Combinations of Antiresorptive Therapies
Because the different classes of antiresorptive drugs work through different mechanisms of action, there is a clinical rationale for studying these agents in combination. Combinations of bisphosphonates and HT or raloxifene have been shown to increase BMD greater than either agent alone.^52-54 At this time, it has not been determined if these combinations reduce fracture risk greater than single agent therapy. Combination therapy is generally reserved for patients who have experienced a fracture while on therapy with a single drug, those who start out with a very low BMD and a history of multiple fractures, and those with very low BMD who lose more bone mass on therapy with a single drug.⁵⁵