The diagnosis and treatment of male osteoporosis: Defining, assessing, and preventing skeletal fragility in men

European Journal of Internal Medicine

Volumn 18, Issue 1, 2007, Pages 6-17

  Boonen, Steven ^a,b   Kaufman, Jean Marc ^c   Goemaere, Stefan ^c   Bouillon, Roger ^a,b   Vanderschueren, Dirk ^a,b  

^a UNIVERSITY HOSPITALS LEUVEN   (Belgium)

^b UNIVERSITY OF LEUVEN   (Belgium)

^c GHENT UNIVERSITY HOSPITAL   (Belgium)

Author keywords

Bone mineral density; Men; Osteoporosis

Indexed keywords

ALENDRONIC ACID; CALCIUM; PARATHYROID HORMONE[1-34]; PSYCHOTROPIC AGENT; RISEDRONIC ACID;

ALCOHOL ABUSE; ANDROGEN DEFICIENCY; ANDROGEN THERAPY; BODY MASS; BONE DENSITOMETRY; CLINICAL FEATURE; CUSHING SYNDROME; DRUG EFFECT; DRUG EFFICACY; DRUG RESPONSE; FEMALE; FRACTURE; HUMAN; HYPOGONADISM; IDIOPATHIC HYPERCALCIURIA; MALE; OSTEOPOROSIS; REVIEW; SEX DIFFERENCE; TREATMENT OUTCOME; TREATMENT RESPONSE; VITAMIN SUPPLEMENTATION;

EID: 33846107771     PISSN: 09536205     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.ejim.2006.09.005     Document Type: Review

References (111)

