In light of this evidence, it is not surprising that HERS found no significant differences in peripheral fracture risk for estrogen-treated women. This is not necessarily a negative finding of the therapeutic effect on bone-active agents, however. One likely explanation may be that anti-resorptive therapies have only a very small effect on the peripheral skeleton. What is needed at this juncture is a longitudinal study of estrogen on the incidence of vertebral and peripheral fractures in the elderly. These results should be available at the conclusion of the Women's Health Initiative study.
Some patients continue to fracture even when they are placed on effective treatments.
Although it is clear that BMD is an important factor related to fracture risk, there must be other factors, such as the quality of bone, that contribute to the propensity to fracture. Further study is needed to fully address this issue. Conclusions Undoubtedly, the full story on bone loss, fractures, and the relative efficacy of available osteoporosis treatments is not yet written. Again, further study is needed on this issue. As the baby-boom generation ages, the importance of these issues and the monitoring and prevention of osteoporosis will undoubtedly grow.