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01-03-2005 | Consensus Statement

Evidence-based guidelines for the treatment of postmenopausal osteoporosis: a consensus document of the Belgian Bone Club

Authors: Steven Boonen, Jean-Jacques Body, Yves Boutsen, Jean-Pierre Devogelaer, Stefan Goemaere, Jean-Marc Kaufman, Serge Rozenberg, Jean-Yves Reginster

Published in: Osteoporosis International | Issue 3/2005

Excerpt

Osteoporosis is widely recognized as a major public health concern. The cumulative lifetime fracture risk for a 50-year woman with osteoporosis is as high as 60% [1]. In Belgium, the annual costs of osteoporotic fractures are currently estimated in the range of 150 million euros, on a societal perspective [2]. Effective fracture prevention would have a major impact on women’s morbidity and to a lesser extend mortality. The availability of new therapeutic agents has made clinical decision-making in osteoporosis more complex [3]. Because individual clinicians cannot systematically collect all the evidence bearing on the efficacy of osteoporosis therapies, they require summaries for consistent therapeutic patterns [3]. As recommended by the International Osteoporosis Foundation (IOF), nation-specific guidelines are requested to take into consideration the specificities of each and every health care environment. The present document is the result of a national consensus, based on a systematic review and a critical appraisal of the currently available literature. It offers an evidence-based update to previous Belgian Bone Club treatment guidelines [4], with the aim of providing clinicians with an unbiased assessment of osteoporosis treatment effect. …

Cummings SR, Black MD, Rubin SM (1989) Lifetime risks of hip. Colles’ or vertebral fracture rate and coronary heart disease among white postmenopausal women. Arch Intern Med 149:2445–2448CrossRefPubMed

Autier P, Haentjens P, Bentin J, Baillon JM, Grivegnee AR, Closon MC, Boonen S (2000) Costs induced by hip fractures: a prospective controlled study in Belgium. Osteoporos Int 11:373–380CrossRefPubMed

The Osteoporosis Methodology Group and The Osteoporosis Research Advisory Group (2002) Meta-analyses of therapies for postmenopausal osteoporosis. Endocr Rev 28:496–507

Kaufman JM, Body JJ, Boonen S, Devogelaer JP, Raeman F, Rozenberg S, Reginster JY (2000) L’ostéoporose involutive de la femme: stratégie thérapeutique. Un point de vue actualisé du Belgian Bone Club. Rev Med Liège 55:443–448

NIH Consensus Conference Development panel on optimal calcium intake (1994) Optimal calcium intake. JAMA 272:1942–1948CrossRefPubMed

Deprez X, Fardellone P (2003) Nonpharmacologic prevention of osteoporotic fractures. Joint Bone Spine 70:448–457CrossRefPubMed

Chapuy MC, Arlot ME, Duboeuf F, Brun J, Crouzet B, Arnaud S, Delmas PD, Meunier PJ (1992) Vitamin D₃ and calcium to prevent hip fractures in the elderly women. N Engl J Med 327:1637–1642PubMed

Chapuy MC, Arlot ME, Delmas PD, Meunier PJ (1994) Effect of calcium and cholecalciferol treatment for three years on hip fractures in elderly women. BMJ 308:1081–1082PubMed

Chapuy MC, Pamphile R, Paris E, Kempf C, Schlichting M, Arnaud S, Garnero P, Meunier PJ (2002) Combined calcium and vitamin D₃ supplementation in elderly women: confirmation of reversal of secondary hyperparathyroidism and hip fracture risk: the Decalyos II study. Osteoporos Int 13:257–264CrossRefPubMed

10.

Dawson-Hughes B, Harris SS, Krall EA, Dallal GE (1997) Effect of calcium and vitamin D supplementation on bone density in men and women 65 years of age or older. N Engl J Med 337:670–676CrossRefPubMed

11.

Lips P, Graafmans WC, Ooms ME, Bezemer PD, Bouter LM (1996) Vitamin D supplementation and fracture incidence in elderly persons. A randomized, placebo-controlled clinical trial. Ann Intern Med 124:400–406PubMed

12.

Trivedi DP, Doll R, Khaw KT (2003) Effect of four monthly oral vitamin D₃ (cholecalciferol) supplementations on fractures and mortality in men and women living in the community: randomised double blind controlled trial. BMJ 326:469–474CrossRefPubMed

13.