1. Orwoll E.S. Osteoporosis in men. Endocrinol Metab Clin N Am 27 (1998) 349-367
2. Seeman E. Osteoporosis in men. Osteoporos Int 9 2 Suppl (1999) S97-S110
3. Bilezikian J.P. Osteoporosis in men. J Clin Endocrinol Metab 84 (1999) 3431-3434
4. Ebeling P. Osteoporosis in men. New insights into aetiology, pathogenesis, prevention and management. Drugs Aging 13 (1998) 421-434
5. Siddiqui N., Shetty K., and Duthie E. Osteoporosis in older men. Geriatrics 54 (1999) 20-28
6. Orwoll E.S., and Klein R.F. Osteoporosis in men. Endocr Rev 16 (1995) 87-116
7. Cooper C., Campion G., and Melton III L.J. Hip fractures in the elderly: a world-wide projection. Osteoporos Int 2 (1992) 285-289
8. De Laet C., Van Hout B., Burger H., Hofman A., and Pols H. Bone density and risk of hip fracture in men and women. BMJ 315 (1997) 221-225
9. Jones G., Nguyen T., Sambrook P.N., Kelly P.J., Gilbert C., and Eisman J.A. Symptomatic fracture incidence in elderly men and women: the Dubbo Osteoporosis Epidemiology Study (DOES). Osteoporos Int 4 (1994) 277-282
10. Schwartz A.V., Kelsey J.L., Maggi S., Tuttleman M., Ho S., Jonsson P., Poor G., et al. International variation in the incidence of hip fractures: cross-national project on osteoporosis for the World Health Organization Program for Research on Aging. Osteoporos Int 9 (1999) 242-253
11. Elffors I., Allander E., Kanis J.A., Gullberg B., Johnell O., Dequeker J., et al. The variable incidence of hip fracture in southern Europe: the MEDOS study. Osteoporos Int 4 (1994) 253-263
12. Sanders K.M., Seeman E., Ugoni A.M., Pasco J., Martin T., Skoric B., et al. Age- and gender-specific rate of fractures in Australia: a population-based study. Osteoporos Int 10 (1999) 240-247
13. Huuskonen J., Kroger H., Arnala I., and Alhava E. Characteristics of male hip fracture patients. Ann Chir Gynaecol 88 (1999) 48-53
14. Poor G., Atkinson E.J., O'Fallon W.M., and Melton III L.J. Predictors of hip fractures in elderly men. J Bone Miner Res 10 (1995) 1900-1907
15. Poor G., Atkinson E.J., Lewallen D.G., O'Fallon W.M., and Melton III L.J. Age-related hip fractures in men: clinical spectrum and short-term outcomes. Osteoporos Int 5 (1995) 419-426
16. Schurch M.A., Rizzoli R., Mermillod B., Vasey H., Michel J.P., and Bonjour J.P. A prospective study on socioeconomic aspects of fracture of the proximal femur. J Bone Miner Res 11 (1996) 1935-1942
17. Poor G., Atkinson E.J., O'Fallon W.M., and Melton III L.J. Determinants of reduced survival following hip fractures in men. Clin Orthop 46 (1995) 260-265
18. Melton III L.J. Epidemiology of spinal osteoporosis. Spine 22 (1997) 2S-11S
19. Cooper C., Atkinson E.J., O'Fallon W.M., and Melton III L.J. Incidence of clinically diagnosed vertebral fractures: a population-based study in Rochester, Minnesota, 1985-1989. J Bone Miner Res 7 (1992) 221-227
20. Szulc P., Marchand F., Felsenberg D., and Delmas P.D. Prevalence of vertebral deformities according to the diagnostic method. Rev Rhum Engl Ed 65 (1998) 245-256
21. O'Neill T.W., Felsenberg D., Varlow J., Cooper C., Kanis J.A., and Silman A.J. The prevalence of vertebral deformity in European men and women: the European Vertebral Osteoporosis Study. J Bone Miner Res 11 (1996) 1010-1018
22. Mann T., Oviatt S.K., Wilson D., Nelson D., and Orwoll E.S. Vertebral deformity in men. J Bone Miner Res 7 (1992) 1259-1265
23. Davies K.M., Stegman M.R., Heaney R.P., and Recker R.R. Prevalence and severity of vertebral fracture: the Saunders County Bone Quality Study. Osteoporos Int 6 (1996) 160-165
24. Lunt M., Felsenberg D., Reeve J., Benevolenskaya L., Cannata J., Dequeker J., et al. Bone density variation and its effects on risk of vertebral deformity in men and women studied in thirteen European centers: the EVOS study. J Bone Miner Res 12 (1997) 1883-1894
25. Matthis C., Weber U., O'Neill T.W., and Raspe H. Health impact associated with vertebral deformities: results from the European Vertebral Osteoporosis Study (EVOS). Osteoporos Int 8 (1998) 364-372
26. Melton III L.J., Amadio P.C., Crowson C.S., and O'Fallon W.M. Long-term trends in the incidence of distal forearm fractures. Osteoporos Int 8 (1998) 341-348
