Osteoporosis - From hormonal replacement therapy to bisphosphonates and beyond: A review

Abstract

Objective: To review the old, current, and emerging agents in pharmacological treatment of osteoporosis. Data sources: Published original research work and reviews from 1993 to 31 December 2006 were searched in English on subjects related to epidemiology, pathophysiology, diagnosis, treatment, and prevention of osteoporosis. Study Design: Only articles that emphasise on management. Data extraction: Online and manual library searches done. Data synthesis: Data added up and summarised. Conclusion: Osteoporosis is a serious public health issue. The past 10 years has seen great advances in our understanding of its epidemiology, pathophysiology, and treatment, and further advances are rapidly being made. Bisphosphonates represent the biggest advance in the treatment of osteoporosis, and will probably remain the mainstay of therapy. At the same time other diagnostic and therapeutic approaches, including biological agents, are likely to become more widespread. Combination therapy is generally not recommended due to paucity of data concerning antifracture effectiveness, and, there is currently no definitive answer on the length of treatment with antiresoptive agents.