Heikinheimo RJ, Inkovaara JA, Harju EJ, Haavisto MV, Kaarela RH, Kataja JM, Kokko AM, Kolho LA, Rajala SA (1992) Annual injection of vitamin D and fractures of aged bones. Calcif Tissue Int 51:105–110CrossRefPubMed

14.

Consensus Development Conference on Osteoporosis (1993) Hong Kong, April 1–2, 1993. Am J Med 95(5A):1S–78S

15.

Rozenberg S, Vandromme J, Kroll M, Pastijn A, Degueldre M (1994) Osteoporosis prevention with sex hormone replacement therapy. Int J Fertil Menopausal Stud 39:262–271PubMed

16.

Writing Group for the Women’s Health Initiative Investigators (2002) Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative randomized controlled trial. JAMA 288:321–333PubMed

17.

Hulley S, Grady D, Bush T, Furberg C, Herrington D, Riggs B, Vittinghoff E, for the Heart and Estrogen/progestin Replacement Study (HERS) Research Group (1998) JAMA 280:605–613CrossRefPubMed

18.

Skouby SO, Barlow D, Samsioe G, Gompel A, Pines A, Al-Azzawi F, Graziottin A, Hudita D, Rozenberg S (2004) Climacteric medicine: European Menopause and Andropause Society (EMAS) statements on postmenopausal hormonal therapy. Maturitas 48:19–25CrossRefPubMed

19.

Cauley JA, Robbins J, Chen Z, Cummings SR, Jackson RD, Lacroix AZ, Leboff M, Lewis CE, McGowan J, Neuner J, Pettinger M, Stefanick ML, Wactawski-Wende J, Watts NB (2003) Effects of estrogen plus progestin on risk of fracture and bone mineral density. The Women’s Health Initiative Randomized Trial. JAMA 290:1729–1738CrossRefPubMed

20.

Alexandersen P, Toussaint A, Christiansen C, Devogelaer JP, Roux C, Fechtenbaum J, Gennari C, Reginster JY (2001) Ipriflavone Multicenter European Fracture Study Ipriflavone in the treatment of postmenopausal osteoporosis: a randomized controlled trial. JAMA 285:1482–1488CrossRefPubMed

21.

Alekel DL, St Germain A, Peterson CT, Hanson KB, Stewart JW, Toda (2000) Isoflavone-rich soy protein isolate attenuates bone loss in the lumbar spine of perimenopausal women. Am J Clin Nutr 72:844–852PubMed

22.

Hsu CS, Shen WW, Hsueh YM, Yeh SL (2001) Soy isoflavone supplementation in postmenopausal women. Effects on plasma lipids, antioxidant enzyme activities and bone density. J Reprod Med 46:221–226PubMed

23.

Chen YM, Ho SC, Lam SS, Ho SS, Woo JL (2003) Soy isoflavones have a favorable effect on bone loss in Chinese postmenopausal women with lower bone mass: a double-blind, randomized, controlled trial. J Clin Endocrinol Metab 88:4740–4747CrossRefPubMed

24.

Kreijkamp-Kaspers S, Kok L, Grobbee DE, de Haan EH, Aleman A, Lampe JW, van der Schouw YT (2004) Effect of soy protein containing isoflavones on cognitive function, bone mineral density, and plasma lipids in postmenopausal women: a randomized controlled trial. JAMA 292:65–74CrossRefPubMed

25.

Nikander E, Metsa-Heikkila M, Ylikorkala O, Tiitinen A (2004) Effects of phytoestrogens on bone turnover in postmenopausal women with a history of breast cancer. J Clin Endocrinol Metab 89:1207–1212CrossRefPubMed

26.

Reginster JY (1991) Effect of calcitonin on bone mass and fracture rates. Am J Med 91 [Suppl 5B]:19S–22S

27.

Plosker GL, McTavis D (1996) Intranasal salcaltonin: a review of its pharmacological properties and role in the management of postmenopausal osteoporosis. Drugs Aging 8:378–400PubMed

28.

Reginster JY, Albert A, Lecart MP, Lambelin P, Denis D, Deroisy R, Fontaine MA, Franchimont P (1987) 1-year controlled randomised trial of prevention of early postmenopausal bone loss by intranasal calcitonin. Lancet I :1481–1483CrossRef

29.

