[Therapeutic strategies for osteoporosis].
Therapeutic strategy in osteoporosis should rely on the results of good quality randomized controlled trials. When a fracture has already occurred, first line treatments are alendronate or hormone replacement therapy. Alternatives are cyclical etidronate, or calcitonin in some countries. General measures, such as adequate nutrition and calcium and vitamin D intake, and prevention of falls should be associated to drugs. When there is no history of fracture, the decision will rely on the existence of clinical risk factors and the bone density. Women with a densitometric osteoporosis will be treated as those who have already fractured. Those who have osteopenia can receive hormone replacement therapy, alendronate or raloxifene. No treatment is indicated in women who have normal bone density.
Chapurlat
R
R
Service de Rhumatologie et de Pathologie Osseuse, Pavillon F, H opital Edouard-Herriot, 5, place d'Arsonval, 69437 Lyon Cedex 03.
Delmas
P D
PD
D000058:Accidental Falls / Q000517:prevention & control; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019386:Alendronate / Q000627:therapeutic use; D015519:Bone Density; D002116:Calcitonin / Q000627:therapeutic use; D002136:Calcium, Dietary / Q000008:administration & dosage; D004164:Diphosphonates / Q000627:therapeutic use; D012968:Etidronic Acid / Q000627:therapeutic use; D005260:Female; D050723:Fractures, Bone / Q000517:prevention & control; D020249:Hormone Replacement Therapy; D006801:Humans; D008875:Middle Aged; D009747:Nutritional Physiological Phenomena; D010024:Osteoporosis / Q000188:drug therapy / Q000628:therapy*; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy; D020849:Raloxifene Hydrochloride / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D020845:Selective Estrogen Receptor Modulators / Q000627:therapeutic use; D014807:Vitamin D / Q000627:therapeutic use
D002136:Calcium, Dietary; D004164:Diphosphonates; D020845:Selective Estrogen Receptor Modulators; D014807:Vitamin D; D020849:Raloxifene Hydrochloride; D002116:Calcitonin; D012968:Etidronic Acid; D019386:Alendronate