Osteoporosis.

Area of Science:

• Gerontology
• Orthopedics
• Pharmacology

Background:

• Osteoporosis-related fractures are a growing concern for aging populations, particularly women over 55 and men over 65.
• These fractures lead to significant morbidity, mortality, and increased healthcare expenses.
• Recent research has improved fracture risk assessment and expanded therapeutic options.

Purpose of the Study:

• To review current strategies for osteoporosis fracture risk assessment and management.
• To discuss novel therapeutic approaches targeting bone resorption and formation.
• To highlight challenges in current osteoporosis treatment and suggest future directions.

Main Methods:

• Review of current literature on osteoporosis, fracture risk assessment, and pharmacologic treatments.
• Analysis of clinical guidelines and research findings on bisphosphonates, denosumab, teriparatide, and abaloparatide.
• Discussion of the benefits and limitations of long-term osteoporosis management.

Main Results:

• Fracture risk algorithms combining clinical factors and bone mineral density are standard practice.
• New treatments with distinct mechanisms of action are available.
• Long-term treatment (up to 10 years) with bisphosphonates or denosumab is beneficial for high-risk individuals.
• Short-term use of teriparatide or abaloparatide (18-24 months) for very high-risk patients should be followed by antiresorptive therapy.

Conclusions:

• Effective management of osteoporosis requires long-term, individualized treatment strategies.
• A significant gap exists in the adequate treatment of individuals at high risk for fractures.
• Implementing Fracture Liaison Services and improving therapy adherence are crucial for future management.