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No Bones About It: Osteoporosis Drug Effective For Men, Too

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WebMD Health News

Aug. 30, 2000 -- Thanks to public-awareness efforts, you might have a tough time finding a middle-aged woman who doesn't know she's at increased risk for osteoporosis. But many people would be surprised to learn that men are also at risk of fractures from thinning bones, and a new study shows that drugs can work just as well in men as in women.

As many as two million men in the U.S. have osteoporosis, a thinning of the bones that occurs with age or as a side effect from certain drugs. An additional three million are at increased risk, according to figures from the National Osteoporosis Foundation.

"This should serve as a wake-up call to both the public at large and to medical professionals that men do get osteoporosis," study author, Eric Orwoll, MD, tells WebMD. "Men are very definitely being underdiagnosed and undertreated for this disease. We have in our minds that osteoporosis is an old-ladies' disease, so it is often not caught in men until there is a major problem like a fracture." Orwoll is director of the Bone and Mineral Clinic at the Oregon Health Sciences University in Portland.

In the two-year study, published in the Aug. 31 issue of TheNew England Journal of Medicine, a group of men with osteoporosis were treated with Fosamax, a bone-building drug that is widely prescribed to postmenopausal women for the prevention and treatment of bone loss. The men had improved bone density and fewer overall fractures, compared to those receiving a placebo.

Fewer than 1% of men that took Fosamax experienced fractures of the spine, vs. 7% in the group receiving a placebo. The research was funded by Fosamax manufacturer Merck and Co.

"It really isn't surprising that this drug works as well in men as it does in women, and I am very confident that physicians have been prescribing it for men with osteoporosis for a long time," bone loss expert Michael Kleerekoper, MD, of Detroit's Wayne State University, tells WebMD. "But, because all of the early studies were done in women, Fosamax currently does not have FDA approval for use in men." Kleerekoper, who was not involved with this study, heads the division of endocrinology and metabolism at Wayne State.

While women generally experience rapid bone loss in the years after menopause, men and women lose bone mass at the same rate by the age of 65 or 70. Men and women of any age are also at increased risk for osteoporosis if they take steroids for extended periods to treat chronic diseases such as asthma and rheumatoid arthritis.

Men can also be at increased risk for osteoporosis if they have low levels of the sex hormone testosterone. Approximately one-third of the men enrolled in this study had low testosterone levels, and they fared equally well on therapy as those with normal levels of the hormone.

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