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Overview of treatment approaches to osteoporosis

Journal

BRITISH JOURNAL OF PHARMACOLOGY
Volume 178, Issue 9, Pages 1891-1906

Publisher

WILEY
DOI: 10.1111/bph.15024

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Efficient therapies for osteoporosis treatment include anti-resorptive and bone-forming or dual-action treatments, with different benefits and suitability for different patient types. Long-term management plan with personalized approach is necessary for the chronic condition of osteoporosis.
Efficient therapies are available for the treatment of osteoporosis. Anti-resorptive therapies, including bisphosphonates and denosumab, increase bone mineral density (BMD) and reduce the risk of fractures by 20-70%. Bone-forming or dual-action treatments stimulate bone formation and increase BMD more than the anti-resorptive therapies. Two studies have demonstrated that these treatments are superior to anti-resorptives in preventing fractures in patients with severe osteoporosis. Bone-forming or dual-action treatments should be followed by anti-resorptive treatment to maintain the fracture risk reduction. The BMD gains seen with bone-forming and dual-action treatments are greater in treatment-naive patients compared to patients pretreated with anti-resorptive treatments. However, the antifracture efficacy seems to be preserved. Treatment failure will often lead to switch of treatment from orally to parentally administrated anti-resorptives treatment or from anti-resorptive to bone-forming or dual-action treatment. Osteoporosis is a chronic condition and therefore needs a long-term management plan with a personalized approach to treatment.

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