[Clinical decision and patient education of pharmacotherapy for osteoporosis]

The aim of the pharmacotherapy for osteoporosis is to prevent osteoporotic fractures. It is important to identify the patients who have the risk for fractures and to assess how high the risk is. The Japanese guideline for prevention and treatment of osteoporosis showed the criteria to start the pharmacotherapy of osteoporosis. These criteria indicated that the subjects to be treated with osteoporosis drugs are the patients diagnosed as osteoporosis according to the Japanese diagnostic criteria of osteoporosis and those of osteopenia having one of the major clinical risk factors for osteoporotic fractures. Those factors are patients' history of femoral neck fractures, excessive alcohol or tobacco smoker. Recently 10-year absolute risk for fractures can be estimated by fracture risk assessment tool by WHO group, which is named as FRAX. The way of clinical application of this tool should be discussed in each country.