Drug Insight

Choosing a drug treatment strategy for women with osteoporosis - An evidence-based clinical perspective

Piet P. Geusens, Christian H. Roux, David M. Reid, Willem F. Lems, Silvano Adami, Jonathan D. Adachi, Philip N. Sambrook, Kenneth G. Saag, Nancy E Lane, Marc C. Hochberg

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Many randomized controlled trials (RCTs) have investigated drug treatment for women at high risk of fracture, with a reduction in fracture risk as their end point. There has also been progress in identifying women at the highest risk of fractures. The most important clinical determinant contributing to the clinical decision of initiating and choosing drug therapy for fracture prevention is a woman's fracture risk, which, in RCTs, was determined by menopausal state, age, bone mineral density, fracture history, fall risks and glucocorticoid use. Women with secondary osteoporosis were excluded, except in studies of glucocorticoid use. A second determinant of drug therapy is the evidence for fracture prevention in terms of spectrum (vertebral, nonvertebral and/or hip fractures), size and speed of effect. In the absence of head-to-head RCTs with fracture risk as the end point, however, the efficacy of antifracture drugs cannot be directly compared. Other determinants include the potential extraskeletal benefits and safety concerns of the drug, patient preferences and reimbursement issues.

Original languageEnglish (US)
Pages (from-to)240-248
Number of pages9
JournalNature Clinical Practice Rheumatology
Volume4
Issue number5
DOIs
StatePublished - May 2008

Fingerprint

Osteoporosis
Pharmaceutical Preparations
Randomized Controlled Trials
Glucocorticoids
Therapeutics
Drug Therapy
Fracture Fixation
Patient Preference
Hip Fractures
Bone Density
Safety

ASJC Scopus subject areas

  • Rheumatology

Cite this

Geusens, P. P., Roux, C. H., Reid, D. M., Lems, W. F., Adami, S., Adachi, J. D., ... Hochberg, M. C. (2008). Drug Insight: Choosing a drug treatment strategy for women with osteoporosis - An evidence-based clinical perspective. Nature Clinical Practice Rheumatology, 4(5), 240-248. https://doi.org/10.1038/ncprheum0773

Drug Insight : Choosing a drug treatment strategy for women with osteoporosis - An evidence-based clinical perspective. / Geusens, Piet P.; Roux, Christian H.; Reid, David M.; Lems, Willem F.; Adami, Silvano; Adachi, Jonathan D.; Sambrook, Philip N.; Saag, Kenneth G.; Lane, Nancy E; Hochberg, Marc C.

In: Nature Clinical Practice Rheumatology, Vol. 4, No. 5, 05.2008, p. 240-248.

Research output: Contribution to journalArticle

Geusens, PP, Roux, CH, Reid, DM, Lems, WF, Adami, S, Adachi, JD, Sambrook, PN, Saag, KG, Lane, NE & Hochberg, MC 2008, 'Drug Insight: Choosing a drug treatment strategy for women with osteoporosis - An evidence-based clinical perspective', Nature Clinical Practice Rheumatology, vol. 4, no. 5, pp. 240-248. https://doi.org/10.1038/ncprheum0773
Geusens, Piet P. ; Roux, Christian H. ; Reid, David M. ; Lems, Willem F. ; Adami, Silvano ; Adachi, Jonathan D. ; Sambrook, Philip N. ; Saag, Kenneth G. ; Lane, Nancy E ; Hochberg, Marc C. / Drug Insight : Choosing a drug treatment strategy for women with osteoporosis - An evidence-based clinical perspective. In: Nature Clinical Practice Rheumatology. 2008 ; Vol. 4, No. 5. pp. 240-248.
@article{1b7af853f6e0489fabadd6b0e02dbb70,
title = "Drug Insight: Choosing a drug treatment strategy for women with osteoporosis - An evidence-based clinical perspective",
abstract = "Many randomized controlled trials (RCTs) have investigated drug treatment for women at high risk of fracture, with a reduction in fracture risk as their end point. There has also been progress in identifying women at the highest risk of fractures. The most important clinical determinant contributing to the clinical decision of initiating and choosing drug therapy for fracture prevention is a woman's fracture risk, which, in RCTs, was determined by menopausal state, age, bone mineral density, fracture history, fall risks and glucocorticoid use. Women with secondary osteoporosis were excluded, except in studies of glucocorticoid use. A second determinant of drug therapy is the evidence for fracture prevention in terms of spectrum (vertebral, nonvertebral and/or hip fractures), size and speed of effect. In the absence of head-to-head RCTs with fracture risk as the end point, however, the efficacy of antifracture drugs cannot be directly compared. Other determinants include the potential extraskeletal benefits and safety concerns of the drug, patient preferences and reimbursement issues.",
author = "Geusens, {Piet P.} and Roux, {Christian H.} and Reid, {David M.} and Lems, {Willem F.} and Silvano Adami and Adachi, {Jonathan D.} and Sambrook, {Philip N.} and Saag, {Kenneth G.} and Lane, {Nancy E} and Hochberg, {Marc C.}",
year = "2008",
month = "5",
doi = "10.1038/ncprheum0773",
language = "English (US)",
volume = "4",
pages = "240--248",
journal = "Nature reviews. Rheumatology",
issn = "1759-4790",
publisher = "Nature Publishing Group",
number = "5",

