Treatment of Osteoporosis

3rd July 2007 at 17:15 BST by Dr C.A.Jenner MB BS, FRCA. Permalink.

This article discusses the various options for treatment of osteoporosis.

Treatment of Osteoporosis

Introduction

Osteoporosis is basically defined as a condition that causes the bones to weaken, making them more vulnerable to breakage.

Five in almost every 100 people in the UK suffer from osteoporosis. It is almost four times more common in women than it is in men. Research also shows that about one in every two women and one in five men over the age of 50 will break a bone because of this condition.

Treatment Modalities

There are different levels and kinds of treatment steps involved in the treatment of osteoporosis.

In the further sections, we have discussed each one of these treatments in detail, along with the possible side effects and usage patterns.

1) Bisphosphonates

Bisphosphonates are basically the non-hormonal medicines which work by blocking the breakdown of bones. This class of drugs preserves bone mass and might increase the bone density in the spine and hip, reducing the risk of fractures. There are four biphosphonates available in the UK, including:

• Alendronate (Fosamax)
• Etidronate (Didronel)
• Risedronate (Actonel)
• Ibandronate (Bonviva)

Bisphosphonates are known to be very effective for men, young adults and individuals with steroid-induced osteoporosis. In addition, bisphosphonates also help in preventing osteoporosis in people who require long-term steroid treatment for a disease such as asthma or arthritis.

Possible side effects associated with the use of bisphosphonates include:

• Nausea
• Abdominal pain
• Risk of inflamed esophagus
• Esophagus ulcers

2) Calcium and Vitamin D

Calcium and vitamin D are the most effective nutrients required for the prevention and cure of osteoporosis.

Healthcare professionals suggest that the daily calcium intake for adults age 19 to 50 is 1,000 mg per day. Men and women of 50 years or older need 1,200 mg of calcium every day.

The recommended dosage of vitamin D every day is 5 ug (200 IU) for adults of the age 19 to 50, 10 ug (400 IU) for adults age 51 to 70 and 15 ug (600 IU) or adults age 71 and older.

3) Selective oestrogen-receptor modulator (SERM)

SERM is a synthetic hormone replacement that works by copying the effects of oestrogen on the bones.

This type of drug not only reduces the risk of osteoporosis and heart disease, but also appears not to increase the risk of breast or endometrial cancers. This form of medication is also known to prevent the fractures of the spine.

Currently, the SERM is available in the UK for treatment of osteoporosis by the name raloxifene (Evista).

Raloxifene mimics estrogen's beneficial effects on bone density in postmenopausal women, without some of the risks associated with estrogen, such as increased risk of uterine and breast cancer.

4) Teriparatide

This powerful drug treats osteoporosis in postmenopausal women who are at a high risk of fractures. Unlike many other therapies, this drug works by stimulating new bone growth instead of preventing bone loss.

This particular drug is administered once a day by injection under the skin, on thigh or abdomen.

5) Hormone Replacement Therapy

Hormone Replacement Therapy (HRT) is a prescription-only treatment, which aims to restore hormones to a pre-menopausal level.

Research shows that HRT is quite effective in providing relief from menopausal symptoms such as hot flushes, night sweats and vaginal dryness.

There are a series of risks and benefits associated with the use of HRT for the treatment of osteoporosis. Though earlier it was a very popular form of treatment for osteoporosis, yet in the recent years, concerns about its safety has lead to a change in perception.

Apart from injections, other forms of HRT include patches, creams and vaginal rings.

6) Calcitonin (Miacalcin)

This form of medication is an approved line of treatment of osteoporosis in women who are five years postmenopausal and cannot tolerate the estrogen therapy.

Research indicates that this medicine helps slow bone loss, increases spinal bone density and might also be helpful for relief from fracture pain. In some cases, calcitonin has also been found effective in reducing the risk of hip fracture.

Since calcitonin is a protein, it cannot be taken in the oral form and has to be administered as a nasal spray or an injection. Most common side effects of calcitonin include nasal irritation, inflammation, bloody nose, headache and backache.

In addition, injectable calcitonin may cause an allergic reaction and flushing of the face and hands, excessive urination, nausea and skin rash.

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