Successful management of osteoporosis includes nonpharmacologic and pharmacologic strategies, aimed at fracture prevention. First-line therapies include oral bisphosphonates, an intravenous bisphosphonate (zoledronic acid) that is administered once yearly, the selective estrogen receptor modulator raloxifene and parathyroid hormone. Other selective estrogen receptor modulators are being investigated as potential therapies. Strontium ranelate and denosumab each have a unique mechanism of action and may eventually be available in Canada for the management of osteoporosis. In this article the aforementioned therapies will be reviewed with an emphasis on their efficacy in preventing fractures.
Key words: osteoporosis, osteoporotic fractures, zoledronic acid, parathyroid hormone, raloxifene.
Osteoporosis is common in postmenopausal women and older men. There are various efficacious therapies for the treatment of osteoporosis and the prevention of osteoporotic fractures in Canada. First-line therapies include alendronate, risedronate and raloxifene; all of these are oral antiresorptive therapies. In this article, we review new drug therapies currently or soon to be available in Canada, such as bone formation therapies (parathyroid hormone and strontium ranelate) and intravenous infusions (such as zoledronic acid), and compare them to existing therapies.
Key words: osteoporosis, osteoporotic fractures, parathyroid hormone, strontium, zoledronic acid.
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