 |
|
|
              |
| |
Treatment
How is Osteoporosis Treated?
Although there is no cure for osteoporosis, preventive measures against osteoporosis should be emphasized whenever possible. Ensuring adequate dietary calcium intake is one of the mainstays. This is particularly important in children and adolescents. Calcium requirements may be met either through diet rich in calcium or by use of calcium supplements.
Vitamin D supplementation should be prescribed whenever there is suspicion of inadequate intake and particularly in elderly patients.
There are five steps, which together can optimize bone health and help prevent osteoporosis. They are:
• A balanced diet rich in calcium and vitamin D
• Weight-bearing and resistance-training exercises
• A healthy lifestyle with no smoking or excessive alcohol intake
• Talking to one’s healthcare professional about bone health
The following medications are approved by the FDA for postmenopausal women to prevent and/or treat osteoporosis:
Bisphosphonates
• Alendronate and alendronate plus vitamin D (brand name Fosamax® and Fosamax® plus D)
• Ibandronate (brand name Boniva®)
• Risedronate and risedronate with calcium (brand name Actonel® and Actonel® with Calcium)
• Calcitonin (brand name Miacalcin®)
Bisphosphonates have been shown to decrease risk for hip and spine fractures in postmenopausal women with osteoporosis. They also appear to reduce risk of fracture in men with osteoporosis and in persons who take glucocorticoid medications, such as prednisone.
Estrogen/Hormone Therapy
• Estrogens (brand names, such as Climara®, Estrace®, Estraderm®, Estratab®, Ogen®, Ortho-Est®, Premarin®, Vivelle® and others)
• Estrogens and Progestins (brand names, such as Activella™, FemHrt®, Premphase®, Prempro® and others)
• Parathyroid Hormone – Teriparatide (PTH (1-34) (brand name Fortéo®)
Hormone replacement therapy (HRT) may be used for short term management of menopausal symptoms, but is generally not used for long term prevention of fractures. HRT reduces the chance of fracture and provides excellent relief of menopausal symptoms such as hot flashes, night sweats, and vaginal dryness. However, HRT increases the risk for deep venous thrombosis (blood clots in the leg) and pulmonary embolus (blood clots in the lung). Estrogen combined with a progestin slightly decreases risk for colon cancer, but increases risk for coronary artery disease (heart attack), stroke, and breast cancer. Estrogen alone, without a progestin, increases the risk for stroke and for uterine cancer.
Selective Estrogen Receptor Modulators (SERMs)
• Raloxifene (brand name Evista®)
Raloxifene (Evista®) is a medication that has some but not all of same properties as estrogen; it decreases risk for spine fracture, may reduce risk the for breast cancer, but in a small number of women (3-6%) increases hot flashes. Calcitonin (Miacalcin®), available as a nose spray, is another medication used for osteoporosis. It appears to protect against spine fractures and is sometimes used to help treat the pain of an acute spine fracture.
Alendronate is approved as a treatment for osteoporosis in men and is approved for treatment of glucocorticoid (steroid)-induced osteoporosis in men and women.
Risedronate is approved for prevention and treatment of glucocorticoid-induced osteoporosis in men and women.
Parathyroid hormone is approved for the treatment of osteoporosis in men who are at high risk of fracture.
Treatments under investigation include sodium fluoride, vitamin D metabolites, and other bisphosphonates and selective estrogen receptor modulators.
|
PURCHASE |
|
|
|
|
 |
|
Why Are America’s Bones Shrinking
by Thomas G. Kotronis, Rph |
|
 |
|
|
|
|
 |
|
