Multidisciplinary approach to osteoporosis management

Abstract

Osteoporosis is characterized by reduction in bone mass and disruption of bone architecture, resulting in fractures such as Colle spine and proximal femur. One out of eight men and one out of three women in India suffer from osteoporosis, making India one of the most affected countries in the world. Dual energy X-ray absorptiometry is used to diagnose osteoporosis. With eight groups of medications and about 20 drugs available to treat this condition, it is important to know which agent is to be used for which patient. Calcium, exercise and vitamin D supplements should be considered for all patients. Hormone replacement therapy (HRT) is an option in younger women with increased risk of fracture. Bisphosphonates are usually the frontline agents due to their low cost. Zoledronic acid and ibandronate are the injectable agents which are given when oral agents cannot be given or will not be absorbed or when compliance is an issue. They are more potent than oral agents. Parathyroid hormone, although expensive, is an anabolic agent and preferred in patients with severe osteoporosis with vertebral fractures or in those patients who are intolerant to other therapies. It should be the option in younger post-menopausal women with high risk of fracture.

Keywords

• osteoporosis
• calcium
• bisphosphonates
• hrt
• dexa