Journal ArticleDOI
Effect of fluoride treatment on the fracture rate in postmenopausal women with osteoporosis.
B. Lawrence Riggs,Stephen F. Hodgson,W. Michael O'Fallon,Edmund Y. S. Chao,Heinz W. Wahner,Joan M. Muhs,Sandra L. Cedel,L. Joseph Melon +7 more
TLDR
It is concluded that fluoride therapy increases cancellous but decreases cortical bone mineral density and increases skeletal fragility, and the fluoride-calcium regimen was not effective treatment for postmenopausal osteoporosis.Abstract:
Although fluoride increases bone mass, the newly formed bone may have reduced strength. To assess the effect of fluoride treatment on the fracture rate in osteoporosis, we conducted a four-year prospective clinical trial in 202 postmenopausal women with osteoporosis and vertebral fractures who were randomly assigned to receive sodium fluoride (75 mg per day) or placebo. All received a calcium supplement (1500 mg per day). Sixty-six women in the fluoride group and 69 women in the placebo group completed the trial. As compared with the placebo group, the treatment group had increases in median bone mineral density of 35 percent (P less than 0.0001) in the lumbar spine (predominantly cancellous bone), 12 percent (P less than 0.0001) in the femoral neck, and 10 percent (P less than 0.0001) in the femoral trochanter (sites of mixed cortical and cancellous bone), but the bone mineral density decreased by 4 percent (P less than 0.02) in the shaft of the radius (predominantly cortical bone). The number of new vertebral fractures was similar in the treatment and placebo groups (163 and 136, respectively; P not significant), but the number of nonvertebral fractures was higher in the treatment group (72 vs. 24; P less than 0.01). Fifty-four women in the fluoride group and 24 in the placebo group had side effects sufficiently severe to warrant dose reduction; the major side effects were gastrointestinal symptoms and lower-extremity pain. We conclude that fluoride therapy increases cancellous but decreases cortical bone mineral density and increases skeletal fragility. Thus, under the conditions of this study, the fluoride-calcium regimen was not effective treatment for postmenopausal osteoporosis.read more
Citations
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The Impact of Biomarkers and Surrogate End Points on Regulatory Approval of New Drugs
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Morphological Changes and Stress Redistribution in Osteoporotic Spine
TL;DR: This paper presents a 3D finite element model of a lumbar motion segment that is used to calculate stress distributions in normal and osteoporotic vertebrae with variations in trabecular density, cortical shell thickness, and endplate thickness.
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Mechanism of Mineralization of Collagen‐Based Connective Tissues
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Basic Aspects of Bone Mineralization
TL;DR: The focus of this chapter is on the so-called bone mineralization density distribution (BMDD) in health, disease and treatment where either the deviation in bone turnover or alterations in the Mineralization processes determine the mineralization distribution.
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Material properties of the skull layers of the primate parietal bone: A single-subject study.
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References
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Journal ArticleDOI
Changes in Bone Mineral Density of the Proximal Femur and Spine with Aging: DIFFERENCES BETWEEN THE POSTMENOPAUSAL AND SENILE OSTEOPOROSIS SYNDROMES
B. L. Riggs,Heinz W. Wahner,Ego Seeman,Kenneth P. Offord,William L. Dunn,R. B. Mazess,K. A. Johnson,L. J. Melton +7 more
TL;DR: The data suggest the existence of two distinct syndromes: one form, "postmenopausal osteoporosis," is characterized by excessive and disproportionate trabecular bone loss, involves a small subset of women in the early postmenopausal period, and is associated with hip fractures or vertebral fractures or both.
Journal ArticleDOI
Effect of the fluoride/calcium regimen on vertebral fracture occurrence in postmenopausal osteoporosis: comparison with conventional therapy
TL;DR: The combination of calcium fluoride, and estrogen was more effective than any other combination and grounds for optimism about the efficacy of combinations of available agents with sodium fluoride for fracture in postmenopausal osteoporosis.
Journal ArticleDOI
Concurrent assays of circulating bone Gla-protein and bone alkaline phosphatase: effects of sex, age, and metabolic bone disease.
TL;DR: The serum concentrations of 2 biochemical markers of bone formation, bone Gla-protein (BGP) and bone alkaline phosphatase (BAP), in 164 normal subjects and 164 patients with metabolic bone disorders gave concordant results, however, in patients with glucocorticoid excess.