Treating osteoporosis

If you’ve been diagnosed with osteoporosis, never accept the incorrect and uninformed advice that osteoporosis is a normal part of ageing or that nothing can be done.

There are several treatment options available to reduce bone loss. Many of these potent drugs are capable of reducing the rate of osteoporotic fractures by 70% or more.

The aim of medication used in the treatment of established osteoporosis is to stop further bone loss, to replace or repair bone, and to prevent further fractures.

These drugs can be divided into two broad groups: those that inhibit bone resorption (chewing away of bone) and those that stimulate bone formation (building new bone).

A number of effective medications are approved for the prevention and treatment of osteoporosis. These medications must be tailored to each individual’s specific needs and used in conjunction with recommended lifestyle changes.

Commonly available treatments include:

  • Bisphosphonates
  • Calcitonin
  • Denosumab
  • Selective Oestrogen Receptor Modulators (SERMs)
  • Teriparatide
  • Hormone Replacement Therapy (HRT)
  • Vertebroplasty and kyphoplasty

How effective are the treatments?
In postmenopausal women with osteoporosis, the primary outcome investigated in pharmaceutical trials is the reduction of fracture.

Risk reductions of between 30-70% have been demonstrated for vertebral fractures, while reductions of around 15-20% for non-vertebral fractures and up to 40% for hip fracture have been noted.

However, of the currently approved treatments, only alendronate, risedronate, zoledronic acid and strontium ranelate have been shown to reduce vertebral, non-vertebral and hip fractures.

In men and in glucocorticoid-treated populations, regulatory approval has been obtained on the basis of bridging studies in which similar BMD changes to those seen in postmenopausal women with osteoporosis have been demonstrated.

Staying on treatment
Treatment can only work if medication is taken as recommended. It's common for people with osteoporosis to find taking medication challenging. As a result, up to half of all people stop their treatment after only one year.

Be sure to take your medication exactly as prescribed and to talk to your doctor if you find it difficult to comply.

Are there risks involved?
As with any medication, there are risks and side effects involved with osteoporosis treatment. Talk to your doctor about possible risks and side effects, and how to manage them.

Read more:
Preventing osteoporosis
Symptoms of osteoporosis
Risk factors for osteoporosis

 

Reviewed by Teréza Hough, CEO of the National Osteoporosis Foundation of South Africa: www.osteoporosis.org.za. October 2017.

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