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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/8297

Title: Drug Insight: choosing a drug treatment strategy for women with osteoporosis - an evidence-based clinical perspective
Authors: GEUSENS, Piet
Roux, CH
Reid, DM
Lems, WF
Adami, S.
Adachi, Jonathan D.
Sambrook, PN
Saag, KG
Lane, NE
Hochberg, MC
Issue Date: 2008
Publisher: NATURE PUBLISHING GROUP
Citation: NATURE CLINICAL PRACTICE RHEUMATOLOGY, 4(5). p. 240-248
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.
Notes: Univ Hasselt, Inst Biomed Res, Haselt, Belgium. Univ Paris, Bone Unit, Paris, France. Univ Aberdeen, Aberdeen AB9 1FX, Scotland. Vrije Univ Amsterdam Med Ctr, Amsterdam, Netherlands. Univ Verona, I-37100 Verona, Italy. McMaster Univ, Hamilton, ON L8S 4L8, Canada. Univ Sydney, Sydney, NSW 2006, Australia. Univ Alabama, Birmingham, AL USA. Univ Calif Davis, Med Ctr, Sacramento, CA 95817 USA. Univ Maryland, Sch Med, College Pk, MD 20742 USA.
URI: http://hdl.handle.net/1942/8297
DOI: 10.1038/ncprheum0773
ISI #: 000255348000007
ISSN: 1745-8382
Category: A1
Type: Journal Contribution
Validation: ecoom, 2009
Appears in Collections: Research publications

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