National Trends in Osteoporosis Visits and Osteoporosis Treatment, 1988-2003

Stafford, Randall S.; Drieling, Rebecca L.; Hersh, Adam L.

doi:10.1001/archinte.164.14.1525

Cited by 109 publications

(70 citation statements)

References 45 publications

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“…This finding further supports the conclusion that dissemination of the WHI study results was responsible for the observed changes in patterns of AOM use. In terms of bisphosphonate use, our results corroborate the increase in bisphosphonate use during this time period noted by Stafford et al 19 A few limitations should be considered when interpreting the results of our study. This study did not include teriparatide as one of AOMs, as the drug was approved right before our study period ended.…”

Section: Discussionsupporting

confidence: 91%

“…Another recently published study showed that the number of prescriptions with new AOMs, such as bisphosphonates, had been increasing since the release of these agents. 19 However, additional studies are needed to see if this trend continues on a long-term basis, if the switching occurred from estrogen to nonestrogen type AOM modalities, and if the recognition and treatment of osteoporosis is improved in our study population. During the period immediately before the WHI publication, estrogen was the most prevalent form of AOM prescribed in our population regardless of the primary indication for the therapy, and bisphosphonate was the second prevalent form.…”

Section: Discussionmentioning

confidence: 98%

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Osteoporosis Management in a Medicaid Population after the Women's Health Initiative Study

Lee

Wutoh

Zhang

et al. 2006

Journal of Women's Health

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Objective: Publication of the Women's Health Initiative (WHI) study has changed our understanding on the effects of hormone replacement therapy. This study was designed to evaluate patterns of antiosteoporosis medication (AOM) use in a Medicaid population before and after the release of the WHI study results. Results: The overall prevalence of AOM did not change between pre-WHI and post-WHI study publication. However, there were significant changes in the prevalence of certain AOM drug classes. Estrogen use decreased significantly after the WHI study release for all age and racial groups. The prevalence for bisphosphonates and SERM increased significantly in the post-WHI period.Conclusions: The WHI study influenced patterns of use of all types of AOM, decreasing estrogen and increasing nonestrogen use among postmenopausal women in a Medicaid program. These results suggest that the WHI study affected patterns of use of bone protective pharmacotherapy, with a shift in bone protection therapy use from estrogen to nonestrogen AOMs. 155

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 98%

Osteoporosis Management in a Medicaid Population after the Women's Health Initiative Study

Lee

Wutoh

Zhang

et al. 2006

Journal of Women's Health

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“…Bisphosphonates are indicated mainly for osteolytic conditions associated with cancer (Berenson et al, 1996(Berenson et al, , 2002Hillner et al, 2003;Body, 2009) and osteoporosis (Devogelaer, 2000;Stafford et al, 2004), with efficacy in prevention of vertebral and hip fractures (Hortobagyi et al, 1996;Ross et al, 2003). Several bisphosphonates are available in the US, including alendronate, etidronate, ibandronate, pamidronate, risedronate, and zoledronic acid.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Osteonecrosis of the Jaws

et al. 2011

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Case reports and cohort studies have linked bisphosphonate therapy and osteonecrosis of the jaws (ONJ), but neither causality nor specific risks for lesion development have been clearly established. We conducted a 1:3 case-control study with three dental Practice-based Research Networks, using dentist questionnaires and patient interviews for collection of data on bisphosphonate therapy, demographics, co-morbidities, and dental and medical treatments. Multivariable logistic regression analyses tested associations between bisphosphonate use and other risk factors with ONJ. We enrolled 191 ONJ cases and 573 controls in 119 dental practices. Bisphosphonate use was strongly associated with ONJ (odds ratios [OR] 299.5 {95%CI 70.0-1282.7} for intravenous [IV] use and OR = 12.2 {4.3-35.0} for oral use). Risk markers included local suppuration (OR = 7.8 {1.8-34.1}), dental extraction (OR = 7.6 {2.4-24.7}), and radiation therapy (OR = 24.1 {4.9-118.4}). When cancer patients (n = 143) were excluded, bisphosphonate use (OR = 7.2 {2.1-24.7}), suppuration (OR = 11.9 {2.0-69.5}), and extractions (OR = 6.6 {1.6-26.6}) remained associated with ONJ. Higher risk of ONJ began within 2 years of bisphosphonate initiation and increased four-fold after 2 years. Both IV and oral bisphosphonate use were strongly associated with ONJ. Duration of treatment > 2 years; suppuration and dental extractions were independent risk factors for ONJ.

