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Osteoporosis

Bone Density and Fracture Reduction

06/24/2002

Question:

The information on previous questions has been very helpful. Please explain further how bone density is not necessarily related to fracture reduction (see Evista/Fosamax Combo question). I thought more bone density automatically means fewer fractures.

Answer:

Before medical treatment bone density does appear to correlate with likelihood of fracture. The lower the bone density, the greater the risk of fracture. After medical treatment, however, greater improvement in bone density does not always result in a lower fracture rate. The large studies of different osteoporosis agents have all shown similar rates of fracture reduction despite the fact that there are differences in bone density improvement among the different drugs. It has not been fully explained why this is the case.

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Response by:

Margery   Gass, MD Margery Gass, MD
Formely, Professor, Clinical Obstetrics & Gynecology
College of Medicine
University of Cincinnati