Wallach S (1993) Effects of calcitonin on bone quality and osteoblastic function. Calcif Tissue Int 52:325–339CrossRefPubMed

30.

Silverman S (2001) Calcitonin. Rheum Dis Clin North Am 27:187–196PubMed

31.

Carstens JH (1991) Future horizons for calcitonin: a US perspective. Calcif Tissue Int 49 [Suppl 2]:S2–S6

32.

Takahashi S, Goldring S, Katz M (1995) Downregulation of calcitonin receptor mRNA expression by calcitonin during human osteoclast-like cell differentiation. J Clin Invest 95:167–171PubMed

33.

Cranney A, Tugwell P, Zytaruk N, Robinson V, Weaver B, Shea B, Wells G, Adachi J, Waldegger, Guyatt G, The osteoporosis methodology group, and the osteoporosis research advisory group VI (2002) Meta-analysis of calcitonin for the treatment of postmenopausal osteoporosis Endocr Rev 23(4):540–551

34.

Chestnut CH 3rd, Silverman S, Andriano K, Genant H, Giomona A, Harris S, Kiel D, LeBoff M, Maricic M, Miller P, Moniz C, Peacock M, Richardson P, Watts N, Baylink D (2000) A randomized trial of nasal spray salmon calcitonin in postmenopausal women with established osteoporosis: the prevent recurrence of osteoporotic fracture study. PROOF Study Group. Am J Med 109:267–276CrossRefPubMed

35.

Hizmettli S, Elden H, Kaptanoglu E, Nacitarhan V, Kocagil S (1996) The effect of different doses of calcitonin on bone mineral density and fracture risk in postmenopausal osteoporosis. Int J Clin Pract 52:453–455

36.

Overgaard K, Hansen MA, Jensen SB, Christiansen C (1992) Effect of salcaltonin given intranasally on bone mass and fracture rated in established osteoporosis: a dose-response study. BMJ 305:556–561PubMed

37.

Gennari C, Chierichetti SM, Bigazzi S, Fusi L, Gonnelli S, Ferrara R, Raccheif (1985) Comparative effects on bone mineral content of calcium plus salmon calcitonin given in two different regimens in postmenopausal osteoporosis. Curr Ther Res 38:455–462

38.

Rico H, Revilla M, Hernandez ER, Villa LF, Alverex de Buergo M (1995) Total and regional bone mineral content and fracture rate in postmenopausal osteoporosis treated with salmon calcitonin: a prospective study. Calcif Tissue Int 56:181–185CrossRefPubMed

39.

Kanis JA, Johnell O, Gulberg BO, Allander E, Dilsen G, Gennari C (1992) Evidence for efficacy of drugs affecting bone metabolism in preventing hip fracture. BMJ 305:1124–1128PubMed

40.

Riggs BL, Hartmann LC (2003) Selective estrogen-receptor modulators—Mechanisms of action and application to clinical practice. N Engl J Med 348:618–629CrossRefPubMed

41.

Early Breast Cancer Trialists’ Collaborative Group (1998) Tamoxifen for early breast cancer: an overview of the randomised trials. Lancet 351:1451–1467CrossRefPubMed

42.

Ryan WG, Wolter J, Bagdade JD (1991) Apparent beneficial effect of tamoxifen on bone mineral content in patients with breast cancer: preliminary study. Osteoporos Int 2:39–41PubMed

43.

Lufkin EG, Whitaker MD, Nickelsen T, Argueta R, Caplan RH, Knickerbocker RK, Riggs BL (1998) Treatment of established postmenopausal osteoporosis with raloxifene: a randomized trial. J Bone Miner Res 13:1747–1754PubMed

44.

Ettinger B, Black DM, Mitlak BH, Knickerbocker RK, Nickelsen T, Genant HK, Christiansen C, Delmas PD, Zanchetta JR, Stakkestad J, Gluer CC, Krueger K, Cohen FJ, Eckert S, Ensrud KE, Avioli LV, Lips P, Cummings SR (1999) Reduction of vertebral fracture risk in postmenopausal women with osteoporosis treated with raloxifene: results from a 3-year randomized clinical trial. Multiple Outcomes of Raloxifene Evaluation (MORE) Investigators. JAMA 282:637–645CrossRefPubMed

45.

