Management of postmenopausal osteoporosis.
A hallmark of menopause, which follows the decline in the ovarian production of estrogen, is the aggressive and persistent loss of bone mineral and structural elements leading to loss of bone strength and increased fracture risk. This review focuses on newer methods of diagnosing osteoporosis and assessing fracture risk, as well as on novel management strategies for prevention and treatment. Fracture-risk prediction has been significantly enhanced by the development of methods such as the trabecular bone score, which helps assess bone microarchitecture and adds value to standard bone densitometry, and the Fracture Risk Assessment Tool (FRAX) algorithm techniques. The treatment of osteoporosis, which has the goals of fracture prevention and risk reduction, is moving beyond traditional monotherapies with antiresorptives and anabolic agents into new combination regimens.
Department of Medicine, Endocrine Service, Hospital for Special Surgery, New York, NY, 10021; email: andreopouloup@hss.edu.
Panagiota
P
Andreopoulou
Richard S
RS
Bockman
D015502:Absorptiometry, Photon; D045930:Anabolic Agents / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D002118:Calcium / Q000627:therapeutic use; D000069448:Denosumab; D004164:Diphosphonates / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D015663:Osteoporosis, Postmenopausal / Q000175:diagnosis / Q000188:drug therapy*; D058866:Osteoporotic Fractures / Q000517:prevention & control*; D018570:Risk Assessment; D019379:Teriparatide / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D014807:Vitamin D / Q000627:therapeutic use
D045930:Anabolic Agents; D061067:Antibodies, Monoclonal, Humanized; D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D019379:Teriparatide; D014807:Vitamin D; D000069448:Denosumab; D002118:Calcium
bone microarchitecture; combination therapy; fracture risk