Update on osteoporosis

Abstract

Osteoporosis (decline in bone mineral density and bone quality) is an increasing public health concern. Treatment decisions are increasingly being made on the basis of an individual's fracture risk rather than solely their bone mineral density. Drugs to treat osteoporosis may reduce vertebral fracture risk, non-vertebral fracture risk or both. The most commonly prescribed treatment for osteoporosis is oral bisphosphonates, which inhibit farnesyl pyrophosphate synthase, reducing bone resorption. Other antiresorptive or anabolic treatments are available or in development. Controversies exist regarding prescription of calcium supplementation and regarding optimal vitamin D concentration. Serious side effects of antiresorptive therapies such as osteonecrosis of the jaw and atypical femoral fracture are increasingly recognized. © 2013 Rila Publications Ltd.