Maricic M, Adachi JD, Sarkar S, Wu W, Wong M, Harper KD (2002) Early effects of raloxifene on clinical vertebral fractures at 12 months in postmenopausal women with osteoporosis. Arch Intern Med 162:1140–1143CrossRefPubMed

46.

Delmas PD, Genant HK, Crans GG, Stock JL, Wong M, Siris E, Adachi JD (2003) Severity of prevalent vertebral fractures and the risk of subsequent vertebral and nonvertebral fractures: results from the MORE trial. Bone 33:522–532CrossRefPubMed

47.

Siris E, Adachi JD, Lu Y, Fuerst T, Crans GG, Wong M, Harper KD, Genant HK (2002) Effects of raloxifene on fracture severity in postmenopausal women with osteoporosis: results from the MORE study. Osteoporos Int 13:907–913CrossRefPubMed

48.

Kanis JA, Johnell O, Black DM, Downs RW Jr, Sarkar S, Fuerst T, Secrest RJ, Pavo I (2003) Effect of raloxifene on the risk of new vertebral fracture in postmenopausal women with osteopenia or osteoporosis: a reanalysis of the Multiple Outcomes of Raloxifene Evaluation trial. Bone 33:293–300CrossRefPubMed

49.

Delmas PD, Ensrud KE, Adachi JD, Harper KD, Sarkar S, Gennari C, Reginster JY, Pols HAP, Recker RR, Harris ST, Wu W, Genant HK, Black DM, Eastell R, for the Multiple Outcomes of Raloxifene Evaluation (MORE) Investigators (2002) Efficacy of raloxifene on vertebral fracture risk reduction in postmenopausal women with osteoporosis: four-year results from a randomized clinical trial. J Clin Endocrinol Metab 87:3609–3617CrossRefPubMed

50.

Cummings SR, Karpf DB, Harris F, Genant HK, Ensrud K, Lacroix AZ, Black DM (2002) Improvement in spine bone density and reduction in risk of vertebral fractures during treatment with antiresorptive agents. Am J Med 112: 281–289CrossRefPubMed

51.

Sarkar S, Mitlak BH, Wong M, Stock JL, Black DM, Harper KD (2002) Relationships between bone mineral density and incident vertebral fracture risk with raloxifene therapy. J Bone Miner Res 17:1–10

52.

Bjarnason NH, Sarkar S, Duong T, Mitlak B, Delmas PD, Christiansen C (2001) Six- and 12-month changes in bone turnover are related to reduction in vertebral fracture risk during 3 years of raloxifene treatment in postmenopausal osteoporosis. Osteoporos Int 12:922–930CrossRefPubMed

53.

Cummings SR, Eckert S, Krueger KA, Grady D, Powles TJ, Cauley JA, Norton L, Nickelsen T, Bjarnason NH, Morrow M, Lippman ME, Black D, Glusman JE, Costa A, Jordan VC (1999) The effect of raloxifene on risk of breast cancer in postmenopausal women: results from the MORE randomized trial. Multiple Outcomes of Raloxifene Evaluation. JAMA 281:2189–2197CrossRefPubMed

54.

Barrett-Connor E, Grady D, Sashegyi A, Anderson PW, Cox DA, Hoszowski K, Rautaharju P, Harper KD, MORE Investigators (Multiple Outcomes of Raloxifene Evaluation) (2002) Raloxifene and cardiovascular events in osteoporotic postmenopausal women: four-year results from the MORE randomized trial. JAMA 287:847–857CrossRefPubMed

55.

Zimolo Z, Wesolowski G, Rodan GA (1995) Acid extrusion is induced by osteoclast attachment to bone: Inhibition by alendronate and calcitonin. J Clin Invest 96:2277–2283PubMed

56.

Frith JC, Mönkkönen J, Blackbum GM, Russel RGG, Rogers MJ (1997) Clodronate and liposome-encapsulated clodronate are metabolized to a toxic ATP analog, adenosine 5’-(s-d-dichloromethylene) triphosphate, by mammalian cells in vitro. J Bone Miner Res 12:1358–1367PubMed

57.

Luckman SP, Hughes DE, Coxon FP, Russell RGG, Rogers MJ (1998) Nitrogen-containing bisphosphonates inhibit the mevalonate pathway and prevent post-translational prenylation of GTP-binding proteins, including Ras. J Bone Miner Res 13:581–589PubMed

58.

