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02-28-96 11:07 FROM: NATIONAL OSTEOPOROSIS
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Post-it Fax Note
7671
11912 4/66 pages
To amanda
From Co. Bent Coney
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Phone #
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Fast Facts on Osteoporosis
Definition
Osteoporosis, or porous bone, is a disease characterized by low bone mass and
structural deterioration of bone tissue, leading to bone fragility and an increased
susceptibility to fractures of the hip, spine, and wrist.
Prevalence
Osteoporosis is a major public health threat for 25 million Americans, 80
percent of whom are women. In the U.S. today, 7-8 million individuals
already have the disease and 17 million more have low bone mass, placing
them at increased risk for osteoporosis.
80% of those affected by osteoporosis are women.
One out of every two women and one in five men have an osteoporosis-related
fracture.
By age 75, one third of all men will be affected by osteoporosis.
While osteoporosis is often thought of as an older person's disease, it can strike
at any age.
Osteoporosis is responsible for 1.5 million fractures annually, including:
more than 300,000 hip fractures
500,000 vertebral fractures
200,000 wrist fractures
more than 300,000 fractures at other sites
Cost
The estimated national direct expenditures (hospitals and nursing homes) for
osteoporosis and associated fractures was $10 billion ($27 million each day)
and the cost is rising.
Symptoms
Osteoporosis is often called the "silent disease" because bone loss occurs
without symptoms. People may not know that they have osteoporosis until
their bones become so weak that a sudden strain. bump, or fall causes a
fracture or a vertebra to collapse.
Collapsed vertebrae may initially be felt or seen in the form of severe back
pain, loss of height. or spinal deformities such as stooped posture or dowager's
hump.
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Risk Factors
Certain people are more likely to develop osteoporosis than others. Factors
that increase the likelihood of developing osteoporosis are called "risk factors."
The following risk factors have been identified:
Being female
Thin and/or small frame
Advanced age
A family history of osteoporosis
Early menopause
Abnormal absence of menstrual periods (amenorrhea)
Anorexia nervosa or bulimia
A diet low in calcium
Use of certain medications, such as corticosteroids and anti-convulsants
Low testosterone levels in men
An inactive lifestyle
Cigarette smoking
Excessive use of alcohol
Caucasian or Asian, although African Americans and Hispanic Americans
are at significant risk as well
Women have approximately 10 to 25 percent less total bone mass at maturity
than men, making them more susceptible to osteoporosis. However, five
million American men are affected by osteoporosis and one out of eight men
age 50 and older will develop fractures.
White women 60 years of age or older have at least twice the incidence of
fractures as African-American women. However, one out of five African-
American women are at risk of developing osteoporosis.
Detection
Specialized tests called bone density tests can measure bone density in various
sites of the body. A bone density test can:
Detect osteoporosis before a fracture occurs
Predict your chances of fracturing in the future
Determine your rate of bone loss and/or monitor the effects of treatment
if the test is conducted at intervals of a year or more
Prevention
Building strong bones, especially before the age of 35, can be the best defense
against developing osteoporosis, and a healthy lifestyle can be critically
important for keeping bones strong. So to help prevent osteoporosis:
Eat a balanced diet rich in calcium
Exercise regularly, especially weight-bearing activities
Don't smoke and limit alcohol intake
Talk to your doctor if you have a family history of osteoporosis or no
longer have the protective benefit of estrogen due to natural or surgically-
induced menopause.
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Fractures
The most typical sites of fractures related to osteoporosis are the hip, spine,
wrist, and ribs, although the disease can affect any bone in the body.
Forty percent of all women will have at least one spinal fracture by the time
they reach age 80.
Spinal osteoporosis is eight times more likely to afflict women than men.
The rate of hip fractures is two to three times higher in women than men,
however the death rate for men within one year after 2 hip fracture is 26%
higher than that in women.
A woman's risk of hip fracture is equal to her combined risk of breast, uterine
and ovarian cancer.
