Re: WHI--how my practice is going to deal with it
From: art fougner, md (evsono@pipeline.com)
Sun Jul 14 08:56:35 2002
ok - so what we are looking at is a true failure of public health -
prolly aided and abetted by big pharm - thar's gold in them thar pills.
what we should be doing is gettin to the high schools and pushing
healthy calcium intake and folic acid - a sort of biological retirement
plan. this strategy would be far superior to chasing after decades of
neglect in a hopeless game of catch-up.
just my opinion - i could be wrong.
art
At Sat, 13 Jul 2002, Garry E. Siegel, M.D. wrote:
>
>FWIW, I try for Evista, but many women don't like that it is in the
>hormone/estrogen category, and choose Fosamax or Actonel.
>
>I would be interested to hear what happens to others when:
>1. They try to get asymptomatic menopausal women to take a preventive
>agent such as Actonel, Fosamax, or Evista. Many, if not most of my
>patients are just not interested unless they've had a densitometry
>showing osteopenia. Obviously, in my question, these women in their
>early 50's have not yet had a densitometry, or it was normal.
>2. For those women who will go for preventive therapy, if you
>prefer/suggest Fosamax or Actonel, which one, and weekly or daily, and
>why?
>
>Garry
>
>At Sat, 13 Jul 2002, WHRA wrote:
>>
>>Or Fosamax for the failed Evista patient having hot flashes as a side
>>effect.
>>
>>JK
>>
>>Jay M. Kulkin, MD MBA FACOG
>>Women's Health Resource Associates
>>3475 Oak Valley Road
>>Suite 2640
>>Atlanta, Georgia 30326
>>404-841-0034
>>Fax: 404-841-0054
>>
>>>>>----- Original Message -----
>>From: "Douglas Krell" <officekrell@ix.netcom.com>
>>To: "Multiple recipients of list OB-GYN-L" <ob-gyn-l@mail.medispecialty.com>
>>Sent: Saturday, July 13, 2002 7:30 PM
>>Subject: Re: WHI--how my practice is going to deal with it
>>
>>> Dr. Wolpman writes:
>>>
>>> <I have
>>> <begun to move all my patients off of combo HRT to biphosphonates and
>>> <statins....are you doing the same?
>>>
>>> That's certainly one option....
>>> However I'm moving most of my patients... to Evista
>>>
>>> Last month in the Archives of Internal Medicine bone densitometry experts
>>> agreed that any differerences in antiresoptives are not statistically
>>> significant
>>> in terms of fracture risk reduction...
>>>
>>> With the latest prospective data on Evista showing a 40% reduction in
>>> cardiovascular events
>>> in a high risk group of 1200 patients AND an 84% reduction in ER+ breast
>>> cancers with NO tolerability or dosing issues Evista makes much more sense
>>> for the woman who has no more menopausal vasomotor symptoms.
>>> This goes right along with the idea of OB/GYN being a specialty interested
>>> in preventive health measures.
>>> After 3 months of Evista...lipoproteins and lipids can be evaluated to see
>>> if statins, fibrates, or
>>> niacin is in order.
>>>
>>> Bisphosphonates should be reserved for 70+ year old woman who continues to
>>> develop worsening osteoporosis
>>> despite other measures.
>>>
>>> Douglas Krell MD
>>>
>--
>Garry E. Siegel, M.D.
>Private Practice
>Roswell, GA
>
--
art fougner, md
ich bin ein New Yorker