Body JJ (2002) Bisphosphonates as chemotherapeutic agents. Curr. Opin. in Oncologic, Endocrine & Metabolic Investigational Drugs 2:155–161

59.

Harris ST, Watts NB, Jackson RD et al (1993) Four-year study of intermittent cyclic etidronate treatment of postmenopausal osteoporosis—three years of blinded therapy followed by one year of open therapy. Am J Med 95:557–567CrossRefPubMed

60.

Kaufman JM, Devogelaer JP, Raeman F, Rozenberg S, Body JJ, Westhovens R, Reginster JY (1996) Prevention and treatment of postmenopausal osteoporosis national consensus of the “Belgian Bone Club” November. Clin Rheumatol 16:343–345

61.

Liberman UA, Weiss SR, Broll J et al (1995) Effect of oral alendronate on bone mineral density and the incidence of fractures in postmenopausal osteoporosis. N Engl J Med 333:1437–1443CrossRefPubMed

62.

Black DM, Cummings SR, Karpf DB et al (1996) Randomised trial of effect of alendronate on risk of fracture in women with existing vertebral fractures. Lancet 348:1535–1541CrossRefPubMed

63.

Cummings SR, Black DM, Thomson DE et al, for the Fracture Intervention Trial Research Group (1998) Effect of alendronate on risk of fracture in women with low bone density but without vertebral fractures—Results from the Fracture Intervention Trial. JAMA 280:2077–2082CrossRefPubMed

64.

Karpf DB, Shapiro DR, Seeman E et al (1997) Prevention of nonvertebral fractures by alendronate. A meta-analysis. Alendronate Osteoporosis Treatment Study Groups. JAMA 277:1159–1164CrossRefPubMed

65.

Cranney A, Wells G, Willan A, Griffith L, Zytaruk N, Robinson V, Black D, Adachi J, Shea B, Tugwell P, Guyatt G (2002) Meta-analyses of therapies for postmenopausal osteoporosis. II. Meta-analysis of alendronate for the treatment of postmenopausal women. Endocr Rev 23:508–516CrossRefPubMed

66.

Bone HG, Hosking D, Devogelaer JP, Tucci JR, Emkey RD, Tonino RP, Rodriguez-Portales JA, Downs RW, Gupta J, Santora AC, Liberman UA (2004) Ten years’ experience with alendronate for osteoporosis in postmenopausal women. N Engl J Med 350:1189–1199CrossRefPubMed

67.

de Groen PC, Lubbe DF, Hirsch LJ, Daifotis A, Stephenson W, Freedholm D, Pryor-Tillotson S, Seleznick MJ, Pinkas H, Wang KK (1996) Esophagitis associated with the use of alendronate. N Engl J Med 335:1016–1021CrossRefPubMed

68.

Schnitzer T, Bone HG, Crepaldi G et al (2000) Therapeutic equivalence of alendronate 70 mg once-weekly and alendronate 10 mg daily in the treatment of osteoporosis. Alendronate Once-Weekly Study Group. Aging (Milano) 12:1–12

69.

Harris ST, Watts NB, Genant HK, McKeever CD, Hangartner T, Keller M, Chesnut CH 3rd, Brown J, Eriksen EF, Hoseyni MS, Axelrod D, Miller PD (1999) Effects of risedronate treatment on vertebral and nonvertebral fractures in women with postmenopausal osteoporosis. A randomized controlled trial. JAMA 282:1344–1352CrossRefPubMed

70.

Reginster JY, Minne HW, Sorensen OH, Hooper M, Roux C, Brandi ML, Lund B, Ethgen D, Pack S, Roumagnac I, Eastell R (2000) Randomized trial of the effects of risedronate on vertebral fractures in women with established postmenopausal osteoporosis. Vertebral Efficacy with Risedronate Therapy (VERT) Study Group. Osteoporos Int 11:83–91CrossRefPubMed

71.

Watts NB, Josse RG, Hamdy RC, Hughes RA, Manhart MD, Barton I, Calligeros D, Felsenberg D (2003) Risedronate prevents new vertebral fractures in postmenopausal women at high risk. J Clin Endocrinol Metab 88:542–549CrossRefPubMed

72.