In 1988, about 250,000 Americans age 45 and over were admitted to hospitals
with hip fractures. Osteoporosis was the underlying cause of many of these
injuries.
Individuals suffering hip fractures have a 5 to 20 percent greater risk of dying
within the first year following that injury than others in their age group.
Among those who were living independently prior to a hip fracture, 15 to 25
percent are still in long-term care institutions a year after the injury.
Treatment & Care Although there is no cure for osteoporosis, there are treatments available to
help stop further bone loss and fractures:
Studies have shown that estrogen can prevent the loss of bone mass in
postmenopausal women.
Alendronate, a bisphosphonate, has been recently approved by the Food and
Drug Administration for treatment of postmenopausal osteoporosis.
Calcitonin is another treatment used by both women and men for
osteoporosis. This drug has been shown to slow bone breakdown and also
can reduce the pain associated with osteoporotic fractures.
Treatments under investigation include other bisphosphonates, sodium
fluoride, vitamin D metabolites, and selective estrogen receptor modulators.
Medical experts agree that osteoporosis is highly preventable. However, if the toll of osteoporosis is
to be reduced, the commitment to osteoporosis research must be significantly increased It is
reasonable [O project that with increased research, the future for definitive treatment and prevention
of osteoporosis is very bright.
The National Osteoporosis Foundation is the nation's leading resource for patients, healthcare
professionals, and organizations seeking up-to-date, medically sound information on the causes,
prevention, diagnosis, and treatment of osteoporosis. Please contact us to learn more about NOF,
National Osteoporosis Prevention Week, or how to become a member.
National Osteoporosis Foundation, 1150 17th Street. NW, Suite 500, Washington, DC 20036
02-28-96
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Building A Strong Foundation For You!
The National Osteoporosis Foundation
Educate Physicians and Other
N
(NOF) is the nation's leading resource
Health Professionals
for patients, healthcare professionals.
Because of the complexity of osteoporosis
and organizations seeking up-to-date,
and the rapid changes brought about by
medically sound information and
research. physicians and other healthcare
program materials on the causes.
professionals are turning to NOF for the
latest scientific information on the
prevention. and treatment of
prevention and treatment of osteoporosis.
osteoporosis.
Through our regional and national
Established in 1986 as America's only
educational conferences. Speakers Bureau.
voluntary. nonprofit health organization
and the Physician's Resource Manual on
dedicated to reducing the widespread
Osteoporosis. we provide information and
prevalence of osteoporosis. the
materials to physicians and other health
O
Foundation has grown to include a
professionals.
network of individuals, healthcare
professionals and organizations who
Inform Patients and Their
support its goals. In leading the attack
Families
on osteoporosis, NOF aggressively
NOF serves as a national resource center
works to:
linking patients and their families with
information, resources and services. To
ensure that patients receive all the
Advocate Increased Research
information they need to make informed
Support
health care decisions. the Foundation has
A top priority for NOF is to support a
established the National Osteoporosis Patient
greatly increased federal research effort to
Information Center.
discover the keys to preventing and treating
F
osteoporosis. Through our work. we ensure
We provide patient oriented materials
that research on osteoporosis assumes a
containing up-to-date information on the
prominent place on the national health
diagnosis, prevention and treatment of
agenda.
osteoporosis. as well as strategies for
recovering from fractures. and living with
Provide Direct Support for
osteoporosis.
Research
NOF has established the country's only
The Foundation is governed by a voluntary
privately supported research grant
Board of Trustees and advised by a board of
for osteoporasis. Through this program. we
preeminent scientists.
provide direct financial support to
researchers. In addition NOF supports a
NOF is supported in its efforts through
student fellowship program aimed at
membership dues. contributions and grants
bringing new researchers into the field.
from federal agencies and private
organizations. sales of materials. income
In conjunction with leading federal agencies.
from educational conferences and training
such as the National Institutes of Health and
programs. and through general fundraising
other scientific and medical organizations.
activities. For more information. contact:
the Foundation plays an important role in
organizing and conducting national and
National Osteoporosis Foundation
regional scientific workshops to explore
what is known about osteoparosis and to
National Headquarters:
identify-specific research directions.
