yer clearly behind the times geoff!
the study (published today):
https://www.nejm.org/doi/full/10.1056/NEJMoa1808082the article:
https://www.npr.org/sections/health-sho ... derly-womeAnd while National Osteoporosis Foundation guidelines recommend drug treatment for women at risk for fractures, the American College of Physicians' guidelines say current evidence of the benefit of drugs for osteopenia is "limited."
In the new study, Reid and his colleagues gave women with osteopenia 15-minute infusions of zoledronate or a placebo once every 18 months.
After six years, the women who got zoledronate were about 30 percent less likely to have experienced any fracture and about 50 percent less likely to have experienced a fracture of their spine, the researchers reported.
"I think we've provided an important plank of evidence that can guide our clinical practice going forward," Reid says.
Michael Econs, a professor of medicine at Indiana School of Medicine who serves as the president of the ASBMR, agrees.
"What this paper does is make us think a little more about treating people who we might not have treated before or we thought might be on the line," Econs says. "We are overly worried about exceedingly rare side effects and underworried about common things like fracture. You have to start looking at where the big picture is."
There were no indications of any serious side effects. In fact, the women who got the drug appeared to be less likely to die overall than women who received the placebo, though that finding was not statistically significant. There were, however, statistically significant decreases in heart attacks and cancers among the women getting the drug.
"That's something we don't have clear explanation for," Reid says.
Although the study involved only women, Reid says the drugs may also benefit men.
It's unclear whether other bisphosphonates would be equally beneficial, though they may, Reid says.
and finally: what is osteopenia?
https://www.npr.org/2009/12/21/12160981 ... escriptionThe meeting took place in Rome, in a small hotel at the top of the Spanish Steps. There in 1992, a group of osteoporosis experts gathered under the auspices of the World Health Organization. The meeting had been organized because professional opinion about how to diagnose and measure osteoporosis was all over the map. Doctors and researchers didn't even have a shared view of how osteoporosis should be defined.
For a long time doctors and researchers were only able to diagnose osteoporosis after a woman experienced a bone fracture. But by the early '90s technology had evolved, and bone scanners made it possible to determine whether the bones were weak before any fractures occurred.
The question before the experts in Rome then was this: Since after the age of 30 all bones lose density, how much bone loss was normal? And, how much put women at risk and therefore should be considered a disease?
Anna Tosteson is a professor of medicine at the Dartmouth Institute for Health Policy and Clinical Practice and Dartmouth Medical School who attended the meeting. She says that over a two- or three-day period the experts in the room went back and forth and back and forth, looking at research and trying to decide precisely where on a graph of diminishing bone density to draw a line.
"Ultimately it was just a matter of, 'Well ... it has to be drawn somewhere,' " Tosteson says. "And as I recall, it was very hot in the meeting room, and people were in shirt sleeves and, you know, it was time to kind of move on, if you will. And, I can't quite frankly remember who it was who stood up and drew the picture and said, 'Well, let's just do this.' "
So there in the hotel room someone literally stood up, drew a line through a graph depicting diminishing bone density and decreed: Every woman on one side of this line has a disease.
Then a new question arose: How do you categorize the women who are just on the other side of that line?
To address this issue, Tosteson says, the experts — more or less off the cuff — decided to use the term osteopenia. Tosteson says they created the category mostly because they thought it might be useful for public health researchers who like clear categories for their studies. They never imagined, she says, that people would come to think of osteopenia as a disease in itself to be treated. The chairman of the meeting, John Kanis, of the WHO Collaborating Centre for Metabolic Bone Diseases, says the same thing.
Nevertheless, 17 years later Banghauser, of Richmond, Va., a woman whose bone density is just a hair away from that of the average healthy 30-year old, is not only medicated for osteopenia but literally spends her days worried about breaking a bone.
"I used to run marathons, and I would fall and trip on broken sidewalks," she told me. "And you know initially before I had this diagnosis I didn't think anything of it. But now every time I fall I get up and think, 'Oh, good, I haven't broken anything.' "
"I'm much more aware of making sure I lift my feet up and I don't trip on the sidewalks, but you know, if I didn't know that I had osteopenia, maybe I wouldn't be so cautious."
So how did osteopenia change from a category for public health researchers into a condition that millions of women swallow pills to treat?
fantastic
talk about something that decreases quality of life