Sorensen OH, Crawford GM, Mulder H, Kosking DJ, Gennari C, Mellstrom D, Pack S, Wenderoth D, Cooper C, Reginster JY (2003) Long-term efficacy of risedronate: a 5-year placebo-controlled clinical experience. Bone 32:120–126CrossRefPubMed

73.

Boonen S, McClung M, Eastell R, Fuleihan G, Barton I, Delmas P (2004) Safety and efficacy of risedronate in reducing fracture risk in osteoporotic women 80 years of age or older: Implications for the use of antiresorptive agents in the oldest old. J Am Geriatr Soc 52(11):1832–1839CrossRefPubMed

74.

McClung MR, Geusens P, Miller PD et al (2001) Hip Intervention Program Study Group: Effect of risedronate on the risk of hip fracture in elderly women. Hip Intervention Program Study Group. N Engl J Med 344:333–340CrossRefPubMed

75.

Cranney A, Tugwell P, Adachi J, Weaver B, Zytaruk N, Papaioannou A, Robinson V, Shea B, Wells G, Guyatt G (2002) Meta-analyses of therapies for postmenopausal osteoporosis. III. Meta-analysis of risedronate for the treatment of postmenopausal osteoporosis. Endocr Rev 23:517–523CrossRefPubMed

76.

Brown JP, Kendler DL, McClung MR, Emkey RD, Adachi JD, Bolognese MA, Li Z, Blaske A, Lindsay R (2002) The efficacy and tolerability of risedronate once a week for the treatment of postmenopausal osteoporosis. Calcif Tissue Int 71:103–111CrossRefPubMed

77.

Boonen S, Haentjens P, Vandenput, Vanderschueren D (2004) Preventing osteoporotic fractures with antiresorptive therapy: Implications of microarchitectural changes. J Intern Med 255:1–12

78.

Watts N, Cooper C, Lindsay B, Eastell R, Manhart M, Barton I, van Staa T, Adachi J (2004) Relationship between changes in bone mineral density and vertebral fracture risk associated with risedronate: Greater increases in bone mineral density do not relate to greater decreases in fracture risk. J Clin Densitom 7:255–261CrossRefPubMed

79.

Chesnut CH 3rd, Skag A, Christiansen C, Recker R, Stakkestad JA, Hoiseth A, Felsenberg D, Huss H, Gilbride J, Schimmer RC, Delmas PD (2004) Effects of oral ibandronate administered daily or intermittently on fracture risk in postmenopausal osteoporosis. J Bone Miner Res 19:1241–1249PubMed

80.

Reginster JY, Taquet AN, Fraikin G, Gosset C, Zegels B (1997) Parathyroid hormone in the treatment of involutional osteoporosis: back to the future. Osteoporos Int 7:S163–167PubMed

81.

Neer RM, Arnaud CD, Zanchetta JR, Prince R, Gaich GA, Reginster JY, Hodsman AB, Eriksen EF, Ish-Shalom S, Genant HK, Wang O, Mitlak BH (2001) Effect of parathyroid hormone (1–34) on fractures and bone mineral density in postmenopausal women with osteoporosis. N Engl J Med 344:1434–1441CrossRefPubMed

82.

Marcus R, Wang O, Satterwhite J, Mitlak B (2003) The skeletal response to teriparatide is largely independent of age, initial bone mineral density, and prevalent vertebral fractures in postmenopausal women with osteoporosis. J Bone Min Res 18:18–23

83.

Lindsay R, Scheels WH, Neer R, Pohl G, Adami S, Mautalen SC, Reginster JY, Stepan JJ, Myers SL, Mitlak BH (2004) Sustained vertebral fracture risk reduction after withdrawal of teriparatide (recombinant human parathyroid hormone (1–34)) in postmenopausal women with osteoporosis. Arch Int Med 164:2024–2030CrossRef

84.

Body JJ, Gaich GA, Scheele WH, Kulkarni PM, Miller PD, Peretz A, Dore RK, Correa-Rotter R, Papaioannou A, Cumming DC, Hodsman AB (2002) A randomized double-blind trial to compare the efficacy of teriparatide (recombinant human parathyroid hormone (1–34)) with alendronate in postmenopausal women with osteoporosis. J Clin Endocrinol Metab 87:4528–4535CrossRefPubMed

85.

