title: [Pharmacologic treatment of osteoporosis--2011].
abstract: Osteoporosis affects approximately 9% of the population in Hungary resulting in about 100 000 osteoporotic fractures annually. Thirty-five percent of patients with hip fractures due to osteoporosis will die within 1 year. Direct costs of osteoporosis exceed 25 billion forints per year. Apparently, cost-effective reduction of bone loss and consequent fracture risk will add up to not only financial savings but improvement in quality of life, as well. A number of pharmacological modalities are available for this purpose. The mainstay of the treatment of osteoporosis is the bisphosphonate group that includes effective anti-resorptive compounds mitigating bone loss and fragility. The recently registered denosumab exhibits similar efficacy by neutralizing RANK ligand, however, marked differences can be observed between the two drug classes. Strontium has a unique mechanism of action by rebalancing bone turnover, and thus, providing an efficient treatment option for the not fast bone losers who are at high fracture risk. The purely anabolic teriparatide is available for the extremely severe osteoporotic patients and for those who do not respond to other types of therapy. Older treatment options such as hormone replacement therapy, raloxifene, tibolone or calcitonin may also have a restricted place in the management of osteoporosis.
authors.affiliation: Semmelweis Egyetem, Általános Orvostudományi Kar, I. Belgyógyászati Klinika, Budapest, Korányi Sándor u. 2/A 1083. lakpet@bel1.sote.hu
authors.forename: Péter
authors.initials: P
authors.lastname: Lakatos
mesh_terms: D000465:Algorithms; D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D061067:Antibodies, Monoclonal, Humanized; D015519:Bone Density / Q000187:drug effects*; D050071:Bone Density Conservation Agents / Q000008:administration & dosage* / Q000191:economics; D002118:Calcium / Q000008:administration & dosage; D003362:Cost-Benefit Analysis; D000069448:Denosumab; D004164:Diphosphonates / Q000008:administration & dosage; D016527:Drug Costs; D004359:Drug Therapy, Combination; D015914:Estrogen Replacement Therapy; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D009942:Organometallic Compounds / Q000008:administration & dosage; D010024:Osteoporosis / Q000188:drug therapy* / Q000191:economics; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy; D058866:Osteoporotic Fractures / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D053245:RANK Ligand / Q000008:administration & dosage; D019379:Teriparatide / Q000008:administration & dosage; D013876:Thiophenes / Q000008:administration & dosage; D014807:Vitamin D / Q000008:administration & dosage
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D009942:Organometallic Compounds; D053245:RANK Ligand; D013876:Thiophenes; C081587:strontium ranelate; D019379:Teriparatide; D014807:Vitamin D; D000069448:Denosumab; D002118:Calcium