologic agents; and 4) inattention to concomitant morbid conditions which contribute to an increased incidence of fractures.

Keywords

Trabecular Bone Bone Remodel Postmenopausal Osteoporosis Involutional Osteoporosis Bone Remodel Activity 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in to check access.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Albright, F.: Osteoporosis. Ann. Int. Med. 27, 861, 1947.PubMedGoogle Scholar
  2. 2.
    Anderson, C., Cape, R.D.T., Crilly, R.G., Hodsman, A.B., and Wolfe, B.M.J.: Preliminary observations on a form of coherence therapy for osteoporosis. Calc. Tiss. Int. 36, 341, 1984.CrossRefGoogle Scholar
  3. 3.
    Brocklehurst, J.C., Exton-Smith, A.N., Lempert-Barber, S.M., Hunt, L.P., and Palmer, M.K.: Fracture of the femur in old age: A 2-centre study of associated clinical factors and the cause of the fall. Age and Ageing, 7, 1978.Google Scholar
  4. 4.
    Campbell, A.J., Reinken, J., Allan, B.C., and Martinez, G.S.: Falls in old age: A study of frequency and related clinical factors. Age and Aging, 264, 1981.Google Scholar
  5. 5.
    Chesnutt III, C.H.: Synthetic salmon calcitonin diphosphonates, and anabolic steroids in the treatment of postmenopausal osteoporosis. In, Osteoporosis 2, Copenhagen International Symposium on Osteoporosis, June 3–8, 1984, pp 549–555.Google Scholar
  6. 6.
    Chesnut III, C.H., Baylink, D.Y., Gruber, H.E., Ivey, Y., Matthews, M., Nelp, W.B., and Sisom, K.: Anabolic steroids and calcitonin in the treatment of postmenopausal osteoporosis. In, Clinical Disorders of Bone and Mineral Metabolism. Excerpta Medica, 1983, pp 355–359.Google Scholar
  7. 7.
    Christiansen, C.: Prophylactic treatment for age-related bone loss in women. In, Osteoporosis 2, Copenhagen International Symposium on Osteoporosis, June 3–8, 1984, pp 587–593.Google Scholar
  8. 8.
    Eisinger, Y., Laponche, A.M., and Duaniche, Y.: Trabecular bone mass in postmenopausal osteoporosis - effect of various hormonal treatments. In, Osteoporosis 2, Copenhagen International Symposium on Osteoporosis,. June 3–8, 1984, pp 657–658.Google Scholar
  9. 9.
    Eriksen, E.F., Mosekilde, L., and Melsen, F.: Effect of sodium fluoride, calcium phosphate and vitamin D2 for 5 years on bone balance and remodeling in osteoporotics. In, Osteoporosis 2, Copenhagen International Symposium on Osteoporosis, June 3–8, 1984, pp 659–661.Google Scholar
  10. 10.
    Gallagher, Y.C.: The role of vitamin D in the treatment of postmenopausal osteoporosis. In, Osteoporosis 2, Copenhagen International Symposium on Osteoporosis, June 3–8, 1984, pp 755–761.Google Scholar
  11. 11.
    Gryfe, C.I., Amies, A., and Ashley, M.J.: A longitudinal study of falls in an elderly population: I. Incidence and morbidity. Age and Ageing, 201, 1977.Google Scholar
  12. 12.
    Hart, D.M., Abdalla, H., Clarke, D., and Lindsay, R.: Preservation of bone mass in postmenopausal women during therapy with estrogen and progestogens. In, Osteoporosis 2, Copenhagen International Symposium on Osteoporosis, June 3–8, 1984, pp 697–699.Google Scholar
  13. 13.
    Jaworski, Z.F.G.: Physiology and pathology of bone remodeling. Orthop. Clin. North Am., 485, 1981.Google Scholar
  14. 14.
    Kanis, J.R.: Treatment of osteoporotic fracture. Lancet, 27, 1984.Google Scholar
  15. 15.
    Kleerekoper, M.: Problems associated with the execution of a clinical trial for osteoporosis. Workshop on the Coherence Therapy for Osteoporosis. University of Western Ontario, London, Ontario, Canada, Feb. 10–11, 1984.Google Scholar
  16. 16.
    Kleerekoper, M., Villanueva, A.R., Mathews, C.H.E., Rao, D.S., Pumo, B. and Parfitt, A.M.: PTH mediated bone loss in primary and secondary hyperparathyroidism. In, Clinical Disorders of Bone and Mineral Metabolism. Excerpta Medica, 1983, pp 200–203.Google Scholar
  17. 17.
    Lindsay, R.: Treatment of osteoporosis with antiresorptive drugs - estrogen, progestins and calcium. In, Osteoporosis 2, Copenhagen International Symposium on Osteoporosis, June 3–8, 1984, pp 557–562.Google Scholar
  18. 18.
    Meunier, P.J., Galus, K., Brianson, D., Reeve, J., Podbesek, R., Edouard, C., Arlot, M., Charhon, S., Delmas, P., Benevise, B., Valentin, A., and Chapuy, M.C.: Treatment of primary osteoporosis with drugs that increase bone formation: Sodium fluoride, LPTHl-34, ADFR concept. In, Osteoporosis 2, Copenhagen International Symposium on Osteoporosis, June 3–8, 1984, pp 595–602.Google Scholar
  19. 19.
    Minaire, E., Meunier, P.J., Depassio, Y., Pilonchery, G., and Caulin, F.: Treatment of active osteoporosis with calcitonin. In, Osteoporosis 2, Copenhagen International Symposium on Osteoporosis, June 3–8, 1984, pp 613–615.Google Scholar
  20. 20.
    Nordin, B.E.C., Heyburn, P.J., and Peacock, M.: Osteoporosis and osteo-malacia. Clin. Endocrinol. Metab., 177, 1980.Google Scholar
  21. 21.
    Parfitt, A.M.: Assessment of trabecular bone status - Introduction. In, Clinical Disorders of Bone and Mineral Metabolism. Excerpta Medica, 1983, pp 27–29.Google Scholar
  22. 22.
    Raisz, L.G.: Mechanisms of parathyroid hormone mediated bone loss. In, Clinical Disorders of Bone and Mineral Metabolism. Excerpta Medica, 1983, pp 196–199.Google Scholar
  23. 23.
    Reeve, Y., Podbesek, R.D., Price, T.R., Arlot, M., Bartlett, C., Deacon, A.C., Edouard, C., Green, Y.R., Hesp, R., Hulme, P., Katz, D., Tellez, M., Zanelli, G.D., Zanelli, Y.M., and Meunier, P.J.: Studies of a short-cycle ADFR regimen using parathyroid peptide LPTH 1-34 in idiopathic osteoporosis and in a dog model. In, Osteoporosis 2, Copenhagen International Symposium on Osteoporosis, June 3–8. 1984. pp 567–573.Google Scholar
  24. 24.
    Riggs, B.L., Seeman, E., Hodgson, S.F., Taves, D.L., and 01Fallon, W.M. Effect of the fluoride/calcium regimen on vertebral fracture occurrence in postmenopausal osteoporosis. N. Engl. J. Med., 446, 1982.Google Scholar
  25. 25.
    Singh, A. and Jolly, S.S.: Chronic toxic effects on the skeleton. In, World Health Organization No. 59, Fluoride and Human Health, 1970. pp. 239–244.Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1986

Authors and Affiliations

  • C. Anderson

There are no affiliations available

Personalised recommendations