BMJ  2003;327:355-356 (16 August), doi:10.1136/bmj.327.7411.355

Editorial

Treatment of postmenopausal osteoporosis

Choice of treatment depends on efficacy, individual risk profile, and side effects

The first 150 words of the full text of this article appear below.

Osteoporotic fractures in older women constitute a major cause of disability, mortality, and economic burden.¹ The incidence of fractures related to osteoporosis will increase worldwide over the next three decades as the proportion of women over the age of 65 increases.² It is therefore important that we identify efficacious treatments that will reduce the incidence of osteoporotic fractures. In the past, randomised controlled trials have focused on the surrogate outcome of bone mineral density. The limitation of relying on a surrogate outcome was highlighted by the results of earlier trials, in which increases in bone density did not translate into decreased risk of fracture.³ As a result of stricter standards that required evidence of efficacy against fractures for drug approval, we now have large randomised trials with prevention of fractures as an outcome. Data from these trials provide information on the strength of the evidence for efficacy of the different . . . [Full text of this article]

Department of Medicine (Rheumatology), Queen's University, Kingston, ON, Canada K7L 3N6

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