1150 17th Street. NW Suite 500
Washington. DC 20036
Increase Public Awareness and
phone: 202/223-2226
Knowledge About Osteoporosis
Each year. hundreds of national
Atlanta Regional Office:
National Osteoporosis Foundation
P.O. Box 1991
organizations. federal agencies, corporations.
A 501(c)(3) nonprofit organization:
Tucker. GA 30085
and hospitals work with NOF to promote
Member. National Health Council and
phone: 404/621-9933
National Osteoporosis Prevention Week. the
the Combined Federal Campaign.
nation's major campaign aimed at educating
Meets the standards of the National
the public and healthcare professionals about
Chicago Regional Office:
Charities Information Bureau. Inc.
c/o AMA. Room 7420
osteoporosis. The Foundation's Prevention
515 N. State Street
Week information and media kits and poster,
brochures. newsleuers. and public service
Chicago. IL 60610
announcements are helping to heighten
phone: 312/464-4570
awareness and increase knowledge about this
devastating disease.
02-28-96 11:09 FROM: NATIONAL OSTEOPOROSIS
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National Osteoporosis Foundation
A Decade of Challenge and Achievement
The National Osteoporosis Foundation (NOF) is leading the effort to bring national attention and resources
to bear on the problem of osteoporosis. Founded in 1986 by foremost researchers and clinicians, NOF strives
to reduce and, ultimately to eliminate the widespread prevalence of osteoporosis through programs of public
and professional education, research, patient information and advocacy.
The Foundation is governed by a 19-member Board of Trustees, a 27-member Scientific Advisory Board and
an Honorary Board of national leaders and celebrities.
From the halls of Congress to statehouses, from community hospitals to hundreds of national organizations,
NOF has gained national recognition for osteoporosis as a major public health problem. This dialogue has
not yet been sufficiently translated into constructive and comprehensive national programs and policies to
reduce the human and economic toll of the disease. As a result, tens of millions of women and men at risk
for osteoporosis are empowered to prevent this debilitating disease.
Several recent developments, however, signal an increased Federal commitment to bring osteoporosis under
control. These advances are, in great measure, due to the organizing and educational efforts of the
Foundation.
The Osteoporosis and Related Bone
Department of Defense (DOD)
Diseases National Resource Center -
Appropriations Bill.
Through a competitive grant application
process, the National Osteoporosis
Office of Technology Assessment Report
Foundation has received a $2 million grant
NOF stimulated a Congressional request to
from the National Institutes of Health (NIH)
the Office of Technology Assessment to
to establish The Osteoporosis and Related
evaluate the impact of osteoporosis in the
Bone Diseases National Resource Center.
United States and report on gaps in research,
The Resource Center's mission is to broaden
public and professional education and the
the dissemination of information to the
cost effectiveness of bone mass measurement
general public, patients and health
tests. The reports, Public Information About
professionals and enable NOF to conduct
Osteoporosis, What's Available, What's
behavioral research aimed at the prevention
Needed. Hip Fractures. Outcomes In People
of osteoporosis.
Age Fifty And Over were released in October
1994.
NOF is presently working with a board of
scientific experts to develop osteoporosis
NOF successfully waged a seven year
practice guidelines for physicians. This
campaign to achieve Medicare
project is expected to be concluded in 1995.
reimbursement for bone mass
measurement. Previously Medicare
Ten million dollars for osteoporosis
reimbursement was S68, but as of January 1,
research was appropriated by Congress FY
1995 that amount will increase to $124.
95, including, for the first time, an earmarked
Currently Medicare covers DEXA tests in 41
appropriation in the
states, but NOF continues to work toward a
5milianin
goal of reimbursement nationwide.
