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20-04-2018 | Osteoporosis | Review | Article

Postmenopausal Osteoporosis Treatment Update

Journal:
Current Treatment Options in Rheumatology

Authors: MD, FRCPC Eric Kai-Chung Wong, BScN, MD, MSc, FRCPC, FACP Alexandra Papaioannou

Publisher: Springer International Publishing

Abstract

To summarize existing evidence on the treatment of postmenopausal osteoporosis.
Despite increased interest in new targets for osteoporosis therapy, the mainstay of treatment remains to be bisphosphonates, denosumab, and teriparatide. Abaloparatide is a new parathyroid hormone-related peptide analog that has similar efficacy as teriparatide, but with monthly doses and a lower risk of hypercalcemia. This medication is approved in the USA for severe osteoporosis, but approval is pending in other countries. Romosozumab is a monoclonal antibody directed against sclerostin that has superior fracture protection compared with alendronate, but it may increase the risk of cardiovascular events based on the recent ARCH trial.
A combination of falls prevention, exercise, and adequate intake of calcium and vitamin D is recommended for prevention and treatment of osteoporosis. Pharmacologic therapy should be added to patients at high risk of fractures.

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