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Update in General Internal Medicine
- Keith Roach, MD;
- Scott Stern, MD;
- Diane Altkorn, MD;
- Adam Cifu, MD; and
- Wendy Levinson, MD
- From the University of Chicago Pritzker School of Medicine, Chicago, Illinois.
2000-2001 Series: Update Sessions from ACP-ASIM's 2000 Annual Session
Margaret Ring Gillock, Editor; David Cramer, MD, Co-Editor; and Paul T. Kefalides, MD, Co-Editor
This Update is the result of a continuing journal review program conducted biweekly by members of the section of general medicine at the University of Chicago. We have covered many topics in this summary and have given priority to problems that are frequently encountered. We critically examined both content and methods and selected articles because of their importance to the practicing internist. Although some of these articles may be described again in other Updates in the 2000–2001 Update Series, we comment on them here from the general internal medicine perspective.
Osteoporosis
In women's health, a variety of treatments maintain and perhaps restore bone density. Some approaches use new agents in combination with estrogen. These new options prompt at least four questions: 1) What is the efficacy of raloxifene and the new bisphosphonate risedronate on fracture risk? 2) What is raloxifene's effect on breast cancer risk? 3) Does alendronate have additive benefit for patients with osteoporosis who are receiving hormone replacement therapy [HRT]? 4) How effective is low-dose HRT for women with osteoporosis?
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Ettinger B, Black DM, Mitlak BH, et al. Reduction of vertebral fracture risk in postmenopausal women with osteoporosis treated with raloxifene: results from a 3-year randomized clinical trial. Multiple Outcomes of Raloxifene Evaluation (MORE) Investigators. JAMA. 1999; 282:637-45.
The Multiple Outcomes of Raloxifene Evaluation (MORE) Study was a multicenter randomized, controlled trial examining fracture rates in women treated with raloxifene. A total of 7705 women with osteoporosis (mean age, approximately 66 years; mean time since menopause, approximately 18 years) were randomly assigned to receive raloxifene at 60 mg/d or 120 mg/d or placebo. In general, the improvement in bone mineral density (BMD) was similar for both …
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