02-28-96 11:09 FROM:NATIONAL OSTEOPOROSIS
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National Osteoporosis Foundation
A View To the Future
Strategic Goals: 1995 to the Year 2000
Annual Federal funding for osteoporosis
More than double approved drug therapies
research to exceed $200 million
Education, service and supportive programs
NOF's research program to exceed $2 million
available in major cities
annually
NOF, as the nation's leading authority on
100% of Americans recognize osteoporosis
osteoporosis
causes/consequences and seek care
Expand Board of Trustees to 35
members
70% of patients with osteoporosis have
Continue role of Scientific Advisory
access to quality medical care and supportive
Board as osteoporosis research and
community services
clinical authority
Expand Interspecialty Council
Expand Honorary Board of national
70% of physicians diagnose and treat
leaders and celebrities
osteoporosis
Develop budget of $10-$15 million
Establish 10+ regional offices and
leadership councils
Bone mass measurement tests reimbursed
and accessible to 75% of the population
02-28-96 11:09 FROM:NATIONAL OSTEOPOROSIS
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Four Myths About Osteoporosis:
Knowing the Truth Will Help You Keep Your Bones Strong
1
2
3
4
Osteoporosis is not
I'm a healthy person.
I'm too young to worry
It's too late for me to
serious enough for me
I do the right things.
about osteoporosis now.
do anything about
to worry about.
I'm not at risk.
It's never too early to
osteoporosis.
Osteoporosis is serious
Unfortunately, we can't feel
prevent osteoporosis.
Osteoporosis is defined as
because it progressively and
how strong our bones are.
Building strong bones and
excessive loss of bone
irreversibly weakens our
That's why osteoporosis is
keeping them strong gives
tissue. Bones break when
bones to the point that any
called a "silent thief".
you a head start when bone
they become too thin and
movement, even a bump or
Without knowing it, you
loss occurs. The fact is that
too weak. Although bone
fall, can cause a painful,
could be losing bone tissue,
bone is a living, growing
loss is irreversible, it's
debilitating fracture of the
even if you think you're
tissue which constantly
never too late to take steps
hip, spine or other bones.
doing the right things,
rebuilds. Bone strength
to slow or stop the further
Chronic pain and disability
including exercise and
increases during our youth
loss of bone. The time to
are lasting effects of
eating a calcium-rich diet.
until "peak bone mass" is
detect osteoporosis is now
osteoporosis which can
Osteoporosis is increasingly
reached in our 20's or early
before so much bone is lost
permanently change the
widespread. One in two
30's. After that time all of
that debilitating fractures
way you live. work and
women and one in five men
us gradually lose bone mass
occur. If you are diagnosed
enjoy your free time. One
have a lifetime risk of
because more bone tissue is
with osteoporosis, your
frequent outcome of
developing fractures from
removed than generated.
doctor can prescribe a diet
osteoporosis is hip fracture,
osteoporosis and
When bone loss is
and exercise program
which each year causes
experiencing the loss of
excessive, such as when
tailored to your needs.
nearly as many deaths in the
vitality and independence
women lose the protective
There are also several
United States as all auto
that accompany this
effects of estrogen
medications like estrogen
fatalities.
disease.
following menopause,
and calcitonin currently
osteoporosis may develop.
Because osteoporosis can
Your doctor and the
available to prevent further
This is why women are at
bone loss and help you
be prevented and treated, if
National Osteoporosis
greater risk for osteoporosis
preserve an active lifestyle
you learn what you can do
Foundation can help you
and the fractures that result
and avoid the consequences
now, you won 't have to
learn more about what
from it.
of osteoporosis. Additional
worry about it as you grow
factors place people at risk
older.
Many of the things you can
therapies are also being
for osteoporosis and what
you can do 10 stop excessive
do to build strong bones
researched such as
bone loss.
and prevent bone loss can
bisphosphonates.
also contribute TO your
Talk to your doctor and
overall health. Remember,
contact the National
osteoporosis doesn't just
Osteoporosis Foundation.
happen when you're "old,"
We can recommend steps
it gets started years, even
you can take to maximize
decades earlier.
bone strength and minimize
bone loss.
