Treatment of Primary Osteoporosis With Fluoride and Calcium
Clinical Tolerance and Fracture Occurrence
- B. Lawrence Riggs, MD;
- Stephen F. Hodgson, MD;
- David L. Hoffman, MD;
- Patrick J. Kelly, MD;
- Kenneth A. Johnson, MD;
- Donald Taves, MD, PhD
- From the Divisions of Endocrinology-Metabolism and Internal Medicine (Drs Riggs, Hodgson, and Hoffman) and the Department of Orthopaedics (Drs Kelly and Johnson), Mayo Clinic and Mayo Foundation, Rochester, Minn, and the Department of Pharmacology and Toxicology (Dr Taves), University of Rochester (NY) School of Medicine and Dentistry.
Abstract
Thirty-six patients with primary osteoporosis were treated for up to six years with sodium fluoride, calcium supplements, and, in 24 patients, vitamin D. Major adverse reactions (synovitis, painful plantar fascial syndrome, recurrent vomiting, or anemia) occurred in 15 patients (42%). New vertebral fractures occurred at a rate of 329 fractures per 1,000 years of observation. Almost half of them occurred during the first year of therapy, and they were only one sixth as frequent in 12 patients who had fluoride-induced increased trabeculation on vertebral roentgenograms. Nevertheless, until long-term safety and antifracture efficacy are better established, this regimen should continue to be restricted to investigational use.
(JAMA 243:446-449, 1980)
Footnotes
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Reprint requests to Mayo Clinic, 200 First St SW, Rochester, MN 55901 (Dr Riggs).
