New Treatments for Growing Scourge of Brittle Bones

Patients and physicians do not usually view brittle and broken bones as a health concern as important as breast cancer or heart disease, but they should. Osteoporosis, which causes weak bones in adults, is a subtle, dangerous disease. One in 3 women and 1 in 9 men older than 80 years of age will have a hip fracture as a result of osteoporosis, and 15% to 30% will die of complications related to the fracture. For women, the lifetime risk for dying of hip fracture is the same as the risk of dying of breast cancer, and men older than 50 are at greater risk for osteoporosis-related fracture than they are for prostate cancer, according to the National Osteoporosis Foundation. Vertebral fractures, which are commonly associated with osteoporosis, are also associated with increased mortality. Broken bones wreak havoc in less critical ways—1 study linked osteoporosis-related disability to more inactive days in bed than stroke, myocardial infarction, breast cancer, or chronic obstructive pulmonary disease (1). The World Health Organization identified osteoporosis as second only to cardiovascular disease as a leading health care problem.

Even with today's increased awareness of osteoporosis, as many as half of all persons who have osteoporosis—defined as bone mineral density (BMD) 2.5 or more standard deviations below the mean for young adults—go undiagnosed and untreated. People older than 50 years of age who present to the emergency department with a fracture typically are not screened for osteoporosis, even though fracture is a major indicator of the disease, according to Nelson Watts, MD, at the University of Cincinnati. People on long-term, high-dose corticosteroid therapy develop a significantly increased risk for fracture within 3 months but typically do not receive treatment to prevent bone loss, Watts added. When osteoporosis is treated, undesirable side effects, such as hot flashes …