Editorial

May Is Osteoporosis Month

Authors: Ronald C. Hamdy, MD, FRCP, FACP

Abstract

During the past year, the field of osteoporosis has witnessed many significant developments that are paving the way for great future advancements in the management of this condition. In July 2002, the National Institutes of Health announced unexpectedly that it was terminating the arm of the Women's Health Initiative (WHI) study in which patients were assigned randomly to be administered either conjugated equine estrogen and medroxyprogesterone acetate therapy or placebo. This decision was made on the basis of conclusions drawn by the Data Safety Monitoring Board that the adverse effects of such medication regimens exceeded the potential benefits. 1 The WHI study was designed to evaluate the long-term effects of various hormone replacement therapy (HRT) options.

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References

References 1. Rossouw JE, Anderson GL, Prentice RL, LaCroix AZ, Kooperberg C, Stefanick ML, et al; Writing Group for the Women's Health Initiative Investigators. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: Principal results from the Women's Health Initiative randomized controlled trial. JAMA 2002; 288: 321–333.RossouwJE]]AndersonGL]]PrenticeRL]]LaCroixAZ]]KooperbergC]]StefanickMLWriting Group for the Women's Health Initiative Investigators.Risks and benefits of estrogen plus progestin in healthy postmenopausal women: Principal results from the Women's Health Initiative randomized controlled trialJAMA2002288321 2. Hamdy RC. Lessons learned from the Women's Health Initiative study. South Med J 2002; 95: 951–952 (editorial).HamdyRCLessons learned from the Women's Health Initiative studySouth Med J200295951 3. Watts NB. Lessons from the Women's Health Initiative. South Med J 2002; 95: 952–955 (editorial).WattsNBLessons from the Women's Health InitiativeSouth Med J200295952 4. Jelovsek FR. A gynecologist's view of hormone replacement therapy in light of the Women's Health Initiative. South Med J 2002; 95: 955–957 (editorial).JelovsekFRA gynecologist's view of hormone replacement therapy in light of the Women's Health InitiativeSouth Med J200295955 5. Muse K. After the Women's Health Initiative: What to tell our patients. South Med J 2002; 95: 957–959 (editorial).MuseKAfter the Women's Health Initiative: What to tell our patientsSouth Med J200295957 6. Alpert MA. Hormone replacement therapy to reduce cardiovascular risk: A concept whose time has passed? South Med J 2002; 95: 959–961 (editorial).AlpertMAHormone replacement therapy to reduce cardiovascular risk: A concept whose time has passed?South Med J200295959 7. Peiris A, Iskandar S. Hormone replacement therapy and lipids: Time to reconsider our options? South Med J 2002; 95: 961–963 (editorial).PeirisA]]IskandarSHormone replacement therapy and lipids: Time to reconsider our options?South Med J200295961 8. Krishnan K, Karnad AB. The rise and fall of hormone replacement therapy: Oncologists’ views. South Med J 2002; 95: 963–965 (editorial).KrishnanK]]KarnadABThe rise and fall of hormone replacement therapy: Oncologists’ viewsSouth Med J200295963 9. Stephenson J. FDA orders estrogen safety warnings: Agency offers guidance for HRT use. JAMA 2003; 289: 537–538.StephensonJFDA orders estrogen safety warnings: Agency offers guidance for HRT useJAMA2003289537 10. Brewer HB Jr, Fairwell T, Ronan R, Sizemore GW, Arnaud CD. Human parathyroid hormone: Amino-acid sequence of the amino-terminal residues 1-34. Proc Natl Acad Sci U S A 1972; 69: 3585–358.BrewerHB]]FairwellT]]RonanR]]SizemoreGW]]ArnaudCDHuman parathyroid hormone: Amino-acid sequence of the amino-terminal residues 1-34Proc Natl Acad Sci U S A1972693585 11. Juppner HW, Gardella TJ, Brown EM, Kronenberg HM, Potts JT Jr. Parathyroid hormone and parathyroid hormone related peptide in the regulation of calcium homeostasis and bone development, in DeGroot LJ, Jameson JL (eds): Endocrinology: Parathyroid, Thyroid, Adrenal. Philadelphia, W.B. Saunders Co., 2001, vol 2, ed 4, pp 969–998. 