Osteoporosis secondary prevention
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2], Raviteja Guddeti, M.B.B.S.[3]
Overview
Secondary prevention involves use of pharmacologic therapy as an intervention as soon as osteoporosis is recognized. Primary prevention measures should also be used with pharmacologic therapy. The agent chosen for therapy is based on what would work best for the individual patient.
Secondary prevention
Pharmacologic Therapy
- All patients who are receiving pharmacologic treatment for osteoporosis, should also undergo lifestyle modifications and supplementation to also prevent further bone loss.
- Bisphosphonates - these are potent agents which inhibit resorption of bone[1]. In turn they increase bone mineral density and decrease the risk of fractures. They include drugs called alendronate, risendronate, ibandronate, and zoledronic acid.
- Selective Estrogen Receptor Modulators - otherwise known as SERM's, are approved for the prevention of post-menopausal osteoporosis. They have been shown to increase bone mineral density and decrease the risk of vertebral fractures. Raloxifene [2] is the only SERM approved for use in the United States.
- Estrogen - with or without medroxyprogesterone can be used to prevent osteoporosis, however in general the risks outweigh the benefits, so it is not used as a first-line therapy. It is used in women who have a significant risk of osteoporotic fractures and cannot take non-estrogen medications.
References
- ↑ Zhang J, Wang R, Zhao YL; et al. (2012). "Efficacy of intravenous zoledronic acid in the prevention and treatment of osteoporosis: A meta-analysis". Asian Pac J Trop Med. 5 (9): 743–8. doi:10.1016/S1995-7645(12)60118-7. PMID 22805729. Unknown parameter
|month=ignored (help) - ↑ Dadiboyena S (2012). "Recent advances in the synthesis of raloxifene: a selective estrogen receptor modulator". Eur J Med Chem. 51: 17–34. doi:10.1016/j.ejmech.2012.02.021. PMID 22405286. Unknown parameter
|month=ignored (help)