}

TY - JOUR

T1 - Drug Insight

T2 - Choosing a drug treatment strategy for women with osteoporosis - An evidence-based clinical perspective

AU - Geusens, Piet P.

AU - Roux, Christian H.

AU - Reid, David M.

AU - Lems, Willem F.

AU - Adami, Silvano

AU - Adachi, Jonathan D.

AU - Sambrook, Philip N.

AU - Saag, Kenneth G.

AU - Lane, Nancy E

AU - Hochberg, Marc C.

PY - 2008/5

Y1 - 2008/5

N2 - Many randomized controlled trials (RCTs) have investigated drug treatment for women at high risk of fracture, with a reduction in fracture risk as their end point. There has also been progress in identifying women at the highest risk of fractures. The most important clinical determinant contributing to the clinical decision of initiating and choosing drug therapy for fracture prevention is a woman's fracture risk, which, in RCTs, was determined by menopausal state, age, bone mineral density, fracture history, fall risks and glucocorticoid use. Women with secondary osteoporosis were excluded, except in studies of glucocorticoid use. A second determinant of drug therapy is the evidence for fracture prevention in terms of spectrum (vertebral, nonvertebral and/or hip fractures), size and speed of effect. In the absence of head-to-head RCTs with fracture risk as the end point, however, the efficacy of antifracture drugs cannot be directly compared. Other determinants include the potential extraskeletal benefits and safety concerns of the drug, patient preferences and reimbursement issues.

AB - Many randomized controlled trials (RCTs) have investigated drug treatment for women at high risk of fracture, with a reduction in fracture risk as their end point. There has also been progress in identifying women at the highest risk of fractures. The most important clinical determinant contributing to the clinical decision of initiating and choosing drug therapy for fracture prevention is a woman's fracture risk, which, in RCTs, was determined by menopausal state, age, bone mineral density, fracture history, fall risks and glucocorticoid use. Women with secondary osteoporosis were excluded, except in studies of glucocorticoid use. A second determinant of drug therapy is the evidence for fracture prevention in terms of spectrum (vertebral, nonvertebral and/or hip fractures), size and speed of effect. In the absence of head-to-head RCTs with fracture risk as the end point, however, the efficacy of antifracture drugs cannot be directly compared. Other determinants include the potential extraskeletal benefits and safety concerns of the drug, patient preferences and reimbursement issues.

UR - http://www.scopus.com/inward/record.url?scp=43149114230&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=43149114230&partnerID=8YFLogxK

U2 - 10.1038/ncprheum0773

DO - 10.1038/ncprheum0773

M3 - Article

VL - 4

SP - 240

EP - 248

JO - Nature reviews. Rheumatology

JF - Nature reviews. Rheumatology

SN - 1759-4790

IS - 5

ER -