Med. Pro Praxi 2009; 6(3): 126-134

Pharmacological treatment of postmenopausal osteoporosis

MUDr. Vít Zikán Ph.D

III. interní klinika VFN a 1. LF UK, Praha

The goal of the treatment of postmenopausal osteoporosis is to reduce the risk of fractures and improve the quality of life of patients

with fractures. The fracture risk is multifactorial and bone strength is affected by other parameters of bone quality (e. g., bone microarchitecture).

According to current WHO guidelines, pharmacological treatment should be considered in patients with risk of osteoporotic

fractures. Thus, in a given patient, additional, BMD-independent risk factors for fractures (age, fractures suffered in parents,

long-term treatment with glucocorticoids) are considered. In addition to the fracture risk and osteoporosis aetio logy, the mechanism

of action of the drug and its safety need to be taken into consideration when selecting a preparation for a particular patient. Anticatabolic

(antiresorptive) drugs prevent bone loss and deterioration of bone, but they lack the potential to stimulate new bone formation.

Osteoanabolic drugs that stimulate bone formation and increase bone volume are beneficial in patients with severe osteoporosis and

in cases with primarily low osteoblast activity such as in involutional and glucocorticoid-induced osteoporosis. Osteoporosis is a chronic

condition requiring long-term treatment and long-term adherence of patients to treatment is therefore necessary for successful treatment.

For any pharmacological treatment to be fully effective, sufficient calcium and vitamin D intake are essential.

Keywords: osteoporosis, fractures, risk factors, pharmacotherapy.

Published: June 1, 2009  Show citation