27. Haentjens P., Johnell O., Kanis J., Bouillon R., Cooper C., Lamraski G., et al. Evidence from data searches and life-table analyses for gender-related differences in absolute risk of hip fracture after Colles' or spine fracture: Colles' fracture as an early and sensitive marker of skeletal fragility in Caucasian men. J Bone Miner Res 19 (2004) 1933-1944
28. Greenspan S.L., Myers E.R., Maitland L.A., Resnick N.M., and Hayes W.C. Fall severity and bone mineral density as risk factors for hip fracture in ambulatory elderly. JAMA 271 (1994) 128-133
29. Winner S.J., Morgan C.A., and Evans J.G. Perimenopausal risk of falling and incidence of distal forearm fracture. Br Med J 298 (1989) 1486-1488
30. Greenspan S.L., Myers E.R., Kiel D.P., Parker R.A., Hayes W.C., and Resnick N.M. Fall direction, bone mineral density, and function: risk factors for hip fracture in frail nursing home elderly. Am J Med 104 (1998) 539-545
31. Mussolino M.E., Looker A.C., Madans J.H., Langlois J.A., and Orwoll E.S. Risk factors for hip fracture in white men: the NHANES I Epidemiologic Follow-up Study. J Bone Miner Res 13 (1998) 918-924
32. Grisso J.A., Chiu G.Y., Maislin G., Steinmann W.C., and Portale J. Risk factors for hip fractures in men: a preliminary study. J Bone Miner Res 6 (1991) 865-868
33. Kanis J., Johnell O., Gullberg B., Allander E., Elffors L., Ranstam J., et al. Risk factors for hip fracture in men from southern Europe: the MEDOS study. Mediterranean Osteoporosis Study. Osteoporos Int 9 (1999) 45-54
34. Nguyen T., Sambrook P., Kelly P., Jones G., Lord S., Freund J., et al. Prediction of osteoporotic fractures by postural instability and bone density. Br Med J 307 (1993) 1111-1115
35. Nguyen T.V., Eisman J.A., Kelly P.J., and Sambrook P.N. Risk factors for osteoporotic fractures in elderly men. Am J Epidemiol 144 (1996) 255-263
36. Grisso J.A., Kelsey J.L., O'Brien L.A., Miles C., Sidney S., Maislin G., et al. Risk factors for hip fracture in men. Am J Epidemiol 145 (1997) 786-793
37. Kanis J.A. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: synopsis of a WHO report. WHO Study Group. Osteoporos Int 4 (1994) 368-381
38. Looker A.C., Orwoll E.S., Johnston Jr. C.C., Lindsay R., Wahner H., Dunn W., et al. Prevalence of low femoral bone density in older U.S. adults from NHANES III. J Bone Miner Res 12 (1997) 1761-1768
39. Aaron J.E., Makins N.B., and Sagreiya K. The microanatomy of trabecular bone loss in normal aging men and women. Clin Orthop 83 (1987) 260-271
40. Mosekilde L. Vertebral structure and strength in vivo and in vitro. Calcif Tissue Int 53 1 Suppl (1993) S121-S125
41. Mosekilde L. The effect of modelling and remodelling on human vertebral body architecture. Technol Health Care 6 (1998) 287-297
42. Audran M., Chappard D., Legrand E., Libouban H., and Basle M.F. Bone microarchitecture and bone fragility in men: DXA and histomorphometry in humans and in the orchidectomized rat model. Calcif Tissue Int 69 (2001) 214-217
43. Chavassieux P., and Meunier P.J. Histomorphometric approach of bone loss in men. Calcif Tissue Int 69 (2001) 209-213
44. De Laet C.E., Van Hout B.A., Burger H., Hofman A., and Pols H.A. Bone density and risk of hip fracture in men and women: cross-sectional analysis. BMJ 315 (1997) 221-225
45. Melton L., Atkinson E., O'Connor M., O'Fallon W., and Riggs B. Bone density and fracture risk in men. J Bone Miner Res 12 (1998) 1915-1923
46. Selby P., Davies M., and Adams J. Do men and women fracture bones at similar bone densities?. Osteoporos Int 11 (2000) 153-157
47. Lunt M., O'Neill T., Felsenberg D., Silman A., and Reeve J. Age and bone mineral density have similar effects on the risk of incident vertebral deformity in men and women: results from the European prospective osteoporosis study. Osteoporos Int 11 1 Suppl (2000) S58-S59
48. De Laet C.E., Van Hout B.A., Burger H., Weel A.E., Hofman A., and Pols H.A. Hip fracture prediction in elderly men and women: validation in the Rotterdam study. J Bone Miner Res 13 (1998) 1587-1593
49. Kanis J.A., Johnell O., Oden A., De Laet C., and Mellstrom D. Diagnosis of osteoporosis and fracture threshold in men. Calcif Tissue Int 69 (2001) 218-221
