Letters
Women's health
Volume 181 - Issue 5

Treatment of osteoporosis: why, whom, when and how to treat

Authors:  Ego Seeman and John A Eisman

Med J Aust 2004; 181 (5): 287-288. || doi: 10.5694/j.1326-5377.2004.tb06283.x
Published online: 6 September 2004
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Ego Seeman,* John A Eisman†

* Professor of Medicine and Endocrinologist, Austin Hospital, Studley Road, Heidelberg, VIC 3084. † Professor of Medicine, and Director, Bone and Mineral Research Program, Garvan Institute of Medical Research, St Vincent's Hospital, Sydney, NSW. egosATunimelb.edu.au

In reply: Our article concerned a discussion of evidence-based treatment for the prevention of osteoporotic fractures. Prevention of osteoporosis per se is important, but the approaches chosen must be evidence- based. Calcium supplementation may diminish, but not abolish, bone loss by reducing remodelling rate.1 Any association of a lifelong diet high in calcium appears to be with peak bone mass, not rates of bone loss,2 and may be attributable to differences in protein intake or physical activity. Despite opinion, meta-analysis of prospective, randomised, double-blind, placebo-controlled studies does not support a role for calcium supplementation in reducing fractures.3

Later rather than earlier intervention avoids needless exposure to treatment for large numbers of individuals at low absolute risk of fracture (ie, those who are unlikely to sustain a fracture even without treatment).4 Vitamin D is of course indicated in vitamin D deficiency. However, there is no evidence for anti-fracture efficacy of vitamin D in ambulant community dwellers.5

Authors

  • Ego Seeman2
  • John A Eisman2
  • 1. Austin Hospital, Studley Road, Heidelberg, VIC 3084.
  • 2. and Director, Bone and Mineral Research Program, Garvan Institute of Medical Research, St Vincent's Hospital, Sydney, NSW.

Correspondence: egos@unimelb.edu.au

Competing interests

E S has been paid to sit on medical advisory boards for Aventis, Eli Lilly, and Merck Sharp & Dohme; J A E has been a paid consultant for Aventis, Eli Lilly, Merck Sharp & Dohme, NPS (USA), Organon, Roche and Servier.

References

View this article on Wiley Online Library

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