Prevention and treatment of osteoporosis: a review of current modalities.

This review evaluates response to treatment with various preventive and therapeutic agents in osteoporotic and immediately postmenopausal women. Measurements obtained by several methods are taken in the forearm, spine, and overall skeleton of treatment and placebo groups. Estrogen and estrogen-progestogen combinations, vitamin D metabolites, calcium, fluoride, calcitonin, bisphosphonates, and anabolic steroids are assessed in comparison with placebo and with each other. The efficacy of estrogen-progestogen hormone replacement therapy (HRT) is confirmed as an effective prevention for osteoporosis in postmenopausal women. Early data on nasal salmon calcitonin indicate that it is a promising agent for both prevention and treatment of established osteoporosis. A new estrogen-progestogen combination, oral estradiol and norethisterone acetate (E2 + NETA), has produced greater increases in both cortical and trabecular bone mass than other reported osteoporosis treatments.