Treatment options for osteoporosis and decision making criteria: 2009

Abstract

Osteoporosis is recognized worldwide as a major public health problem since many decades ago, mainly due to the cost of treatment for related fragility fractures. Fortunately, WHO has provided new strategies for identifying populations with a high ten-year fracture risk, which together with increasingly sensitive diagnostic methods make it feasible for decision makers in this field to design cost effective fracture prevention strategies. These strategies are aimed at preventing falls and improving bone strength and therefore diminishing the prevalence and incidence of new or recurrent osteoporosis related fractures. Herein we review the content of these new strategies, and the medical treatments available, as well as their efficacy in the Mexican context. Several countries are now reporting a decreasing incidence and prevalence of osteoporosis related fractures, after 30 years of clinical and population-based interventions. Mexico has several effective anti-fracture drug treatments available. Such drugs can be classified according to the mechanism that makes them effective as: 1) antidestuctive or anticatabolic, 2) bone forming or anabolic, and 3) those with both actions or mixed drugs. The authors argue that treatment strategies that use drugs to strengthen bone tissue must assure normal mineralization of the already formed, remnant bone tissue and/or the newly formed bone tissue in order to encourage biochemical outcomes like formation of mature hydroxyapatite crystals with complete biomechanical and biochemical properties and therefore long term benefits. The present review includes some perspectives that will surely enhance osteoporosis

Three-month bilateral hopping intervention is ineffective in initiating bone biomarker response in healthy elderly men

“…Osteoporosis, falls and related bone fractures negatively impact individual health and welfare and as a result place an economical burden on society (Ortiz-Luna et al 2009;Stevens and Olson 2000). A large proportion of bone fractures (estimates range up to 90%) are caused by falls (Cummings and Melton 2002;Stevens and Olson 2000;Wagner et al 2009).…”

“…A large proportion of bone fractures (estimates range up to 90%) are caused by falls (Cummings and Melton 2002;Stevens and Olson 2000;Wagner et al 2009). There are several potential ways of preventing osteoporosis-related fractures including strengthening bone and/or preventing falls (Ortiz-Luna et al 2009;Stevens and Olson 2000). Preventing fractures with pharmacological interventions may not be cost-efficient (Cummings and Melton 2002) and balance-improving medications are virtually non-existent.…”

Estimating Lower Limb Skeletal Loading

“…Osteoporosis, accidents and subsequent bone fractures cause suffering on an individual level, as well as an economical burden to the society (Ortiz-Luna et al, 2009;Stevens & Olson, 2000). It has been estimated that, in Finland alone, between 30,000 to 40,000 osteoporosis-related fractures occur annually and that 400,000 Finnish people have osteoporosis (Duodecim, 2008).…”

“…There are a few potential ways of preventing bone fracture, i.e. strengthening bones and/or preventing falls (Ortiz-Luna et al, 2009;Stevens & Olson, 2000). In order to withstand prevalent loading without breaking; while remaining relatively light in weight to allow for locomotion, bones have the ability to adapt their structure to functional loading (Frost, 2000;2003;Sievänen, 2005).…”

Theoretical Biomechanics

“…There are a few potential ways of preventing bone fracture, i.e. strengthening bones and/or preventing falls (Ortiz-Luna et al, 2009;Stevens & Olson, 2000). In order to withstand prevalent loading without breaking; while remaining relatively light in weight to allow for locomotion, bones have the ability to adapt their structure to functional loading Sievänen, 2005).…”