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July 21, 1989

Guidelines for Treatment of Osteoporosis in Older Women-Reply

Author Affiliations

Brigham and Women's Hospital Harvard Medical School Boston, Mass

Brigham and Women's Hospital Harvard Medical School Boston, Mass

JAMA. 1989;262(3):353. doi:10.1001/jama.1989.03430030040027

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In Reply. —  The purpose of our article was to underscore the extent of differences between perimenopausal and older women, emphasizing that there is ample reason to question the validity of extrapolating data derived from perimenopausal women to formulate treatment recommendations for older women. Our goal was to stimulate a fresh look at osteoporosis in the elderly, the group at highest risk of fracture. Our conclusions were not that current therapeutic approaches are necessarily wrong, but that there is little evidence that they are correct, that there is much room for doubt, and that there is an urgent need to devise and test new modalities. Until this is accomplished, we believe that it is reasonable to individualize the approach as we outlined. However, as stated in the article, we would place less emphasis on the pharmacologic interventions and more on strategies to detect comorbid conditions and reduce the risk of