[Medical treatment of osteoporosis]

Osteoporosis is a skeletal disease characterized by increased risk of fracture due to reduced bone strength. Osteoporosis-associated fractures not only impair patients' quality of life (QOL) but also diminishes life expectancy. The most important goal in the treatment of osteoporosis is fracture prevention. To achieve this goal, in addition to lifestyle changes including balanced diet, increased exercise and fall prevention, most high-risk patients need pharmacological intervention. Based on the currently available evidence, the first-line medications are bisphosphonates and raloxifene. Active vitamin D alone may not be efficacious enough but may particularly be important in Japan as a surrogate for vitamin D and calcium supplementation. A new bone anabolic therapy by parathyroid hormone (PTH), which is already in clinical use in other countries, is also expected to become available in Japan in the near future.