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The Osteoporosis Revolution
- From the University of Connecticut Health Center, Farmington, Connecticut. For the current author address, see end of text. Acknowledgments: The author thanks Ms. Lynn Limeburner for her careful preparation of the manuscript and members of the Osteoporosis Group at the University of Connecticut Health Center for their comments and criticisms. Grant Support: In part by grant M01-RR-06192 to the University of Connecticut Health Center General Clinical Research Center. Requests for Reprints: Lawrence G. Raisz, MD, Division of Endocrinology and Metabolism, Lowell P. Weicker, Jr., General Clinical Research Center, University of Connecticut Health Center, Farmington, CT 06030.
Abstract
Our concepts of the pathogenesis, diagnosis, prevention, and treatment of osteoporosis are radically changing.Some changes, such as the study of genetic determinants of bone mass and turnover and the identification of local factors in pathogenesis, have just begun. The use of bone densitometry to diagnose and predict fracture risk is well developed but not yet widely applied. Measurement of bone turnover done by using biochemical markers is a promising new diagnostic method that has already proved useful in assessing a patient's response to therapy. Options for prevention and treatment have increased substantially with the Food and Drug Administration's recent approval of alendronate (a bisphosphonate) and nasal calcitonin for treatment of osteoporosis. Some are concerned that these new agents will unduly reduce the use of estrogen, which should remain the mainstay for prevention of bone loss and fractures in postmenopausal women. New therapeutic approaches are needed to treat the established disease. Our goal should be to develop inexpensive and widely applicable methods for diagnosis, prevention, and treatment to limit the enormous increase in osteoporotic fractures that has been predicted as the aging population expands worldwide.
- Copyright ©2004 by the American College of Physicians
