Postmenopausal osteoporosis: Assessment and management

Best Pract Res Clin Endocrinol Metab. 2018 Oct;32(5):739-757. doi: 10.1016/j.beem.2018.09.005. Epub 2018 Sep 22.

Abstract

Osteoporosis increases the risk of fractures, which are associated with increased mortality and lower quality of life. Patients with prevalent fracture are at high risk to of sustaining another one. Optimal protein and calcium intakes, and vitamin D supplies, together with regular weight bearing physical exercise are the corner stones of fracture prevention. Evidence for anti-fracture efficacy of pharmacological interventions relies on results from randomised controlled trials in postmenopausal women with fractures as the primary outcome. Treatments with bone resorption inhibitors, like bisphosphonates or denosumab, and bone formation stimulator like teriparatide, reduce vertebral and non-vertebral fracture risk. A reduction in vertebral fracture risk can already be detected within a year after starting therapy.

Keywords: aging; bisphosphonates; denosumab; fracture; malnutrition; teriparatide.

Publication types

  • Review

MeSH terms

  • Bone Density / physiology
  • Bone Density Conservation Agents / therapeutic use
  • Denosumab / therapeutic use
  • Diphosphonates / therapeutic use
  • Exercise Therapy
  • Female
  • Fractures, Bone / blood
  • Fractures, Bone / prevention & control
  • Humans
  • Osteoporosis, Postmenopausal / diagnosis*
  • Osteoporosis, Postmenopausal / therapy*
  • Quality of Life
  • Randomized Controlled Trials as Topic / methods
  • Randomized Controlled Trials as Topic / statistics & numerical data
  • Teriparatide / blood
  • Vitamin D / blood

Substances

  • Bone Density Conservation Agents
  • Diphosphonates
  • Teriparatide
  • Vitamin D
  • Denosumab