Postmenopausal osteoporosis: Current and future treatment options

Carrie McAdam-Marx, Joanne LaFleur, Carmen Kirkness, Carl Asche

Research output: Contribution to journalReview articlepeer-review

2 Scopus citations


Purpose: Postmenopausal osteoporosis (PMO) is a significant health and economic burden on the U.S. Costs related to osteoporosis are approximately $14 billion per year, driven primarily by fractures. We undertook a review of clinical trial and pharmacoeconomic literature related to PMO to summarize efficacy and cost-effectiveness data for current and future pharmaceutical treatment options. Methods: We searched Medline, International Pharmaceutical Abstracts, Business Source Premier, and Research Digest (published by the International Society for Pharmacoeconomics and Outcomes Research) for articles from 1995 to 2006 using osteoporosis-related terms. We selected articles for review if they focused on a PMO population, if they were stratified by sex and age to identify the PMO population, if they reported fracture endpoints, or if they covered U.S. pharmacoeconomic data. Results: Current pharmacotherapy for PMO includes antiresorptive agents (bisphosphonates, selective estrogen receptor modulators, and calcitonin), which reduce bone turnover, and anabolic agents (parathyroid hormone), which stimulate bone development. Antiresorptive products reduce vertebral fracture rates by 30% to 70% and are cost-effective in preventing fractures in women with osteoporosis and low bone mineral density (BMD) or with a previous fragility fracture. Teriparatide, a parathyroid hormone (PTH) reduces vertebral fracture rates by 65% to 69%, although cost-effectiveness is limited to high-risk patients of advanced age or with very low BMD. Promising products under review include strontium ranelate, available for PMO outside the U.S., and PTH (1-84), an anabolic agent. Conclusion: Antiresorptive agents are cost-effective for preventing fractures in women with osteoporosis, but they might not offer enough protection in high-risk populations. Thus, there is a cost-effective place for an anabolic agent in the highest-risk patients. Strontium ranelate and PTH (1-84) may offer additional therapeutic options in preventing fractures in PMO.

Original languageEnglish (US)
Pages (from-to)392-402
Number of pages11
JournalP and T
Issue number7
StatePublished - Jul 2007
Externally publishedYes

ASJC Scopus subject areas

  • Pharmacology (medical)


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