Major drug therapies now exist for treating osteoporosis. Unfortunately, studies continue to report that doctors fail to evaluate and adequately treat both men and women for this condition, even after a fracture. In a 2002 study of Caucasian women over age 60, fewer than 2% were evaluated for osteoporosis or spinal fracture by their doctors. Among those who were diagnosed, only 36% received appropriate medication. Two studies in 2003 further reported that among adults who had sustained fractures, less than 5% of men and fewer than half of women were evaluated and treated according to recommended guidelines. In one of the studies, only 24% of women were given treatments for osteoporosis after a fracture. In both studies, the older a woman was the less likely she was to have adequate evaluation or treatment.
Drugs Used to Treat Osteoporosis. There are two types of drugs used to treat osteoporosis:
Antiresorptive Drugs.
Antiresorptives include bisphosphonates, hormone replacement therapy, SERMs, and calcitonin. Bisphosphonates are the standard drugs used for osteoporosis. These drugs block resorption (bone break down) and so slow the rate of bone remodeling, but they cannot rebuild bone. In fact, because resorption and reformation occur naturally as a continuous process, blocking resorption may eventually also reduce bone formation.
Anabolic, or Bone-Forming, Drugs.
Drugs that rebuild bone are known as anabolics. The primary anabolic drug is low-dose parathyroid hormone (PTH), which is administered as injections. It is proving to be very effective in restoring bone and preventing fractions. PTH is still relatively new, and long-term effects are still unknown. Fluoride is another bone-building drug, but it has limitations and is not commonly used.
Both types of drugs are effective in preventing bone loss and fractures, although they vary in their effectiveness and safety.
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