Aging Bones by Gerald N. Grob

Author:Gerald N. Grob
Language: eng
Format: epub
Publisher: Johns Hopkins University Press
Published: 2014-07-12T16:00:00+00:00

CHAPTER SIX

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Therapeutic Expansion

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Although concern with osteoporosis accelerated during and after the 1980s, the therapeutic armamentarium remained relatively limited. ERT was by far the most frequently prescribed medication, even though there were disagreements on how it should be used. Other therapies, including calcitonin, anabolic steroids, sodium fluoride, and human parathyroid hormone, did not compare with ERT. Vitamin D and calcium supplementation were not controversial regimens, and patients were often urged to use them. But the preponderant view was that none of these interventions could compare with the effectiveness of estrogen.

As long as the boundaries of the diagnosis of osteoporosis were circumscribed, drug companies had little incentive to develop alternative therapies and challenge Ayerst’s Premarin. But as the numbers of women diagnosed as either osteopenic or osteoporotic grew, interest in developing new therapies increased accordingly, particularly as doubts about the safety of ERT were raised. During and after the 1990s, a variety of new drugs entered the medical armamentarium. They were accompanied by recommendations from specialty groups and organizations stating that virtually all women should consider pharmacological therapy to prevent hip and vertebral fractures. The pharmaceutical industry played a major role through its financial support of both research and clinical trials, to say nothing of publicity campaigns designed to persuade clinicians and patients of the importance and effectiveness of pharmacological therapy to prevent or treat osteopenia and osteoporosis.

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