Management of primary osteoporosis

Area of Science:

• Gerontology
• Pharmacology
• Orthopedics

Background:

• Osteoporotic fractures pose a significant health challenge, with prevention being more effective than treatment.
• Hormone replacement therapy (HRT) is a traditional approach for postmenopausal osteoporosis but carries risks and uncertainties regarding long-term benefits.
• Emerging evidence questions the sustained efficacy and safety of HRT, necessitating alternative strategies.

Purpose of the Study:

• To review current and emerging therapeutic strategies for preventing and treating osteoporotic fractures.
• To compare the efficacy and safety profiles of various osteoporosis medications.
• To highlight advancements in osteoporosis management, focusing on newer agents and administration routes.

Main Methods:

• Review of randomized controlled trials and clinical studies on osteoporosis treatments.
• Comparative analysis of hormone replacement therapy (HRT), selective estrogen receptor modulators (SERMs), bisphosphonates, and bone-forming agents.
• Evaluation of drug efficacy, safety, administration routes, and patient compliance.

Main Results:

• Bisphosphonates (alendronate, risedronate) significantly reduce vertebral and hip fracture risk, with newer formulations (oral ibandronate, IV zoledronic acid) offering less frequent administration.
• Selective estrogen receptor modulators (SERMs) are proposed as alternatives to HRT for elderly women.
• Teriparatide (rhPTH 1-34) shows promise for severe osteoporosis, despite complex administration.

Conclusions:

• Osteoporosis management is evolving, with a shift towards SERMs and improved bisphosphonate regimens.
• Less frequent administration of potent bisphosphonates and bone-forming agents represent significant advancements.
• Optimizing prevention and treatment strategies is crucial for managing osteoporotic fractures effectively.