[Pharmacologic therapy of osteoporosis]

This paper reviews the pharmacologic therapies for the prevention and the treatment of osteoporosis. Vitamin D metabolites, estrogen, estrogen-progestin, calcitonin and ipriflavone are effective regimens for the prevention of bone loss and the treatment of osteoporosis. Since estrogen deficiency is the main cause for postmenopausal osteoporosis, estrogen supplementation is the most effective therapy for postmenopausal osteoporosis. Estrogen progestin combination therapy is one of the most potent therapies to increase both cortical and trabecular bone mass. Vitamin D has efficacy on increasing intestinal calcium absorption and decreasing fracture rate in osteoporotic patients. Calcitonin inhibits osteoclastic bone resorption and also has inherent analgesic properties. Several studies have suggested that new delivery systems of estrogen (transdermal) and calcitonin (transnasal) are effective in osteoporosis. Recent studies revealed that bisphosphonate and hPTH (1-34) were new potent agents for the treatment of osteoporosis. Bisphosphonate would be effective to osteoporosis by reducing bone resorption. hPTH may have a primary action to increase bone formation. Treated patients should be monitored using bone mineral density and biochemical markers for evaluating the response to therapy.