NATIONAL OSTEOPOROSIS FOUNDATION. 1150 17th Street, N.W., Suite 500. Washington D.C. 20036-4603
PERCENTAGE OF WOMEN WHO IDENTIFIED CONSEQUENCES OF OSTEOPOROSIS
Osteoporosis leads to 300,000 hip
Permanent disability
32%
fractures annually. Twenty-five
percent of those who fracture a hip
Hip fractures
18%
after age 55 are not able to walk
again without assistance, and 15 to
Curvature of the spine
20%
20 percent are in long-term
institutions one year after the injury.
Bones fracture easily
14%
Osteoporosis leads to 50,000 deaths
annually, mostly as a result of
Restricts mobility/crippling
13%
complications associated with hip
fractures. Loss of height and
Loss of height
7%
stooped posture often result when
vertebrae, the small bones that
Death due to injury
6%
make up the spine, fracture or
collapse.
02-28-96 11:10 :NATIONAL OSTEOPOROSIS
Don't know
24%
PERCENTAGE OF WOMEN WHO IDENTIFIED RISK FACTORS FOR OSTEOPOROSIS
Race (caucasian)
27%
Slender build
24%
Family history
39%
ID:2022232237
Early menopause
49%
Poor diet (lack of calcium)
81%
Lack of exercise
72%
Source:
Smoking
52%
A Gallup survey of 750 women, ages
45- to 75-years-old. The survey has a
Alcohol consumption
40%
margin of error of +4 percentage
PAGE
points.
8/13
02-28-96 11:10 FROM: NATIONAL OSTEOPOROSIS
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OSTEOPOROSIS FACTS
Financial Costs
The economic impact of
year 2020 unless more
osteoporosis is enormous. In
aggressive steps are taken to
the United States. the
prevent and treat the disease.
medical, nursing home. and
As the US population ages.
social costs of fractures
the number of persons likely
resulting from osteoporosis
to develop osteoporosis and
and its consequences are
the accompanying financial
currently estimated to be
costs for managing the
$10 - 18 billion a year. These
disease will increase
costs are expected to grow to
dramatically.
more than $60 billion by the
Medical, Nursing Home and Social Costs of Hip Fractures
60 Billion
40 Billion
20 Billion
1990
2020
Source: National Osteoporosis Foundation, 1993
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OSTEOPOROSIS FACTS
Causes of Stooped Posture
Osteoporosis weakens the
(flattened) or may mend in a
and Loss of Height
bones, making them more
wedge shape. Over time.
likely to fracture.
multiple fractures of the spine
Osteoporosis-related
can result in stooped posture,
fractures occur most often in
a loss of height and continual
the hip, wrist and spine. The
pain (right). Preventing
spine is made up of a series
osteoporosis is important
of small connected bones
since bone loss is
called vertebrae (left).
irreversible. An early
While vertebral fractures do
diagnosis is critical.
heal, the bones do not go
Osteoporosis is symptomless.
back to their original shape.
The first sign of the disease is
Healed vertebral fractures
often a fracture.
become compressed
Normal Spine
Osteoporotic Spine
Source: National Osteoporosis Foundation. 1993
02-28-96
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Calcium-Rich Foods
Serving
Calcium
Food Item
Size
(mg)
Fat (g)
Calories
Milk
Whole
8 oz.
288
S.0
150
1% milk
8 OZ.
300
2.6
102
2% milk
S oz.
297
4.7
121
Skim milk
S oz.
302
0.4
86
Yogurt
-Plain fat-free (w/added milk solids)
8 oz.
452
0.4
127
Plain low-fat (w/added milk solids)
8 oz.
415
3.5
144
Fruit low-fat
8 oz.
314
2.6
225
Cheese
American Cheese
1 oz.
124
8.9
106
Cheddar Cheese
1 oz.
204
9.4
114
Cottage Cheese. 1% low-fat
1 cup
138
2.3
164
Mozzarella Cheese, part skim
1 oz
147
6.1
80
Muenster Cheese
1 oz.
