This study analyzed the transition from normal BMD or osteopenia to osteoporosis; in women 67 years of age or older, the time for 10% to develop osteoporosis was approximately 15 years for normal BMD or mild osteopenia at baseline, 5 years for moderate osteopenia, and 1 year for advanced osteopenia.

Recent case reports and series have identified a subgroup of atypical femoral-shaft fractures associated with bisphosphonate use. This study analyzed data from three large, randomized bisphosphonate trials. Subtrochanteric or diaphyseal femur fractures were very rare, even among women who had been treated with bisphosphonates for as long as 10 years. In patients with osteoporosis, proven benefits for fracture reduction appear to outweigh the possible risk of femoral-shaft fractures.

Women between 59 and 80 years of age with a bone mineral density T score of –2.5 or less at the femoral neck or spine received the selective estrogen-receptor modulator lasofoxifene (either 0.25 or 0.5 mg daily) or placebo for 5 years. Lasofoxifene was associated with lower risks of fractures, estrogen-receptor–positive breast cancer, coronary heart disease, and stroke, with no increase in endometrial cancer, but there was an increase in venous thromboembolic events.

Autoantibodies against osteoprotegerin, blocking the inhibitory effect of osteoprotegerin on signaling by the receptor activator of nuclear factor κB, were identified in a man with celiac disease who presented with severe osteoporosis and high levels of markers of bone turnover. The osteoporosis did not respond to treatment of his celiac disease but was completely reversed by bisphosphonate therapy.

In this trial, women between the ages of 60 and 90 with low bone mineral density received twice-yearly subcutaneous injections of denosumab, a fully human monoclonal antibody against the receptor activator of nuclear factor-κB ligand, which inhibits the development and activity of osteoclasts, or placebo. Denosumab was associated with a reduced risk of vertebral, nonvertebral, and hip fractures.

Men receiving androgen-deprivation therapy for nonmetastatic prostate cancer are at high risk for bone loss and fractures. This placebo-controlled study investigated the effects of denosumab, a fully human monoclonal antibody against the receptor activator of nuclear factor-κB ligand, on bone mineral density and fractures in such men. Use of denosumab was associated with increased bone mineral density at all sites and reduction in the incidence of new vertebral fractures.

In this multicenter, randomized, double-blind, placebo-controlled trial involving patients with one or two painful osteoporotic vertebral fractures, vertebroplasty did not result in greater improvement than a sham procedure in overall pain, physical functioning, or quality of life at 3 or 6 months after treatment.

In this randomized trial involving patients with osteoporotic vertebral compression fractures, patients who underwent vertebroplasty had improvements in pain and disability measures that were similar to those in patients who underwent a sham procedure.