50. Leslie W.D., Adler R.A., El-Hajj Fuleihan G., Hodsman A.B., Kendler D.L., McClung M., et al. Application of the WHO classification to populations other than postmenopausal Caucasian women: the 2005 ISCD Official Positions. J Clin Densitom 9 (2006) 22-30
51. Boonen S., Vanderschueren D., Geusens P., and Bouillon R. Age-associated endocrine deficiencies as potential determinants of femoral neck (type II) osteoporotic fracture occurrence in elderly men. Int J Androl 20 (1997) 134-143
52. Boonen S., Vanderschueren D., Cheng X.G., Verbeke G., Dequeker J., Geusens P., et al. Age-related (type II) femoral neck osteoporosis in men: biochemical evidence for both hypovitaminosis D- and androgen deficiency-induced bone resorption. J Bone Miner Res 12 (1997) 2119-2126
53. Vanderschueren D., Vandenput L., Boonen S., Van Herck E., Swinnen J., and Bouillon R. An aged rat model of partial androgen deficiency: prevention of both loss of bone and lean body mass by low-dose androgen replacement. Endocrinology 141 (2000) 1642-1647
54. Rapado A., Hawkins F., Sobrinho L., Diaz-Curiel M., Galvao-Telles A., Arver S., et al. Bone mineral density and androgen levels in elderly males. Calcif Tissue Int 65 (1999) 417-421
55. Slemenda C.W., Longcope C., Zhou L., Hui S.L., Peacock M., and Johnston C.C. Sex steroids and bone mass in older men. Positive associations with serum ooestrogens and negative associations with androgens. J Clin Invest 100 (1997) 1755-1759
56. Khosla S., Melton III L.J., Atkinson E.J., O'Fallon W.M., Klee G.G., and Riggs B.L. Relationship of serum sex steroid levels and bone turnover markers with bone mineral density in men and women: a key role for bioavailable oestrogen. J Clin Endocrinol Metab 83 (1998) 2266-2274
57. Center J.R., Nguyen T.V., Sambrook P.N., and Eisman J.A. Hormonal and biochemical parameters in the determination of osteoporosis in elderly men. J Bone Miner Res 84 (1999) 3626-3635
58. Riggs B.L., Khosla S., and Melton III L.J. A unitary model for involutional osteoporosis: oestrogen deficiency causes both type I and type II osteoporosis in postmenopausal women and contributes to bone loss in aging men. J Bone Miner Res 13 (1998) 763-773
59. Greendale G.A., Edelstein S., and Barrett-Connor E. Endogenous sex steroids and bone mineral density in older women and men: the Rancho Bernardo Study. J Bone Miner Res 12 (1997) 1833-1843
60. Morishima A., Grumbach M.M., Simpson E.R., Fisher C., and Qin K. Aromatase deficiency in male and female siblings caused by a novel mutation and the physiological role of oestrogens. J Clin Endocrinol Metab 80 (1995) 3689-3698
61. Smith E.P., Boyd J., Frank G.R., Takahashi H., Cohen R., Specker B., et al. Estrogen resistance caused by a mutation in the estrogen-receptor gene in a man. N Engl J Med 331 (1994) 1056-1061
62. Vanderschueren D., Boonen S., and Bouillon R. Action of androgens versus oestrogens in male skeletal homeostasis. Bone 23 (1998) 391-394
63. Bilezikian J.P., Morishima A., Bell J., and Grumbach M.M. Increased bone mass as a result of oestrogen therapy in a man with aromatase deficiency. N Engl J Med 339 (1998) 599-603
64. Bouillon R., Bex M., Vanderschueren D., and Boonen S. Exposure to estrogen essential for male pubertal periosteal bone expansion. J Clin Endocrinol Metab 89 (2004) 6025-6029
65. Barrett-Connor E., Mueller J., Van Mühlen D., Laughlin G., Schneider D., and Sartoris D. Low levels of estradiol are associated with vertebral fractures in older men but not women: the Rancho Bernardo Study. J Clin Endocrinol Metab 85 (2000) 219-223
66. Falahati-Nini A., Riggs B.L., Atkinson E.J., O'Fallon W.M., Eastell R., and Khosla S. Relative contributions of testosterone and estrogen in regulating bone resorption and formation in normal elderly men. J Clin Invest 106 (2000) 1553-1560
67. Kelepouris N., Harper K.D., Gannon F., Kaplan F.S., and Haddad J.G. Severe osteoporosis in men. Ann Intern Med 123 (1995) 452-460
68. Scane A.C., Francis R.M., Sutcliffe A.M., Francis M.J., Rawlings D.J., and Chapple C.L. Case-control study of the pathogenesis and sequelae of symptomatic vertebral fractures in men. Osteoporos Int 9 (1999) 91-97
69. Legrand E., Chappard D., Pascaretti C., Duquenne M., Krebs S., Rohmer V., et al. Trabecular bone microarchitecture, bone mineral density, and vertebral fractures in male osteoporosis. J Bone Miner Res 15 (2000) 13-19
