[Drug selection and treatment goal in osteoporosis therapy.]

The goal of treatment for osteoporosis is to reduce the risk of fracture. Achieving effective reductions in the risk of fracture requires evidence-based drug selection and careful consideration of patient background, including concomitant diseases and drug adherence. Selective estrogen receptor modulators(SERM)and active vitamin D ₃ such as eldecalcitol are well indicated in early menopausal women with no history of fragility fractures. Moreover, elderly individuals with a history of fragility fractures are at high risk of vertebral and hip fractures, so bisphosphonates, denosumab and teriparatide are well indicated in these patients. Although no well-established goal has been devised for the treatment of osteoporosis in Japan, the strategy of goal-directed treatment of osteoporosis has been reported in the United States.