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Advances in osteoporosis from 1970 to 2018

Gallagher, J. Christopher, MD

doi: 10.1097/GME.0000000000001263
2018 NAMS/Pfizer – Wulf H. Utian Endowed Lecture

In 1970, there were no drugs under study for osteoporosis. Estrogen was used, but little was known about the correct dose for preventing bone loss. At that time, fractures were not even recognized as a disease, but regarded as part of normal aging. From 1970 to this year (2018), there have been extensive advances in the osteoporosis field ranging from fracture epidemiology to the remarkable invention of bone density measurements. There have been major advances in therapeutic options available for patients for prevention and treatment of osteoporosis. In parallel, the advances in the laboratory helped elucidate the process of bone remodeling, not only at the macroscopic level but also at the cellular level. This led to rapid advances in translational research from cellular biology to new therapies exemplified by the development of monoclonal antibodies for osteoporosis. Further understanding of the signaling pathways in bone cells will lead to new small molecules made for osteoporosis treatment, perhaps causing less adverse events. University-based research throughout the world has been a leader in most of these advances, and Pharma support for phase 1 to 4 studies helped bring these discoveries to patients. In the osteoporosis field alone, one sees the tremendous value of grant support for university research by National funding agencies such as the National Institute of Health in this country and similar agencies in other countries. There are clinical challenges that have to be solved with long-term compliance with osteoporosis medication if we want to reduce fracture incidence in the long term.

Department of Endocrinology, Creighton University, Omaha, NE.

Address correspondence to: J. Christopher Gallagher, MD, Department of Endocrinology, Creighton University, 2400 Burt St, Criss Building, Suite 281 Omaha NE 68131. E-mail:

Received 5 July, 2018

Revised 24 September, 2018

Accepted 24 September, 2018

The content of this article was presented by Dr John Christopher Gallagher as the NAMS/Pfizer—Wulf H. Utian Endowed Lecture in San Diego, CA, at the Annual Meeting of The North American Menopause Society (NAMS) on October 5, 2018.

An endowment from Pfizer to NAMS established this annual lectureship, with faculty selected by the NAMS Scientific Program Committee.

Funding/support: None.

Financial disclosure/conflicts of interest: None reported.

© 2018 by The North American Menopause Society.