Parathyroid Hormone plus Alendronate — A Combination That Does Not Add Up

Abstract

The past 10 years have witnessed tremendous advances in our ability to treat osteoporosis. The old mainstays of therapy, estrogen and calcitonin, have fallen out of favor because of concern about long-term safety or lack of efficacy. In their wake have come a selective estrogen-receptor modulator (raloxifene), bisphosphonates (alendronate and risedronate), and most recently, parathyroid hormone. Raloxifene and the bisphosphonates belong to the class of antiresorptive drugs: by inhibiting bone resorption, they prevent further bone loss, and since bone formation and further mineralization continue for some time, these agents also result in moderate increases in bone mineral density. In contrast, . . .