Osteoporosis Drug Cuts

Spine Fracture Risk A drug used to prevent osteoporosis can also reduce the risk of spinal fractures by as much as 50 percent in women who already have the bone-thinning disease, a study found.

The research is the largest study to date of raloxifene, the latest in a series of drugs that postmenopausal women can take instead of estrogen to protect against broken bones.

Bruce Ettinger of Kaiser Permanente Medical Care Program in Oakland, Calif., led the three-year study of 7,705 women in 25 countries.

The findings were published in today's Journal of the American Medical Association. The research was funded by Eli Lilly & Co. of Indianapolis, which sells raloxifene as Evista.

The news comes one month after data from the same women showed that raloxifene appears to lower the risk of breast cancer by 70 percent. That is a major advantage for postmenopausal women who want the bone-strengthening benefits of estrogen but fear the slightly increased risk of breast cancer from long-term use.

Raloxifene was approved by the Food and Drug Administration in 1997. Like other osteoporosis drugs, it adds bone mineral density early in treatment and thereafter slows the loss of bone mineral.

Ettinger said the four approved osteoporosis drugs should not be considered competitors, because their benefits and limitations are so different.

TB Infects Third Of World's People

Nearly a third of the world's population is infected with the bacterium that causes tuberculosis, according to a new report, with 7.96 million new cases of the disease reported in 1997.

The study, by the World Health Organization (WHO), blamed poor control strategies for the situation, adding that more than half of the new cases reported in 1997 occurred in five Southeast Asian countries.

Control failures also were cited for high rates in sub-Saharan Africa and Eastern Europe, along with high rates of HIV infection in some African countries, where the disease has hit people whose immune systems have been weakened.

The study, published in today's Journal of the American Medical Association, estimated that in the 212 countries monitored by WHO, 1.86 billion people, or 32 percent of the global population, carry the bacterium that causes the disease.

The study said people are sometimes not aware they have tuberculosis because their bodies respond so effectively that infected areas heal. However, the disease can become active again when the immune system weakens or when the person becomes malnourished.

The researchers said Southeast Asia accounted for the largest number of tuberculosis cases, with 44 percent of the area's population infected. That area was followed by the Western Pacific region at 36 percent and Africa with 35 percent.

In the eastern Mediterranean, the infection rate was 29 percent, followed by 18 percent in the Americas and 15 percent in Europe.

The authors said high rates of infection with both the tuberculosis bacterium and HIV caused high tuberculosis rates in some African countries.

The study said that in 1997, 7.96 million people contracted tuberculosis and about 1.87 million died from it. Of the new cases, 3.5 million involved infectious lung versions of the disease. The organization said the last previous infection level reading was for 1990, when 7.5 million new cases were recorded.