70. Compston J. Secondary causes of osteoporosis in men. Calcif Tissue Int (2001) 193-195
71. Seeman E., Melton III L.J., O'Fallon W.M., and Riggs B.L. Risk factors for spinal osteoporosis in men. Am J Med 75 (1983) 977-983
72. Reid I.R. Glucocorticoid osteoporosis: mechanisms and management. Eur J Endocrinol 137 (1997) 209-217
73. Wei J.T., Gross M., Jaffe C.A., Gravlin K., Lahaie M., Faerber G.J., et al. Androgen deprivation therapy for prostate cancer results in significant loss of bone density. Urology 54 (1999) 607-611
74. Daniell H.W. Osteoporosis after orchiectomy for prostate cancer. J Urol 157 (1997) 439-444
75. Diamond T., Campbell J., Bryant C., and Lynch W. The effect of combined androgen blockade on bone turnover and bone mineral densities in men treated for prostate carcinoma: longitudinal evaluation and response to intermittent cyclic etidronate therapy. Cancer 83 (1998) 1561-1566
76. Eriksson S., Eriksson A., Stege R., and Carlstrom K. Bone mineral density in patients with prostatic cancer treated with orchidectomy and with oestrogens. Calcif Tissue Int 57 (1995) 97-99
77. Finkelstein J.S., Klibanski A., Neer R.M., Doppelt S.H., Rosenthal D.I., Segre G.V., et al. Increases in bone density during treatment of men with idiopathic hypogonadotropic hypogonadism. J Clin Endocrinol Metab 69 (1989) 776-783
78. Finkelstein J.S., Klibanski A., and Neer R.M. A longitudinal evaluation of bone mineral density in adult men with histories of delayed puberty. J Clin Endocrinol Metab 81 (1996) 1152-1155
79. Bertelloni S., Baroncelli G.I., Ferdeghini M., Perri G., and Saggese G. Normal volumetric bone mineral density and bone turnover in young men with histories of constitutional delay of puberty. J Clin Endocrinol Metab 83 (1998) 4280-4283
80. Stanley H.L., Schmitt B.P., Poses R.M., and Deiss W.P. Does hypogonadism contribute to the occurrence of a minimal trauma hip fracture in elderly men?. J Am Geriatr Soc 39 (1991) 766-771
81. Hoidrup S., Gronbaek M., Gottschau A., Lauritzen J., and Schroll M. Alcohol intake, beverage preference, and risk of hip fracture in men and women. Am J Epidemiol 149 (1999) 993-1001
82. Burger H., de Laet C.E., van Daele P.L., Weel A.E., Witteman J.C., Hofman A., et al. Risk factors for increased bone loss in an elderly population: the Rotterdam study. Am J Epidemiol 147 (1998) 871-879
83. Burger H., De Laet C.E., Weel A.E., Hofman A., and Pols H.A. Added value of bone mineral density in hip fracture risk scores. Bone 25 (1999) 369-374
84. Perry III H.M., Fallon M.D., Bergfeld M., Teitelbaum S.L., and Avioli L.V. Osteoporosis in young men: a syndrome of hypercalciuria and accelerated bone turnover. Arch Intern Med 142 (1982) 1295-1298
85. Zerwekh J.E., Sakhaee K., Breslau N.A., Gottschalk F., and Pak C.Y. Impaired bone formation in male idiopathic osteoporosis: further reduction in the presence of concomitant hypercalciuria. Osteoporos Int 2 (1992) 128-134
86. Khosla S., Lufkin E.G., Hodgson S.F., Fitzpatrick L.A., and Melton III L.J. Epidemiology and clinical features of osteoporosis in young individuals. Bone 15 (1994) 551-555
87. Bilezikian J.P., Kurland E.S., and Rosen C.J. Male skeletal health and osteoporosis. Trends Endocrinol Metab 10 (1999) 244-250
88. Kurland E.S., Rosen C.J., Cosman F., McMahon D., Chan F., Shane E., et al. Insulin-like growth factor-I in men with idiopathic osteoporosis. J Clin Endocrinol Metab 82 (1997) 2799-2805
89. Block J.E., and Stubbs H. Hip fracture-associated mortality reconsidered. Calcif Tissue Int 61 (1997) 84
90. Johansson A.G., Eriksen E.F., Lindh E., Langdahl B., Blum W.F., Lindahl A., et al. Reduced serum levels of the growth hormone-dependent insulin-like growth factor binding protein and a negative bone balance at the level of individual remodeling units in idiopathic osteoporosis in men. J Clin Endocrinol Metab 82 (1997) 2795-2798
91. Ljunghall S., Johansson A.G., Burman P., Kampe O., Lindh E., and Karlsson F.A. Low plasma levels of insulin-like growth factor 1 (IGF-1) in male patients with idiopathic osteoporosis. J Intern Med 232 (1992) 59-64