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“…All of the pharmacologic agents approved for the treatment of osteoporosis were tested only in the context of supplemental calcium intake, and there is no evidence to indicate what their effectiveness might be in the absence of augmented calcium intake. Nevertheless, as Stafford et al (43) have noted, while physician encounters with respect to osteoporosis have increased dramatically since the introduction of alendronate in the United States in 1995, recommendations concerning calcium intake have fallen by nearly 50%, so that fewer than one in four such encounters include any mention of calcium. Corroboration of that statistic is provided by household consumption data (44) that show that 73% of the households in which a bisphosphonate is being used are not purchasing enough calcium supplement products to ensure that at least one tablet would be consumed per day per household.…”

Section: Sourcesmentioning

confidence: 99%

Calcium intake and disease prevention

Heaney

2006

Arq Bras Endocrinol Metab

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While the fundamental metabolic function of calcium is to serve as a second messenger, coupling intracellular responses to extracellular signals, nutritional deficiency of calcium is manifested at a higher level of organization: 1) depletion of the calcium nutrient reserve; 2) inadequate complexation of digestive byproducts; and 3) collateral effects of hormones produced primarily to compensate for low calcium intake. The first mechanism contributes to the osteoporosis problem, the second to kidney stones and colon cancer, and the third to hypertension, preeclampsia, obesity, and insulin resistance, among others. Adequate calcium intakes (1000-1500 mg/d) in adults have been shown in controlled trials to lower the risk of osteoporotic fractures, kidney stones, obesity, and hypertension. The best source of calcium is dairy foods, largely because the disorders concerned depend upon multiple nutrients, not just calcium, and dairy provides a broad array of essential nutrients in addition to calcium, and at low cost. RESUMO Ingesta de Cálcio e Prevenção de Doença.Enquanto a principal função metabólica do cálcio é atuar como um secundo mensageiro, acoplando as respostas intracelulares aos sinais extracelulares, a deficiência nutricional do cálcio é manifestada num nível mais alto de organização: 1) depleção da reserva de cálcio; 2) inadequada formação em complexo digestivo; 3) efeitos colaterais dos hormônios produzidos para compensar a baixa reserva de cálcio. O primeiro mecanismo contribui para o surgimento da osteoporose, o secundo para cálculos renais e câncer, e o terceiro hipertensão arterial, preeclampsia, obesidade e resistência insulínica, entre outros. Uma adequada ingesta de cálcio (1000-1500 mg/d) tem mostrado em estudos clínicos controlados em adultos, reduzir os riscos de fraturas osteoporóti-cas, cálculos renais, obesidade e hipertensão. A melhor fonte de cálcio são os laticínios, porque além do cálcio, fornecem múltiplos nutrientes e são de baixo custo.

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National Trends in Osteoporosis Visits and Osteoporosis Treatment, 1988-2003

Abstract: New medications for osteoporosis offering improved efficacy and convenient dosing were associated with increased frequency of patient visits and treatment. This finding suggests that new drug therapy contributed to increased disease recognition and treatment.

Cited by 109 publications

References 45 publications

Osteoporosis Management in a Medicaid Population after the Women's Health Initiative Study

Osteoporosis Management in a Medicaid Population after the Women's Health Initiative Study

Risk Factors for Osteonecrosis of the Jaws

Calcium intake and disease prevention

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