Current Approaches to Osteoporosis Treatment
In line with advances in bone biology knowledge, the past several years have held major therapeutic advances in osteoporosis treatment. In adults at risk for fracture, osteoporosis treatment decreases fracture risk by approximately 70%. In patients with a prior hip fracture, secondary prevention has been shown to reduce both fracture risk and mortality. In this review, we describe the medications most likely to be prescribed by rheumatologists and the concerns pertaining to their use. In Table 1, we summarize the efficacy of these medications in preventing fractures. In Table 2, we describe our approach to medication selection in unique clinical circumstances that may be encountered by practicing rheumatologists. Although detailed discussion is beyond the scope of this article, we wish to emphasize the importance of adequate calcium and vitamin D supplementation in osteoporosis treatment. The National Osteoporosis Foundation recommends elemental calcium dietary intake of 1200 mg per day in split daily dosing for postmenopausal women. The recommended intake for vitamin D is 800–1000 IU per day with a target 25(OH) Vitamin D level of at least 30 ng/ml. Furthermore, regular weight bearing exercise, fall prevention and risk factor modification such as avoidance of smoking and excessive alcohol intake are important interventions to maintain bone health.
Current Medications for Osteoporosis Treatment
In line with advances in bone biology knowledge, the past several years have held major therapeutic advances in osteoporosis treatment. In adults at risk for fracture, osteoporosis treatment decreases fracture risk by approximately 70%. In patients with a prior hip fracture, secondary prevention has been shown to reduce both fracture risk and mortality. In this review, we describe the medications most likely to be prescribed by rheumatologists and the concerns pertaining to their use. In Table 1, we summarize the efficacy of these medications in preventing fractures. In Table 2, we describe our approach to medication selection in unique clinical circumstances that may be encountered by practicing rheumatologists. Although detailed discussion is beyond the scope of this article, we wish to emphasize the importance of adequate calcium and vitamin D supplementation in osteoporosis treatment. The National Osteoporosis Foundation recommends elemental calcium dietary intake of 1200 mg per day in split daily dosing for postmenopausal women. The recommended intake for vitamin D is 800–1000 IU per day with a target 25(OH) Vitamin D level of at least 30 ng/ml. Furthermore, regular weight bearing exercise, fall prevention and risk factor modification such as avoidance of smoking and excessive alcohol intake are important interventions to maintain bone health.