New findings with old drugs for osteoporosis.
BACKGROUND
Postmenopausal osteoporosis is common and is associated with stooped posture, loss of height, back pain and fractures.


OBJECTIVE
This evaluation is of clinical outcome trials with tibolone (Long-Term Intervention of Fractures with Tibolone) and strontium ranelate (Spinal Osteoporosis Therapeutic Intervention) in postmenopausal osteoporosis.


RESULTS
Although the Long-Term Intervention of Fractures with Tibolone trial established that tibolone decreased the incidence of vertebral and non-vertebral fractures in postmenopausal osteoporosis, it also showed that tibolone caused a small increase in the incidence of stoke. The Spinal Osteoporosis Therapeutic Intervention trial established that strontium ranelate decreased the incidence of vertebral fractures, but had little effect on the incidence of non-vertebral fractures.


CONCLUSIONS
As some of the bisphosphonates (alendronate, risedronate, zoledronic acid) have been shown to prevent hip fractures without increasing the incidence of stroke, they should be preferred to tibolone and strontium in the treatment of postmenopausal osteoporosis.
Doggrell
Sheila A
SA
Queensland University of Technology, School of Life Sciences, GPO Box 2334, QLD4001, Australia. sheila.doggrell@qut.edu.au
D050071:Bone Density Conservation Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D004164:Diphosphonates / Q000627:therapeutic use; D005260:Female; D006801:Humans; D009652:Norpregnenes / Q000009:adverse effects / Q000627:therapeutic use*; D009942:Organometallic Compounds / Q000009:adverse effects / Q000627:therapeutic use*; D015663:Osteoporosis, Postmenopausal / Q000517:prevention & control*; D020521:Stroke / Q000139:chemically induced; D013876:Thiophenes / Q000009:adverse effects / Q000627:therapeutic use*
D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D009652:Norpregnenes; D009942:Organometallic Compounds; D013876:Thiophenes; C081587:strontium ranelate; C027385:tibolone