Pharmacological Treatment of Osteoporosis

Osteoporosis can be classified into two big categories, clinical osteoporosis and densitometric osteoporosis. Clinical osteoporosis involves a fragility fracture, and no densitometry is needed to start treatment. Densitometric osteoporosis is defined by means of a bone mineral density assessment. Treatment should be considered depending on the global fracture risk, and taking the densitometric results into account. The first step in the pharmacological treatment of osteoporosis is to identify whether it is a primary disease or whether the bone mass loss is secondary to another disease. In the case of a secondary osteoporosis, treatment of the primary disease is the most important step. Pharmacological treatment should then be considered if the fracture risk is too high. The purpose of pharmacological treatment in osteoporosis is to reduce the risk of fracture. According to the World Health Organization’s more than half of the patients suffering a fragility fracture do not have densitometric osteoporosis. (Siris et al., 2004) When any medication is started for osteoporosis treatment it must be remembered that this illness will require treatment for a long time and that the drug has to be given in conjunction with advise regarding lifestyle changes. It is therefore imperative to evaluate and make decisions based on issues such as cost, evaluation of cost-efficiency, and patient adaptability to drug safety.