Drug increases bone density in postmenopausal women, study says

OSTEOPOROSIS: description risk symptoms treatment prevention Choose a link above to learn more about osteoporosis. Source: WebMD

VIDEO CNN's Rhonda Rowland reports on the use of bone cement Windows Media 28K 80K

August 18, 1999
Web posted at: 10:05 a.m. EDT (1405 GMT)

In this story: Vertebral fractures reduced 35 to 50 percent Doctors develop bone cement technique RELATED STORIES, SITES

(CNN) -- A drug prescribed to prevent osteoporosis, raloxifene, increases bone mineral density in the spine and hip and helps reduce spinal fracture in women with osteoporosis, according to a study in this week's Journal of the American Medical Association (JAMA).

"Three years of raloxifene treatment preserves bone density, reduces bone turnover and reduces the incidence of vertebral fractures in postmenopausal women with osteoporosis," researchers from Kaiser Permanente in Oakland, California, wrote.

Osteoporosis is a disease of the skeleton caused by an imbalance in the body's bone-rebuilding cycle, resulting in bone loss. Millions of older Americans, mostly women, suffer from the disease. Menopause is one of the greatest risk factors, as the loss of estrogen that occurs during menopause can lead to rapid bone loss.

In an accompanying editorial, Dr. Michael R. McClung of Providence Health System and Oregon Osteoporosis Center in Portland wrote, "Osteoporosis is no longer a disorder about which nothing can be done.... Clinicians now have the tools to identify individual patients at high risk of fractures on the basis of clinical factors such as previous fractures and with (bone mineral density) testing."

Vertebral fractures reduced 35 to 50 percent

To determine if raloxifene therapy had an effect on vertebral and nonvertebral fractures in postmenopausal women, the researchers studied 7,705 women 31 to 80 years old from 25 countries who were at least two years past menopause and had osteoporosis.

During the three-year study, participants received either 60 or 120 milligrams a day of raloxifene or a placebo. The women also received calcium and a form of vitamin D supplement. To check for vertebral fractures, X-rays were taken when the women joined the study, at 24 months and again at 36 months. Other follow-up appointments checked for nonvertebral fractures and bone density.

"The risk for vertebral fractures, detected clinically or by radiography, was decreased by 35 percent to 50 percent among women treated with raloxifene for 36 months," the authors wrote. "We found about a 2 percent to 3 percent increase in spine and hip bone mineral density after two and three years of raloxifene treatment compared with those who were in placebo group."

Between the raloxifene and placebo groups, the risk of nonvertebral fractures did not differ significantly.

Researchers also found raloxifene was associated with a lower incidence of breast cancer.

On the down side, the JAMA study found women taking raloxifene had increased risk of blood clots. Only .3 percent of the placebo group developed blood clots, compared to 1 percent of women in the raloxifene group. The risk is about the same as that of postmenopausal women who take estrogen therapy and tamoxifen.

Doctors develop bone cement technique

While raloxifene can help to prevent fractures, another technique can help heal them.

Until now there was not a lot medicine could do for the many men and women who experience spinal fractures. But at Emory University in Atlanta, Dr. Jacques Dion has helped develop a procedure called vertebroplasty.

"A complicated word, it just means that you're stabilizing a vertebra, in this particular case by injection of bone cement," Dion said.

Vertebroplasty is done while the patient is awake and takes only an hour or two.

Acrylic cement is injected directly into the damaged vertebrae to prevent further collapse.

Doctors recommend that after a fracture is fixed, medications be used to prevent further fractures.

Medical Correspondent Rhonda Rowland contributed to this report