Osteoporosis update: effective prevention and treatment

Abstract

Osteoporosis is a public health threat to approximately 44 million individuals in the USA, or 55% of men and women over the age of 50 years. The primary goal of osteoporosis management is to prevent fracture, the most devastating consequence. Risk factors and bone mineral density can be assessed to determine appropriate action for prevention and treatment of osteoporosis. Prevention strategies include lifestyle modification, fall prevention, and adequate intake of calcium and vitamin D. Current treatment options include antiresorptive agents and anabolic agents. Adherence and cost issues play major roles in establishing optimal therapy for individual patients. New agents in development are designed to improve osteoporosis treatment and patient adherence. This review focuses on current and future prevention and treatment options for postmenopausal osteoporosis.

Keywords::

• alendronate
• anabolic agents
• bisphosphonates
• calcitonin
• estrogen
• ibandronate
• osteoporosis
• postmenopausal osteoporosis
• primary prevention
• risedronate
• selective estrogen receptor modulators
• teriparatide
• therapeutics

Notes

Adapted from [202]

*Major risk and additional risk factors are detailed in BOX 1.

‡Most important risk factors are: prior low-trauma fracture as an adult and low BMD in patients with or without fractures, and other risk factors for hip fracture are history of hip fracture in a first-degree relative, weight loss and low body weight, cigarette smoking, increased likelihood of falling, tallness, high bone turnover, and advancing age.

BMD: Bone mineral density; DXA: Dual-energy x-ray absorbtiometry.

Adapted from [17,202].