Black DM, Greenspan SL, Ensrud KE, Palermo L, McGowan JA, Lang LF, Garnero P, Bouxsein ML, Bilezikian JP, Rosen CJ (2003) The effects of parathyroid hormone and alendronate alone or in combination in postmenopausal osteoporosis. N Engl J Med. 349:1207–1215

86.

Kholsa S (2003) Parathyroid hormone plus alendronate—a combination that does not add up. N Engl J Med. 349:1277–1279

87.

Meunier PJ, Slosman D, Delmas P, Sebert JL, Brandi ML, Albanese C, Lorenc R, Pors-Nielsen S, de Vernejoul MC, Roces A, Reginster JY (2002) Strontium ranelate: dose-dependent effects in established postmenopausal vertebral osteoporosis: a 2-year randomized placebo controlled trial. J Clin Endocrinol Metab 87:2060–2066CrossRefPubMed

88.

Reginster JY, Spector T, Badurski J, Ortolani S, Martin TJ, Diez-Perez A, Lemmel E, Balogh A, Pors-Nielsen S, Phenekos C, Meunier PJ (2002) A short-term run-in study can significantly contribute to increasing the quality of long-term osteoporosis trials. The Strontium Ranelate Phase III Program. Osteoporos Int 13(S1):S30CrossRef

89.

Meunier PJ, Roux C, Seeman E, Ortolani S, Badurski JE, Spector T, Cannata J, Balogh A, Lemmel EM, Pors-Nielsen S, Rizzoli R, Genant HK, Reginster JY (2004) The effects of strontium ranelate on the risk of vertebral fracture in women with postmenopausal osteoporosis. N Engl J Med 350:459–468CrossRefPubMed

90.

Reginster JY, Sawicki A, Devogelaer JP, Padrino JM, Kaufman JM, Doyle DV, Fardellone P, Graham J, Felsenberg D, Tulassay Z, Soren-Sen OH, Luisetto G, Rizzoli R, Blotman F, Phenekos C, Meunier PJ (2002) Strontium ranelate reduces the risk of hip fracture in women with postmenopausal osteoporosis. Osteoporos. Int 13(S3):O14

91.

Rubin LA, Hawker GA, Peltekova VD, Fielding LJ, Ridout R, Cole DE (1999) Determinants of peak bone mass: clinical and genetic analyses in a young female Canadian cohort. J Bone Miner Res 14:633–643PubMed

92.

Drake AJ, Armstrong DW 3rd, Shakir KMM (2004) Bone mineral density and total bone mineral content in 18-to-22-year-old women. Bone 34:1037–1043CrossRefPubMed

93.

Cooper C, Barker DJP, Wickham C (1988) Physical activity, muscle strength and calcium intake in fracture of the proximal femur in Britain. BMJ 297:1443–1446PubMed

94.

Cummings SR, Nevitt MC, Browner WS, Stone K, Fox KM, Ensrud KE et al (1995) Risk factors for hip fracture in white women. N Engl J Med 332:767–773CrossRefPubMed

95.

Dargent-Molina P, Favier F, Grandjean H, Baudoin C, Schott AM, Hausherr E et al (1996) Fall-related factors and risk of hip fracture: the EPIDOS prospective study. Lancet 348:145–149CrossRefPubMed

96.

Albrand G, Munoz F, Sornay-Rendu E, DuBoeuf F, Delmas PD (2003) Independent predictors of all osteoporosis-related fractures in healthy postmenopausal women: The OFELY Study. Bone 32:78–85CrossRefPubMed

97.

Jensen JE, Jensen TG, Smith TK, Johnston DA, Dudrick SJ (1982) Nutrition in orthopaedic surgery. J Bone Joint Surg Am 64:1263–1272

98.

Hannan MT, Tucker KL, Dawson-Hughes B, Cupples LA, Felson DT, Kiel DP (2000) Effect of dietary protein on bone loss in elderly men and women: the Framingham osteoporosis study. J Bone Miner Res. 15:2504–2512

99.

Wengren HJ, Munger RG, West NA, Cutler DR, Corcoran CD, Zhang J et al (2004) Dietary protein intake and risk of osteoporotic hip fracture in elderly residents in Utah. J Bone Miner Res 19:537–545PubMed

100.

