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In 2000, the prevalence of osteoporosis in the United States was estimated to be 10 percent. Most patients with osteoporosis are women (91 to 96 percent) who are 65 years of age or older (70 to 80 percent). More effective and convenient antiosteoporosis medications (AOMs) boosted patient visits to the doctor for osteoporosis four-fold between 1994 (1.3 million visits) and 2003 (6.3 million visits). In addition, the proportion of visits in which AOMs were prescribed increased 15 percent from 1988 (82 percent) to 2003 (97 percent), according to a study supported by the Agency for Healthcare Research and Quality (HS13405).
The largest annual increases (76 percent and 46 percent, respectively) in osteoporosis visits occurred in 1996 and 1998. This coincided with market approval of the first oral daily bisphosphonate, alendronate (Fosamax) in September 1995 and the selective estrogen receptor modulator, raloxifene (Evista), in December 1997 to treat osteoporosis. In 1988 bisphosphonates were prescribed in 1 percent of osteoporosis visits, but by 2003, they were prescribed during 73 percent of visits. This suggests that doctors rapidly adopted use of the new medications to treat osteoporosis, notes Randall S. Stafford, M.D., Ph.D., of Stanford University. Prior to 1994, estrogen and calcium were the leading choices for osteoporosis therapy, with lesser roles for calcitonins and bisphosphonates.
In conclusion, Dr. Stafford notes that treatment of osteoporosis has improved in recent years in association with the availability of new medications. This finding suggests that new drug therapy has contributed to increased disease recognition and treatment. The study findings are based on an analysis of national prescribing patterns by office-based U.S. physicians from the IMS HEALTH National Disease and Therapeutic Index.
See "National trends in osteoporosis visits and osteoporosis treatment, 1988-2003," by Dr. Stafford, Rebecca L. Drieling, B.A., and Adam L. Hersh, M.D., Ph.D., in the July 26, 2004, Archives of Internal Medicine 164, pp. 1525-1530.
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