12. Niall HD, Sauer RT, Jacobs JW, Keutmann HT, Segre GV, O'Riordan JL, et al. The amino-acid sequence of the amino-terminal 37 residues of human parathyroid hormone. Proc Natl Acad Sci U S A 1974; 71: 384–388.NiallHD]]SauerRT]]JacobsJW]]KeutmannHT]]SegreGV]]O'RiordanJLThe amino-acid sequence of the amino-terminal 37 residues of human parathyroid hormoneProc Natl Acad Sci U S A197471384 13. Potts JT Jr, Tregear GW, Keutmann HT, Niall HD, Sauer R, Deftos LJ, et al. Synthesis of a biologically active N-terminal tetratriacontapeptide of parathyroid hormone. Proc Natl Acad Sci U S A 1971; 68: 63–67.PottsJT]]TregearGW]]KeutmannHT]]NiallHD]]SauerR]]DeftosLJSynthesis of a biologically activeN-terminal tetratriacontapeptide of parathyroid hormoneProc Natl Acad Sci U S A19716863 14. Dobnig H, Turner RT. The effects of programmed administration of human parathyroid hormone fragment (1-34) on bone histomorphometry and serum chemistry in rats. Endocrinology 1997; 138: 4607–4612.DobnigH]]TurnerRTThe effects of programmed administration of human parathyroid hormone fragment (1-34) on bone histomorphometry and serum chemistry in ratsEndocrinology19971384607 15. Dobnig H, Turner RT. Evidence that intermittent treatment with parathyroid hormone increases bone formation in adult rats by activation of bone lining cells. Endocrinology 1995; 136: 3632–3638.DobnigH]]TurnerRTEvidence that intermittent treatment with parathyroid hormone increases bone formation in adult rats by activation of bone lining cellsEndocrinology19951363632 16. Kalu DN, Doyle FH, Pennock J, Foster GV. Parathyroid hormone and experimental osteosclerosis. Lancet 1970; 1: 1363–1366.KaluDN]]DoyleFH]]PennockJ]]FosterGVParathyroid hormone and experimental osteosclerosisLancet197011363 17. Podbesek R, Edouard C, Meunier PJ, Parsons JA, Reeve J, Stevenson RW, et al. Effects of two treatment regimes with synthetic human parathyroid hormone fragment on bone formation and the tissue balance of trabecular bone in greyhounds. Endocrinology 1983; 112: 1000–1006.PodbesekR]]EdouardC]]MeunierPJ]]ParsonsJA]]ReeveJ]]StevensonRWEffects of two treatment regimes with synthetic human parathyroid hormone fragment on bone formation and the tissue balance of trabecular bone in greyhoundsEndocrinology19831121000 18. Reeve J, Meunier PJ, Parsons JA, Bernat M, Bijvoet OL, Courpron P, et al. Anabolic effect of human parathyroid hormone fragment on trabecular bone in involutional osteoporosis: A multicentre trial. Br Med J 1980; 280: 1340–1344.ReeveJ]]MeunierPJ]]ParsonsJA]]BernatM]]BijvoetOL]]CourpronPAnabolic effect of human parathyroid hormone fragment on trabecular bone in involutional osteoporosis: A multicentre trialBr Med J19802801340 19. Rodan GA, Martin TJ. Role of osteoblasts in hormonal control of bone resorption: A hypothesis. Calcif Tissue Int 1981; 33: 349–351.RodanGA]]MartinTJRole of osteoblasts in hormonal control of bone resorption: A hypothesisCalcif Tissue Int198133349 20. Tam CS, Heersche JN, Murray TM, Parsons JA. Parathyroid hormone stimulates the bone apposition rate independently of its resorptive action: Differential effects of intermittent and continuous administration. Endocrinology 1982; 110: 506–512.TamCS]]HeerscheJN]]MurrayTM]]ParsonsJAParathyroid hormone stimulates the bone apposition rate independently of its resorptive action: Differential effects of intermittent and continuous administrationEndocrinology1982110506 21. Cosman F, Lindsay R. Is parathyroid hormone a therapeutic option for osteoporosis? A review of the clinical evidence. Calcif Tissue Int 1998; 62: 475–480.CosmanF]]LindsayRIs parathyroid hormone a therapeutic option for osteoporosis? A review of the clinical evidenceCalcif Tissue Int199862475 22. Cosman F, Nieves J, Woelfert L, Formica C, Gordon S, Shen V, et al. Parathyroid hormone added to established hormone therapy: Effects on vertebral fracture and maintenance of bone mass after parathyroid hormone withdrawal. J Bone Miner Res 2001; 16: 925–931.CosmanF]]NievesJ]]WoelfertL]]FormicaC]]GordonS]]ShenVParathyroid hormone added to established hormone therapy: Effects on vertebral fracture and maintenance of bone mass after parathyroid hormone withdrawalJ Bone Miner Res200116925 23. Dempster DW, Cosman F, Kurland ES, Zhou H, Nieves J, Woelfert L, et al. Effects of daily treatment with parathyroid hormone on bone microarchitecture