Efficacy and safety of pharmacological agents in managing osteoporosis in the old old: Review of the evidence

Charles A. Inderjeeth, Adrian C.H. Foo, Michelle M.Y. Lai and Paul Glendenning

The objective of this review was to review the published literature on the clinical efficacy and safety of specific anti osteoporosis treatments in the reduction in fracture risk in females ? 75 years of age.  Two hundred and fifty-two potentially relevant abstracts were identified. Only six publications were deemed to meet full eligibility criteria and one met most criteria.

This review reinforces the irony that the least evidence is available for fragility fracture reduction in the group at greatest risk; the old old and those with non vertebral and hip fracture. Although there is good evidence for the benefit of the bisphosphonates (Alendronate and Risedronate), Teriparatide and Strontium Ranelate in vertebral fracture reduction, there are very limited data for non vertebral and hip fracture reduction. Strontium Ranelate is the only agent to date that has demonstrated a reduction in non vertebral and hip fracture events in this high risk elderly female population.

Bone, 2009, 44(5), 744-751

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