Re: Fosamax PLUS estrogen?

From: Jeffrey W. Clemens (clemens@duq2.cc.duq.edu)
Wed Jul 30 08:47:54 1997


Listers,

>Estrogen and Fosomax work at different areas of remodeling bone.
Not quite! They work on different aspects of osteoclast (OC) physiology

> Estrogen affects osteoblasts, which make new bone.

Not quite. The best evidence to date suggests that the effects of estrogens are to decrease the formation of OCs from their precursor cell type (see Roodman GD, "Advances in Cell Biology:the Osteoclast", Endocrine Reviews 17(4):308, 1996. OCs are the only bone cell demonstrated to have estrogen receptor. There may be paracrine-mediated effects on osteoblast function. The same issue contains reviews of the calcium-sensing receptor (p 289) and biological markers of bone turnover and their clinical applications (p. 333).

Fosamax decreases ruffled border activity/formation of the OC, thereby reducing bone resorption.

As well discussed in this forum, there are undesirable estrogenic side effects and fosamax has side effects also. Dual therapy could perhaps reduce the dose necessary for both agents-estrogens reducing the number of OCs and fosamax reducing the activity of the remaining differentiated OCs. Anyone up for an RCT (or know of one)?

Jeff

--
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Jeffrey W. Clemens, Ph.D.
Assistant Professor
Dept. of Biological Sciences
Duquesne University
Pittsburgh, PA 15282
412-396-4597
Fax 412-396-5907
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