and turnover in patients with osteoporosis: A paired biopsy study. J Bone Miner Res 2001; 16: 1846–1853.DempsterDW]]CosmanF]]KurlandES]]ZhouH]]NievesJ]]WoelfertLEffects of dai ly treatment with parathyroid hormone on bone microarchitecture and turnover in patients with osteoporosis: A paired biopsy studyJ Bone Miner Res2001161846 24. Finkelstein JS, Klibanski A, Arnold AL, Toth TL, Hornstein MD, Neer RM. Prevention of estrogen deficiency-related bone loss with human parathyroid hormone (1-34): A randomized controlled trial. JAMA 1998; 280: 1067–1073.FinkelsteinJS]]KlibanskiA]]ArnoldAL]]TothTL]]HornsteinMD]]NeerRMPrevention of estrogen deficiency-related bone loss with human parathyroid hormone (1-34): A randomized controlled trialJAMA19982801067 25. Hodsman AB, Fraher LJ, Watson PH, Ostbye T, Stitt LW, Adachi JD, et al. A randomized controlled trial to compare the efficacy of cyclical parathyroid hormone versus cyclical parathyroid hormone and sequential calcitonin to improve bone mass in postmenopausal women with osteoporosis. J Clin Endocrinol Metab 1997; 82: 620–628.HodsmanAB]]FraherLJ]]WatsonPH]]OstbyeT]]StittLW]]AdachiJDA randomized controlled trial to compare the efficacy of cyclical parathyroid hormone versus cyclical parathyroid hormone and sequential calcitonin to improve bone mass in postmenopausal women with osteoporosisJ Clin Endocrinol Metab199782620 26. Hodsman AB, Kisiel M, Adachi JD, Fraher LJ, Watson PH. Histomorphometric evidence for increased bone turnover without change in cortical thickness or porosity after 2 years of cyclical hPTH(1-34) therapy in women with severe osteoporosis. Bone 2000; 27: 311–318.HodsmanAB]]KisielM]]AdachiJD]]FraherLJ]]WatsonPHHistomorphometric evidence for increased bone turnover without change in cortical thickness or porosity after 2 years of cyclical hPTH(1-34) therapy in women with severe osteoporosisBone200027311 27. Jilka RL, Weinstein RS, Bellido T, Roberson P, Parfitt AM, Manolagas SC. Increased bone formation by prevention of osteoblast apoptosis with parathyroid hormone. J Clin Invest 1999; 104: 439–446.JilkaRL]]WeinsteinRS]]BellidoT]]RobersonP]]ParfittAM]]ManolagasSCIncreased bone formation by prevention of osteoblast apoptosis with parathyroid hormoneJ Clin Invest1999104439 28. Kurland ES, Cosman F, McMahon DJ, Rosen CJ, Lindsay R, Bilezikian JP. Parathyroid hormone as a therapy for idiopathic osteoporosis in men: Effects on bone mineral density and bone markers. J Clin Endocrinol Metab 2000; 85: 3069–3076.KurlandES]]CosmanF]]McMahonDJ]]RosenCJ]]LindsayR]]BilezikianJPParathyroid hormone as a therapy for idiopathic osteoporosis in men: Effects on bone mineral density and bone markersJ Clin Endocrinol Metab2000853069 29. Lindsay R, Nieves J, Formica C, Henneman E, Woelfert L, Shen V, et al. Randomised controlled study of effect of parathyroid hormone on vertebral-bone mass and fracture incidence among postmenopausal women on oestrogen with osteoporosis. Lancet 1997; 350: 550–555.LindsayR]]NievesJ]]FormicaC]]HennemanE]]WoelfertL]]ShenVRandomised controlled study of effect of parathyroid hormone on vertebral-bone mass and fracture incidence among postmenopausal women on oestrogen with osteoporosisLancet1997350550 30. Neer RM, Arnaud CD, Zanchetta JR, Prince R, Gaich GA, Reginster JY, et al. Effect of parathyroid hormone (1-34) on fractures and bone mineral density in postmenopausal women with osteoporosis. N Engl J Med 2001; 344: 1434–1441.NeerRM]]ArnaudCD]]ZanchettaJR]]PrinceR]]GaichGA]]ReginsterJYEffect of parathyroid hormone (1-34) on fractures and bone mineral density in postmenopausal women with osteoporosisN Engl J Med20013441434 31. Roe EB, Sanchez SD, Del Puerto GA, Pierini E, Bacchetti P, Cann CE, et al. Parathyroid hormone 1-34 and estrogen produce dramatic bone density increases in postmenopausal osteoporosis: Results from a placebo-controlled randomized trial. J Bone Miner Res 1999; 14 (Suppl 1): S137.RoeEB]]SanchezSD]]Del PuertoGA]]PieriniE]]BacchettiP]]CannCEParathyroid hormone 1-34 and estrogen produce dramatic bone density increases in postmenopausal osteoporosis: Results from a placebo-controlled randomized trialJ Bone Miner Res199914S137 32. Reference not provided