203
8.5
104
Parmesan Cheese, grated
1 tbsp.
69
1.5
23
Ricotta Cheese, part skim
1/2 cup
337
9.8
171
Ricotta Cheese. whole milk
1/2 cup
257
16.1
216
Ice Cream. Vanilla
10 % Fat
1 cup
176
14.3
269
16 To Fat (Rich)
1 cup
151
23.7
349
Orange Sherbet
1 cup
103
3.8
270
Ice Milk, Vanilla
Hard
1 cup
176
5.6
184
Soft Serve
1 cup
274
4.6
223
Fish and Shellfish
Oysters. raw
12
76
4.2
116
Sardines, canned in oil. drained,
4
184
5.6
100
including bones
Salmon. pink, canned. including bones
3 oz.
181
5.1
118
Shrimp. canned. drained
3 oz.
50
1.7
102
Vegetables
Bok Choy. raw (Chinese Cabbage)
1 cup
74
0
9
Broccoli. cooked, drained. from raw
1 cup
178
0.4
46
Broccoli, cooked, drained. from frozen
1 cup
94
0.2
SO
Soybeans, mature, boiled
1 cup
175
15.4
298
Collards. cooked, drained. from raw
1 cup
148
0.3
27
Turnip greens, cooked. drained.
I cup
193
0.4
30
from raw (leaves and stems)
Tofu
1 cup
*260
11.8
366
Orange (Naval)
1 whole
56
0.1
65
Almonds (Dry Roasted)
1 oz.
so
14.7
167
The calcium content of tofu may vary depending on processing methods. Tofu processed with calcium salts can have as
much as 300 mg calcium per 4 02 Often. the label of the manufacturer can provide more specific information.
NOTE:
You may also increase the calcium in foods by following these suggestions:
1.
Add non-fat powdered dry milk to all soups. casseroles, and drinks.
2.
Sesame seeds provide 60 mg of calcium per oz. and sunflower seeds provide 33 mg of calcium
per oz. These can be sprinkled on casseroles or salads.
3.
Buy juices, cercal and bread that are fortified with calcium.
4.
Replace whole milk and cream with skim and low-fat milk in recipes.
5.
Replace sour cream with yogurt in recipes.
6.
Some bottled waters contain calcium, SO check the labels for more information.
Commonly Used (15th ed.). New York; Harper Collins Publishers. Inc.
02-28-96 11:11 FROM: NATIONAL OSTEOPOROSIS
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Medications Used to Treat Osteoporosis
Currently, there are three medications that are approved by the Food and Drug Administration
(FDA) for the treatment of postmenopausal osteoporosis. All three of these medications are
classified as anti-resorptive medications; they slow or stop the bone resorbing portion of the
bone remodeling cycle but do not slow the bone forming portion of the cycle. As a result,
new formation continues at a greater rate than bone resorption, and bone density may increase.
Bone remodeling consists of two distinct stages: bone resorption and bone formation. During
resorption, special cells on the bone's surface dissolve bone tissue and create small cavities on
the bone surface. During formation, other cells fill the cavities with new bone tissue.
Usually, bone resorption and bone formation are linked so that they occur in close sequence
and remain balanced. When a disease such as osteoporosis is present, the link is damaged and
bone loss occurs.
Estrogen replacement therapy (ERT) and Hormone replacement therapy (HRT)
ERT has been proven to not only reduce bone loss but to also reduce the number of hip and spinal
fractures in postmenopausal women. ERT is administered most commonly in the form of a pill
or skin patch and is effective even when started after age 70. Today, most physicians prescribe
the hormone progestin along with estrogen (HRT) for those women who have an intact uterus.
ERT/HRT has been shown to have beneficial effects on both bone health and cardiovascular health
and relieves menopause symptoms. Side effects may include nausea, bloating, breast tenderness,
and high blood pressure. The question of whether ERT/HRT increases the risk of breast cancer
is still being studied by medical experts.
Calcitonin
Calcitonin is a naturally occurring hormone involved in calcium regulation and bone metabolism.
