Current controversies in clinical management of postmenopausal osteoporosis.
Osteoporosis is a frequent disease in postmenopausal women. Despite the fact that fragility fractures cause many problems - a bio-psycho-social burden for the individual and an economic burden for the society - osteoporosis is still underdiagnosed and undertreated. Controversies exist concerning assessment with different tools for initiating a disease-specific treatment, patient monitoring with bone turnover markers, and treatment duration due to potential side effects in long-term treatment. This manuscript outlines and discusses these controversies and the presented cases, representatives for frequent clinical problems, may give guidance for the clinician in deciding how and how long to treat his/her patient. Re-evaluations of the patients on a regular basis are essential to warrant the necessity of treatment continuation and may improve patients' compliance.
Department of Physical Medicine & Rehabilitation, Medical University of Vienna.
K
K
Kerschan-Schindl
1st Medical Department and Ludwig Boltzmann Institute of Osteology, Hanusch Hospital, Vienna.
P
P
Mikosch
Department of Internal Medicine, Division of Endocrinology and Metabolism, Medical University of Graz.
B
B
Obermayer-Pietsch
Department of Internal Medicine I, Medical University of Innsbruck.
R W
RW
Gasser
Department of Internal Medicine, Division of Endocrinology and Metabolism, Medical University of Graz.
H-P
HP
Dimai
Department of Internal Medicine, Division of Endocrinology and Metabolism, Medical University of Graz.
A
A
Fahrleitner-Pammer
Schilddrüsen Endokrinologie Osteoporose Institut Dobnig GmbH, Graz.
H
H
Dobnig
1st Medical Department and Ludwig Boltzmann Institute of Osteology, Hanusch Hospital, Vienna.
P
P
Roschger
Institute for Physical Medicine and Rehabilitation, Krankenhaus Hietzing mit Neurologischem Zentrum Rosenhügel, Vienna.
E
E
Preisinger
1st Medical Department and Ludwig Boltzmann Institute of Osteology, Hanusch Hospital, Vienna.
K
K
Klaushofer
Department II Rheumatology/Osteology & Gastroenterology, St Vincent Hospital, Vienna.
H
H
Resch
Department of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna.
P
P
Pietschmann
D015519:Bone Density / Q000187:drug effects*; D050071:Bone Density Conservation Agents / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D015663:Osteoporosis, Postmenopausal / Q000150:complications / Q000188:drug therapy*; D058866:Osteoporotic Fractures / Q000209:etiology / Q000517:prevention & control*; D010349:Patient Compliance; D018570:Risk Assessment
D050071:Bone Density Conservation Agents