Neville CE, Murray LJ, Boreham AG, Gallagher AM, Twisk J, Robson PJ et al (2002) Relationship between physical activity and bone mineral status in young adults: The Northern Ireland young hearts project. Bone 30:792–798CrossRefPubMed

101.

MacKelvie KJ, Petit MA, Khan KM, Beck TJ, McKay HA (2004) Bone mass and structure are enhanced following a 2-year randomized controlled trial of exercise in prepubertal boys. Bone 34:755–764CrossRefPubMed

102.

Danz AM, Zittermann A, Schiedermaier U, Klein K, Hotzel D, Schonau E (1998) The effect of a specific strength-development exercise on bone mineral density in perimenopausal and postmenopausal women. J Women’s Health 7:701–709

103.

Nelson ME, Fiatarone MA, Morganti CM, Trice I, Greenberg RA, Evans WJ (1994) Effects of high-intensity strength training on multiple risk factors for osteoporotic fractures. JAMA 272:1909–1914CrossRefPubMed

104.

Uusi-Rasi K, Kannus P, Cheng S, Sievänen H, Pasanen M, Heinonen A et al (2003) Effect of alendronate and exercise on bone and physical performance of postmenopausal women: a randomized controlled trial. Bone 33:132–143CrossRefPubMed

105.

Uusi-Rasi K, Sievänen H, Heinonen A, Kannus P, Vuori I (2004) Effect of discontinuation of alendronate treatment and exercise on bone mass and physical fitness: 15-month follow-up of a randomized, controlled trial. Bone 35(3):799–805CrossRefPubMed

106.

Sinaki M, Itoi E, Wahner HW, Wollan P, Gelzcer R, Mullan BP et al (2002) Stronger back muscles reduce the incidence of vertebral fractures: a prospective 10-year follow-up of postmenopausal women. Bone 30:836–841CrossRefPubMed

107.

Grisso JA, Kelsey JL, O’Brien LA, Miles CG, Sidney S, Maislin G et al (1997) Risk factors for hip fracture in men. Hip fracture study group. Am J Epidemiol 145:786–793PubMed

108.

Grisso JA, Kelsey JL, Strom BL, Chiu GY, Maislin G, O’Brien LA et al (1991) Risk factors for falls as a cause of hip fracture in women. The Northeast Hip Fracture Study Group. N Engl J Med 324:1326–1331PubMed

109.

Robertson MC, Campbell AJ, Gardner MM, Devlin N (2002) Preventing injuries in older people by preventing falls: a meta-analysis of individual-level data. J Am Geriatr Soc 50:905–911CrossRefPubMed

110.

Schwartz AV, Kelsey JL, Sidney S, Grisso JA (1998) Characteristics of falls and risk of hip fracture in elderly men. Osteoporos Int 8:240–246CrossRefPubMed

111.

Lauritzen JB, Petersen MM, Lund B (1997) Effect of external hip protectors on hip fractures. Lancet 350:563–564

112.

Kannus P, Parkkari J, Niemi S, Pasanen M, Palvanen M Jaarvinen M et al (2000) Prevention of hip fracture in elderly people with the use of a hip protector. N Engl J Med 343:1506–1513CrossRefPubMed

113.

van Schoor NM, Smit JH, Twisk JW, Bouter LM, Lips P (2003) Prevention of hip fractures by external hip protectors: a randomized controlled trial. JAMA 289:1957–1962CrossRefPubMed

114.

Birks YF, Hildreth R, Campbell P, Sharpe C, Torgerson DJ, Watt I (2003) Randomised controlled trial of hip protectors for the prevention of second hip fracture. Age Ageing 32:442CrossRefPubMed

Title: Evidence-based guidelines for the treatment of postmenopausal osteoporosis: a consensus document of the Belgian Bone Club
Authors: Steven Boonen
Jean-Jacques Body
Yves Boutsen
Jean-Pierre Devogelaer
Stefan Goemaere
Jean-Marc Kaufman
Serge Rozenberg
Jean-Yves Reginster
Publication date: 01-03-2005
Publisher: Springer-Verlag
Published in: Osteoporosis International / Issue 3/2005
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-004-1812-1

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Evidence-based guidelines for the treatment of postmenopausal osteoporosis: a consensus document of the Belgian Bone Club

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