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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Journal ArticleDOI
Sustained-Release Sodium Fluoride in the Management of Established Postmenopausal Osteoporosis
Charles Y.C. Pak,Khashayar Sakhaee,Craig D. Rubin,Joseph E. Zerwekh,Norman H. Bell,Angelo A. Licata,C. Conrad Johnston,Bernard R. Rubin,Veronica K. Piziak,Helen Graham,Joyce E. Ballard,William Fears,Richard Berger,Stanley Cohen +13 more
Journal ArticleDOI
Osteoporosis and its treatment
TL;DR: Osteoporosis is common among postmenopausal women and in the past it was frequently regarded by clinicians as a normal part of aging, with little need for therapeutic intervention.
Journal ArticleDOI
The Effects of Simple Interventions on Tooth Mortality: Findings in One Trial and Implications for Future Studies
TL;DR: The PGT findings suggested that it is possible to design trials based on clinically relevant endpoints, such as tooth mortality, and that tooth mortality is simple to assess and more relevant than the unvalidated surrogate endpoints that have largely failed for more than 20 years to provide reliable answers to certain controversial issues regarding treatment efficacy.
Journal ArticleDOI
Sodium fluoride does not increase human bone cell proliferation or protein synthesis in vitro.
Jeffrey B. Kopp,P. Gehron Robey +1 more
TL;DR: The data suggest that fluoride does not actin vitro upon differentiated osteoblastic bone cells derived from adult human patients, and exposure to fluoride under conditions of low serum supplementation did not alter either the total protein synthesis of the cells or their biosynthetic profile.
Journal ArticleDOI
The effect of treatment with calcitonin on vertebral fracture rate in osteoporosis.
Peter Burckhardt,Bernard Burnand +1 more
TL;DR: Failure to allow for the initial prevalence of vertebral fractures at the individual level in therapeutic trials of calcitonin to treat osteoporosis and prevent new fractures might have contributed to the absence of a demonstrable benefit of the treatment in those studies.
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.