Treatment
Drug treatment of osteoporosis focuses on slowing bone loss, promoting bone growth,
and reducing the risk of fractures, in addition to easing the pain of fractures.
Traditionally, estrogen therapy has been used, as it has been effective in reducing bone
loss, increasing bone density in the spine and hip, and reducing the risk of spine and hip
fractures in postmenopausal women. However, estrogen alone can increase the risk of
developing endometrial cancer, stroke, and possibly ovarian cancer with long-term use.
Therefore, hormone therapy, such as Prempro, a combination of estrogen and progestin,
is prescribed to women who have not had a hysterectomy.
Other drugs to treat osteoporosis fall into one of four classes: bisphophonates, selective
estrogen receptor modulators (SERMs), calcitonin, and bone-forming agents.
Bisphosphonates reduce bone loss by suppressing osteoclast-mediated bone
resorption. They are taken up by osteoclasts during resorption, and once inside the cell,
inhibit an enzyme that leads to osteoclast deactivation and apoptosis. Bisphosphanates,
which include the drugs alendronate (Fosamax), risedronate (Actonel), and ibandronate
(Boniva), are approved by the Food and Drug Administration (FDA) for both prevention
and treatment of postmenopausal osteoporosis.
Selective estrogen receptor modulators (SERMs) provide the benefits of estrogen
therapy without its unwanted side effects. They mimic the effects of estrogen on the
skeleton and lipids, without targeting the uterus or breast. SERMs prevent bone loss in
the spine, hip, and total body and reduce the risk of vertebral fractures. Raloxifene
(Evista) is currently the only FDA-approved SERM.
Calcitonin inhibits osteoclast activity and exerts rapid, transient, and reversible inhibition
of bone resorption. Calcitonin slows bone loss, increases spinal density, relieves pain
associated with bone fractures, as well as reduces the risk of spinal and hip fractures. In
women who are at least five years postmenopause, calcitonin, available as an injection
and a nasal spray, slows bone loss, increases spinal bone density, and reportedly
relieves the pain associated with bone fractures.
Bone forming agents stimulate new bone formation in both the spine and the hip.
Although the mechanism of action is not known, parathyroid hormone (PTH) appears to
stimulate bone formation. Continuous secretion of PTH, as in hyperparathyroidism, leads
to bone breakdown. However, intermittent injections of PTH seem to build bone.
Teriparatide (Forteo) is an injectable form of human parathyroid hormone.
Drug treatment of osteoporosis focuses on slowing bone loss, promoting bone growth,
and reducing the risk of fractures, in addition to easing the pain of fractures.
Traditionally, estrogen therapy has been used, as it has been effective in reducing bone
loss, increasing bone density in the spine and hip, and reducing the risk of spine and hip
fractures in postmenopausal women. However, estrogen alone can increase the risk of
developing endometrial cancer, stroke, and possibly ovarian cancer with long-term use.
Therefore, hormone therapy, such as Prempro, a combination of estrogen and progestin,
is prescribed to women who have not had a hysterectomy.
Other drugs to treat osteoporosis fall into one of four classes: bisphophonates, selective
estrogen receptor modulators (SERMs), calcitonin, and bone-forming agents.
Bisphosphonates reduce bone loss by suppressing osteoclast-mediated bone
resorption. They are taken up by osteoclasts during resorption, and once inside the cell,
inhibit an enzyme that leads to osteoclast deactivation and apoptosis. Bisphosphanates,
which include the drugs alendronate (Fosamax), risedronate (Actonel), and ibandronate
(Boniva), are approved by the Food and Drug Administration (FDA) for both prevention
and treatment of postmenopausal osteoporosis.
Selective estrogen receptor modulators (SERMs) provide the benefits of estrogen
therapy without its unwanted side effects. They mimic the effects of estrogen on the
skeleton and lipids, without targeting the uterus or breast. SERMs prevent bone loss in
the spine, hip, and total body and reduce the risk of vertebral fractures. Raloxifene
(Evista) is currently the only FDA-approved SERM.
Calcitonin inhibits osteoclast activity and exerts rapid, transient, and reversible inhibition
of bone resorption. Calcitonin slows bone loss, increases spinal density, relieves pain
associated with bone fractures, as well as reduces the risk of spinal and hip fractures. In
women who are at least five years postmenopause, calcitonin, available as an injection
and a nasal spray, slows bone loss, increases spinal bone density, and reportedly
relieves the pain associated with bone fractures.
Bone forming agents stimulate new bone formation in both the spine and the hip.
Although the mechanism of action is not known, parathyroid hormone (PTH) appears to
stimulate bone formation. Continuous secretion of PTH, as in hyperparathyroidism, leads
to bone breakdown. However, intermittent injections of PTH seem to build bone.
Teriparatide (Forteo) is an injectable form of human parathyroid hormone.
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Osteoporosis
Protect your bone at every age...
Live Well, Live Strong, Live Long
Protect your bone at every age...
Live Well, Live Strong, Live Long