92. Reed B.Y., Zerwekh J.E., Sakhaee K., Breslau N.A., Gottschalk F., and Pak C.Y. Serum IGF 1 is low and correlated with osteoblastic surface in idiopathic osteoporosis. J Bone Miner Res 10 (1995) 1218-1224
93. Kurland E.S., Chan F.K., Rosen C.J., and Bilezikian J.P. Normal growth hormone secretory reserve in men with idiopathic osteoporosis and reduced circulating levels of insulin-like growth factor-I. J Clin Endocrinol Metab 83 (1998) 2576-2579
94. Rosen C.J., Kurland E.S., Vereault D., Adler R.A., Rackoff P.J., Craig W.Y., et al. Association between serum insulin growth factor-I (IGF-I) and a simple sequence repeat in IGF-I gene: implications for genetic studies of bone mineral density. J Clin Endocrinol Metab 83 (1998) 2286-2290
95. Gillberg P., Johansson A.G., and Ljunghall S. Decreased oestradiol levels and free androgen index and elevated sex hormone-binding globulin levels in male idiopathic osteoporosis. Calcif Tissue Int 64 (1999) 209-213
96. Vermeulen A., Verdonck L., and Kaufman J.M. A critical evaluation of simple methods for the estimation of free testosterone in serum. J Clin Endocrinol Metab 84 (1999) 3666-3672
97. Dawson-Hughes B., Harris S.S., Krall E.A., and Dallal G.E. Effect of calcium and vitamin D supplementation on bone density in men and women 65 years of age or older. N Engl J Med 337 (1997) 670-676
98. Orwoll E.S., Oviatt S.K., Mclung M.R., Deftos L.J., and Sexton G. The rate of bone mineral loss in normal men and the effects of calcium and cholecalciferol supplementation. Ann Intern Med 112 (1990) 29-34
99. 3) for prevention of fractures in primary care. BMJ 330 (2005) 1003-1008
100. 3 and calcium for secondary prevention of low-trauma fractures in elderly people (Randomised Evaluation of Calcium Or vitamin D, RECORD): a randomised placebo-controlled trial. Lancet 365 (2005) 1621-1628
101. Jackson R.D., Lacroix A.Z., Gass M., Wallace R.B., Robbins J., and Lewis C.E. Calcium plus vitamin D supplementation and the risk of fractures. N Engl J Med 354 (2006) 669-683
102. Boonen S., Vanderschueren D., Haentjens P., and Lips P. Calcium and vitamin D in the prevention and treatment of osteoporosis: a clinical update. J Intern Med 259 (2006) 539-552
103. Katznelson L., Finkelstein J.S., Schoenfeld D.A., Rosenthal D.I., Anderson E.J., and Klibanski A. Increase in bone density and lean body mass during testosterone administration in men with acquired hypogonadism. J Clin Endocrinol Metab 81 (1996) 4358-4365
104. Snyder P.J., Peachey H., Hannoush P., Berlin J.A., Loh L., Holmes J.H., et al. Effect of testosterone treatment on bone mineral density in men over 65 years of age. J Clin Endocrinol Metab 84 (1999) 1966-1972
105. Amory J.K., Watts N.B., Easley K.A., Sutton P.R., Anawalt B.D., Matsumoto A.M., et al. Exogenous testosterone or testosterone with finasteride increases bone mineral density in older men with low serum testosterone. J Clin Endocrinol Metab 89 (2004) 503-510
106. Neer R.M., Arnaud C.D., Zanchetta J., Prince R., Gaich G.A., Reginster J.Y., et al. Effect of parathyroid hormone (1-34) on fractures and bone mineral density in postmenopausal women with osteoporosis. N Engl J Med 344 (2001) 1434-1441
107. Kaufman J.M., Orwoll E., Goemaere S., San Martin J., Hossain A., Dalsky G., et al. Teriparatide effects on vertebral fractures and bone mineral density in men with osteoporosis: treatment and discontinuation of therapy. Osteoporos Int 16 (2005) 510-516
108. Meunier P.J., Delmas P.D., Eastell R., McClung M.R., Papapoulos S., Rizzoli R., et al. Diagnosis and management of osteoporosis in postmenopausal women: clinical guidelines. International Committee for Osteoporosis Clinical Guidelines. Clin Ther 21 (1999) 1025-1044
109. Adachi J.D., Bensen W.G., Brown J., Hanley D., Hodsman A., Josse R., et al. Intermittent etidronate therapy to prevent corticosteroid-induced osteoporosis. N Engl J Med 337 (1997) 382-387
110. Orwoll E.S., Ettinger M., Weiss S., Miller P., Kendler D., Graham J., et al. Alendronate for the treatment of osteoporosis in men. N Engl J Med 343 (2000) 604-610
111. Reid D.M., Adami S., Devogelaer J.-P., and Chines A.A. Risedronate increases bone density and reduces vertebral fracture risk within one year in men on corticosteroid therapy. Calcif Tissue Int 69 (2001) 242-247