PerspectiveLessons from osteoporosis clinical trials

We now have a diverse menu of osteoporosis therapies as a result of multiple randomized, controlled trials. These randomized, controlled trials have taught us the value of final endpoints such as incident fractures versus intermediate endpoints such as bone mineral density and bone markers. The success of randomized, controlled trials depends on identification of high-risk patients. Strategies have been developed to identify high-risk patients using risk factors. Finally the importance of both skeletal and extraskeletal safety is discussed.