It slows bone loss and has been known to have an analgesic or pain killing effect. Calcitonin is
a protein which means that it can cause an allergic reaction, and it cannot be taken orally because
it would be digested before it could work. Calcitonin may be taken as a injection or by nasal
spray. It does not affect other organs or systems in the body, but injectable calcitonin may cause
unpleasant side effects including flushing of the face and hands, urinary frequency, nausea, and
a skin rash. The only side effect reported with nasal calcitonin is a runny nose.
Alendronate
Alendronate (brand name Fosamax) is a newly approved medication from the class of drugs called
bisphosphonates. Bisphosphonates also slow or stop bone loss. Results from two three year trials
in postmenopausal women with osteoporosis found that alendronate resulted in small increases in
bone density in both the spine and hip. Side effects are uncommon but may include abdominal
or musculoskeletal pain, nausea, heartburn, or irritation of the esophagus. Like all
bisphosphonates, alendronate must be taken on an empty stomach. The manufacturer recommends
taking this medication with a glass of water first thing in the morning and then waiting at least
one-half hour, and preferably one hour, before the first food, beverage, or medication of the day
with a full glass of plain water.
02-28-96 11:11 FROM: NATIONAL OSTEOPOROSIS
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Medications Used to Treat Osteoporosis
Currently, there are three medications that are approved by the Food and Drug Administration
(FDA) for the treatment of postmenopausal osteoporosis. All three of these medications are
classified as anti-resorptive medications; they slow or stop the bone resorbing portion of the
bone remodeling cycle but do not slow the bone forming portion of the cycle. As a result,
new formation continues at a greater rate than bone resorption, and bone density may increase.
Bone remodeling consists of two distinct stages: bone resorption and bone formation. During
resorption, special cells on the bone's surface dissolve bone tissue and create small cavities on
the bone surface. During formation, other cells fill the cavities with new bone tissue.
Usually, bone resorption and bone formation are linked so that they occur in close sequence
and remain balanced. When a disease such as osteoporosis is present, the link is damaged and
bone loss occurs.
Estrogen replacement therapy (ERT) and Hormone replacement therapy (HRT)
ERT has been proven to not only reduce bone loss but to also reduce the number of hip and spinal
fractures in postmenopausal women. ERT is administered most commonly in the form of a pill
or skin patch and is effective even when started after age 70. Today, most physicians prescribe
the hormone progestin along with estrogen (HRT) for those women who have an intact uterus.
ERT/HRT has been shown to have beneficial effects on both bone health and cardiovascular health
and relieves menopause symptoms. Side effects may include nausea, bloating, breast tenderness,
and high blood pressure. The question of whether ERT/HRT increases. the risk of breast cancer
is still being studied by medical experts.
Calcitonin
Calcitonin is a naturally occurring hormone involved in calcium regulation and bone metabolism.
It slows bone loss and has been known to have an analgesic or pain killing effect. Calcitonin is
a protein which means that it can cause an allergic reaction, and it cannot be taken orally because
it would be digested before it could work. Calcitonin may be taken as a injection or by nasal
spray. It does not affect other organs or systems in the body, but injectable calcitonin may cause
unpleasant side effects including flushing of the face and hands, urinary frequency, nausea, and
a skin rash. The only side effect reported with nasal calcitonin is a runny nose.
Alendronate
Alendronate (brand name Fosamax) is a newly approved medication from the class of drugs called
bisphosphonates. Bisphosphonates also slow or stop bone loss. Results from two three year trials
in postmenopausal women with osteoporosis found that alendronate resulted in small increases in
bone density in both the spine and hip. Side effects are uncommon but may include abdominal
or musculoskeletal pain, nausea, heartburn, or irritation of the esophagus. Like all
bisphosphonates, alendronate must be taken on an empty stomach. The manufacturer recommends
taking this medication with a glass of water first thing in the morning and then waiting at least
one-half hour, and preferably one hour, before the first food, beverage, or medication of the day
with a full glass of plain water.