[Combination therapies on osteoporosis]

Combination therapies of bisphosphonates with conjugated equine estrogen (CEE) , vitamin D or parathyroid hormone (PTH) on osteoporotics have been discussed. Combined therapy of bisphosphonate with CEE increased lumbar bone mineral density (LBMD) and femoral neck bone mineral density (FBMD) in elderly patients. Furthermore combination therapy of bisphosphonate with CEE reduced new vertebral fractures in elderly osteoporotics. Similarly combination therapy of bisphosphonate with vitamin D is also advantageous to the increase of LBMD and FBMD. It is likely that the merit of combination therapy is to increase not only the lumbar BMD, but also the femoral BMD, although monotherapy is only to increase lumbar BMD. In contrast to CEE vitamin D seems to assist the effect of bisphosphonate in non-respondent patients to bisphosphonate. However, combination therapy of bisphosphonate with PTH might be complex in reducing the effect of alendronate.