December 8, 1997

Early Prevention vs Late Treatment for Osteoporosis

Author Affiliations

Department of Medicine Arizona Health Sciences Center 1501 N Campbell Ave Tucson, AZ 85724

Arch Intern Med. 1997;157(22):2545-2546. doi:10.1001/archinte.1997.00440430021002

OSTEOPOROSIS IS a major national health problem, and perhaps the most common chronic illness of postmenopausal women. After 50 years of age, approximately 40% of white women will suffer 1 or more fractures, with 17.5% of these being fractures of the hip.1 The financial impact is enormous (approximately $14 billion in the United States in 19952) and likely to rise exponentially during the next few decades.3 Although effective agents are currently available for both prevention and treatment, questions remain about optimal patient selection, dosage, duration, and timing for initiation of treatment. In this issue of the ARCHIVES, 2 articles4,5 separately address the issues of prevention and treatment, and help clarify some of the questions listed above.

Although prevention is intuitively more attractive than treatment of established disease, universal application of therapy for prevention may not be justified if the therapy has significant cost, adverse effects, poor

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