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[Osteoporosis in men]
1Service des maladies osseuses, Departement des spécialités de medecine HUG, Geneve. emmanuel.biver@hcuge.ch
Revue Medicale Suisse
|July 5, 2013
Summary
Osteoporotic fractures affect 1 in 5 men by age 50. Key risk factors include prior fractures, glucocorticoid use, and androgen deprivation therapy, with treatments showing efficacy similar to women.
Area of Science:
- Geriatric Medicine
- Endocrinology
- Orthopedics
Context:
- Osteoporosis significantly impacts men, with 20% experiencing fractures by age 50.
- Risk factors extend beyond bone mineral density (BMD), including comorbidities and fall risk.
- Common triggers for male osteoporosis include fragility fractures, long-term oral glucocorticoid use, and androgen deprivation therapy for prostate cancer.
Purpose:
- To review the multifaceted nature of osteoporosis and fracture risk in men.
- To highlight key risk factors and clinical situations associated with male osteoporosis.
- To discuss the efficacy of osteoporosis treatments in men.
Summary:
- Osteoporosis affects 1 in 5 men by age 50, with numerous risk factors beyond decreased bone mineral density (BMD).
- Prevalent fragility fracture, oral glucocorticoid therapy (≥3 months), and androgen deprivation therapy are primary risk indicators.
- Pharmacological interventions like bisphosphonates, denosumab, and teriparatide demonstrate efficacy in increasing BMD and altering bone turnover markers in men, comparable to women.
- Zoledronic acid and denosumab have provided the initial anti-fracture data specifically for men.
Impact:
- Enhances understanding of osteoporosis prevalence and risk stratification in the male population.
- Informs clinical practice regarding the identification and management of high-risk men.
- Supports the use of established osteoporosis therapies in men based on emerging evidence.
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