Bisphosphonates for Osteopenia in Postmenopausal Women —Reply

In Reply The topic addressed by our article was the efficacy and safety of bisphosphonate treatment for women with postmenopausal osteoporosis, not osteopenia. Dr Snyder comments that we stated that no clinical trials have assessed the benefit of treatment with bisphosphonates in women with osteopenia. However, our article instead stated that while some organizations recommend treatment initiation in postmenopausal women with osteopenia who have a 10-year fracture probability (calculated using the FRAX tool) at or above intervention thresholds proposed by the National Osteoporosis Foundation, the benefit of treatment in patients selected on the basis of these criteria has not been assessed in clinical trials. Snyder refers to a trial of intravenous zoledronate vs placebo in 2000 women aged 65 years and older (mean age, 71 years) with osteopenia defined by at least 1 BMD T score between −1.0 and −2.5 at the hip (total hip or femoral neck) on either side that reported a reduction in clinical fracture (but not hip fracture) risk with zoledronate treatment.
Source: JAMA - Category: General Medicine Source Type: research