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Controversies in osteoporosis management: antiresorptive therapy for preventing bone loss: when to use one or two antiresorptive agents?

Clinical obstetrics and gynecology
December 1, 2013
J Christopher Gallagher et al. (2 authors)
Journal ArticleReviewHuman Study
Study Details

Study Goal

The researchers aimed to evaluate the effectiveness of combination therapies, including calcium supplementation, in preventing bone loss in postmenopausal women and older women with impaired calcium absorption.

Results Summary

The study found that combination therapies, such as calcium with bisphosphonates or calcitriol, increased bone density more effectively than monotherapy, particularly in older women with impaired calcium absorption and postmenopausal women on weaker antiresorptives.

Population

Early postmenopausal women and older women over 65 years of age with impaired calcium absorption.

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (3)
InterventionDirectionEndpointPopulationDosageImpactClaim #
combination therapies
increase
bone density
-
more than monotherapy
increase
#1
combination of bisphosphonates and calcium supplementation
decrease
bone loss
women who initially receive a weaker antiresorptive such as the SERM raloxifene
-
is necessary to prevent
#2
combination of calcitriol with bisphosphonates
increase
bone density
older women over 65 years of age who often have impaired calcium absorption
more than monotherapy
has been shown to increase
#3
Abstract

Women who have significant bone loss or a new fracture on monotherapy are considered for combination therapy. Combination therapies increase bone density more than monotherapy by targeting different parts of the osteoclast pathway.In early postmenopausal women who are symptomatic, the use of combination antiresorptives should include hormone therapy with a bisphosphonate or with bazodoxifene. In women who initially receive a weaker antiresorptive such as the SERM raloxifene, a combination with bisphosphonates and calcium supplementation is necessary to prevent bone loss. In older women over 65 years of age who often have impaired calcium absorption, the combination of calcitriol with bisphosphonates has been shown to increase bone density more than monotherapy.

Medical Subject Headings (MeSH)
AlendronateBone Density Conservation AgentsCalcitriolCalcium, DietaryDiphosphonatesDrug Therapy, CombinationEstrogen Replacement TherapyFemaleHumansOsteoporosis, PostmenopausalRaloxifene Hydrochloride
Study Links
Quality Scores
SafetyNot Assessed
Efficacy85/10
Quality75/10
Citation Metrics
Total Citations6
Citations/Year0.5
Relative Citation Ratio0.24
NIH Percentile12.2%
Research Impact Scores
APT Score0.05
Weight Score1.34
Normalized Score0.69
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