Pharmacotherapy of osteoporosis in postmenopausal women: focus on safety.
The therapy of osteoporosis has made enormous strides in the last decade. There is now a range of interventions, each with its pros and cons. Calcium and vitamin D supplementation remain the foundation and have few safety issues. Bisphosphonates are widely used, though gastrointestinal tolerance is a problem with some oral preparations. Intravenous administration may circumvent this, although this introduces the smaller problem of acute phase reactions. The side effect profile of hormone replacement therapy (HRT) is still being delineated after 40 years of use, with substantial new information expected in the next few years. This will clarify its place in the medical management of the menopause. Raloxifene appears to have a superior safety profile to HRT, though its efficacy on bone may be less. While none of these options is suitable for everyone, the range of available therapies does mean that most patients can find an intervention that is effective and acceptable.
Reid
Ian R
IR
Department of Medicine, University of Auckland, Private Bag 92019, Auckland, New Zealand. i.reid@auckland.ac.nz
D002116:Calcitonin / Q000627:therapeutic use; D002136:Calcium, Dietary / Q000008:administration & dosage / Q000627:therapeutic use; D004164:Diphosphonates / Q000009:adverse effects / Q000627:therapeutic use*; D015914:Estrogen Replacement Therapy / Q000009:adverse effects*; D005260:Female; D020249:Hormone Replacement Therapy / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy / Q000517:prevention & control; D020849:Raloxifene Hydrochloride / Q000009:adverse effects / Q000627:therapeutic use*; D012449:Safety; D020845:Selective Estrogen Receptor Modulators / Q000008:administration & dosage / Q000627:therapeutic use; D014807:Vitamin D / Q000008:administration & dosage / Q000627:therapeutic use
D002136:Calcium, Dietary; D004164:Diphosphonates; D020845:Selective Estrogen Receptor Modulators; D014807:Vitamin D; D020849:Raloxifene Hydrochloride; D002116:Calcitonin