HISTORY

Osteoporosis develops when bone mineral density (BMD) and bone mass decreases or when the quality or structure of bone changes, leading to a decrease in bone strength that can increase the risk of fractures. Fractures occur most often in bones of the hip, vertebrae, and wrist.

Factors that may increase the risk for osteoporosis include: Sex: Chances of developing osteoporosis are greater in females. Age: Bone loss happens quicker and new bone growth is slower. Body size: Slender, thin-boned women and men are at greater risk. Race: White and Asian women are at highest risk. Family history: Hereditary factors may increase risk. Diet: A diet low in calcium and vitamin D may increase risk for osteoporosis and fracture.

Diagnosis: DEXA Scan (DXA) measures the BMD at sites that are prone to fracture (e.g., hip, spine). Bone density measurement by DXA at the hip and spine is generally considered the most reliable way to diagnose osteoporosis and predict risk of fracture.

ACTION

Bisphosphonates: Nonhormonal drugs that decrease bone resorption by binding to active sites of bone remodeling and inhibit osteoclasts. Slow down bone loss, which may decrease risk of fractures.

Selective estrogen receptor modulator (SERM): Decreases bone resorption, increasing BMD and decreasing the incidence of fractures.

Conjugated estrogens and selective estrogen receptor modulator: Increases BMD in postmenopausal women.

Parathyroid hormone analogs: Increase BMD by stimulating bone formation.

RANK ligand (RANKL) inhibitor: Inhibits osteoclast formation, function, and survival, reducing bone resorption. Increases BMD and reduces the incidence of new vertebral and hip fractures.

Sclerostin inhibitor: Binds to and inhibits sclerostin, increasing bone formation and decreasing bone resorption.