Treatment Options for Osteoporosis Sundeep Khosla, M.D., B. Lawrence Riggs, M.D.  Mayo Clinic Proceedings  Volume 70, Issue 10, Pages 978-982 (October 1995) DOI: 10.4065/70.10.978 Copyright © 1995 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 1 Patterns of change in bone mineral density (BMD) in lumbar spine of women with osteoporosis during various treatment regimens. When antiresorptive (AR) drug is given, response varies directly with rate of bone turnover at baseline. When turnover rate is high, gains of 8 to 20% may be achieved but plateau after 2 to 3 years. Mechanism for waning of therapeutic effect is unknown; magnitude and duration of initial increase in bone density seem to be too great to be explained entirely by refilling of increased numbers of resorption cavities present when bone turnover rate is high. When turnover rate is normal or low, bone mass is stabilized but does not increase. With no treatment, bone loss continues, although its rate varies among individual patients. When formation-stimulating (FS) drug, such as fluoride, is given, BMD increases linearly up to 10% annually for at least 4 years. Dashed line represents no change in BMD. (From Riggs and Melton.1 By permission.) Mayo Clinic Proceedings 1995 70, 978-982DOI: (10.4065/70.10.978) Copyright © 1995 Mayo Foundation for Medical Education and Research Terms and Conditions