The treatment gap: The missed opportunities for osteoporosis therapy

Despite substantial advances in delineation of the epidemiology, pathophysiology, risk assessment and treatment of osteoporosis over the last three decades, a substantial proportion of men and women at high risk of fracture remain untreated the so-called treatment gap. This review summarises the important patient-, physicianand policyrelated causes of this treatment gap, before discussing in greater detail: (a) the evidence base for the efficacy of bisphosphonates in osteoporosis; (b) recent evidence relating to the adverse effects of this widely used therapeutic class, most notably atypical femoral fracture and osteonecrosis of the jaw; (c) available strategies to improve both secondary and primary prevention pathways for the management of this disorder.

Automated summary

Despite significant progress in understanding osteoporosis over the past three decades, there is still a treatment gap where many high-risk individuals go untreated. This review highlights the patient, physician, and policy-related factors contributing to this gap, and focuses on discussing the efficacy and adverse effects of bisphosphonates in osteoporosis treatment, as well as strategies to improve prevention pathways for the disorder.