Vitamin D and Osteoporosis

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     1  Osteoporosis New Trends inPrevention and Treatment Prof. Bari Kaplan MD. . 2-4-2003
     2  The management of postmenopausal osteoporosis first focuses on identifying the woman’s risk factors, then selecting measures that will reduce modifiable risk factors through lifestyle changes and, if indicated, pharmacologic therapy.
     3  If pharmacologic therapy is indicated FDA-approved options are: Estrogens (prevention only) according FDA new statement. Bisphosphonates and Selective estrogen-receptor modulators (prevention and treatment), Calcitonin (treatment only). PTH
     4  Anti fracture efficacy of the most frequently used treatment of postmenopausal osteoporosis in addition to the effects of calcium or vitamin D supplementation, or both, as derived from placebo controlled randomized trials. Delmas, The Lancet 359:2018-2026, 2002
     5  Magnitude of the Treatment Effect on Vertebral and Non Vertebral Fractures in Postmenopausal Woman with Osteoporosis CRANNEY A et al . ENDOCRINE REV 2002, 23(4);570 - 578 CA=Calcitonon,VIT D=Vitamin D,ALN=Alendronate ,RIS=Risedronate ,RLX=Raloxifen,SCT=Calcitonin,FLU=Fluoride,ETD =Etidronate 0.2 0 0.4 0.6 0.8 1 1.2 1.4 1.6 Relative Risk for Fractures CA n=576 VIT D n=1,130 ALN n=9,360 RIS n=2,604 RLX n=6,828 HRT n=3,117 SCT n=1,108 FLU n=646 SPINE # NONSPINE # P < 0.05 P=0.05 ETD n=1,076
     6  Osteoporosis preventionT-score –1 to –2.5 Osteoporosis treatment with or without previous fracture T-score < -2.5 Osteoporosis treatment with multiple fractures and at risk for hip fracture 50 55 60 65 70 75 80 85 90 Raloxifene Age (years) HRT=hormone replacement therapy HRT Therapeutic Management of Postmenopausal Osteoporosis PTH Short-term vasomotor symptom management Bisphosphonates