[Pharmacotherapy and prevention of osteoporosis]

In the article data regarding pharmacological prevention of primary osteoporosis is reviewed. Some main aspects of the disease are underlined. The primary prevention of osteoporosis is targeted on building up and sustaining the strength of the skeleton during different periods of human life. The secondary prevention is aimed to avert the fractures in the case of developed osteoporosis. The main mechanism of fracture risk lowering is prevention of bone mineral density (BMD) reduction. The prevention is based on risk-factor modification. It is important, that success during prevention of osteoporosis may be reached, if the group with high risk of disease development will be identified in time. In the article the risk-groups for BMD determination, the WHO criteria of disease diagnostics, as well the prevention approaches--healthy life style promotion and pharmacological prevention were presented. The main group of agents acting against bone resorption: bisphosphonates (BP), calcitonin, hormone replacement therapy, selective modulators of estrogen receptors, as well as fluorides stimulating bone production and recombinant agent of parathyroid hormone--teriparatide were discussed. Bisphosphonates are most powerful inhibitors of bone resorption and are discussed as first line agents for prevention and care of osteoporosis. At present, there are a large number of antiresorptive agents, with different pharmacodynamics and pharmacokinetics and the task for physician is to define the correct treatment in each case.