Osteoporosis

Osteoporosis is a silent and strong risk factor for fracture, as hypertension is for stroke. Among individuals above 50 or older, one in every two women and one in every four men will have an osteoporosis-related fracture. Bone mineral density (BMD) testing is recommended to diagnose osteoporosis, especially in high risk individuals.

The high risk individuals for osteoporosis are:

  • All women aged 65 or above
  • All men aged 70 or above
  • Women or men who have fractures after age 50
  • Menopausal women under age 65 who are at high risk of osteoporosis, including stopping estrogen therapy
  • Men aged 50 to 69 with risk factors for osteoporosis

Management of osteoporosis

Patients should take proper nutrition and healthy life style changes to promote bone health. A well balanced, nutritious diet rich in fruits and vegetables is essential. Osteoporosis patients are required to take 1000-1200mg of calcium per day, the recommended dietary allowance (RDA) of calcium per day, collectively from all the sources such as food and supplements.

Osteoporosis treatment requires use of FDA approved medication in below mentioned category of patients.

  • All postmenopausal women and men with vertebral or hip fracture
  • Individuals with a T-score ? -2.5 at the femoral neck or spine, excluding secondary causes
  • Low bone mass (T-score: -1.0 to -2.5 at the femoral neck or spine) and a high fracture probability (for 10-years: hip fracture ? 3%, or a major fracture ? 20%) in patients aged above 50 and currently not on osteoporosis medication. (US-adapted WHO algorithm)
  • Selective patients with clinician’s advice

Following are the list of FDA Approved Osteoporosis Medications:

  • Bisphosphonates (antiresorptive medications): Alendronate (Fosamax, Fosamax D), Ibandronate (Boniva), Risedronate (Actonel, Atelvia), Zoledronic acid (Reclast)
  • Other antiresorptive medications: Calcitonin (Fortical, Miacalcin), Denosumab (Prolia), Estrogen therapy or hormone therapy, Raloxifene (Evista)
  • Anabolic medication: teriparatide (Forteo)
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