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Year : 2006  |  Volume : 8  |  Issue : 2  |  Page : 59-73

Osteoporosis : Pathophysiology, Diagnosis And Treatment



Correspondence Address:
Nidhi Malhotra


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Osteoporosis is defined as a systemic skeletal disorder characterized by low bone mass and microarchitectural deterioration of bone tissue with a consequent increase in bone fragility and susceptibility to fracture. Recent advances in the understanding of bone biology have improved the therapeutic options for osteoporosis. Management strategies for osteoporosis include nonpharmacological and pharmacological measures. Nonpharmacological measures (diet, exercise, smoking cessation) are recommendd for all patients regardless of BMD. Pharmacological interventions are expensive and should therefore be targeted to those at high risk of fractures. These drugs act on the bone remodeling cycle, where they either decrease bone remodelimg (anticatabolics) or increase bone remodeling and formation (anabolics). Bisphosphonates are the most potent antiresorptives available, of which, alendronate and risedronate are the most commonly used and form the first line of drugs for postmenopausal and corticosteroid induced osteoporosis. Ibandronate, a recently introduced newer bishosphonate, is another promising agent. Other anticatabolics in use are Calcitonin, Hormone Replacement Therapy (HRT) and Selective Estrogen Receptor Modulaters (SERMS). These are commonly used in patients with mild to moderate degree of osteoporosis. The anabolic agent commonly in use is Parathyroid homone, Teriparatide (1-34). Its use is recommended in severe osteoporosis. Regardless of mode of treatment adequate calcium and vitamin D intake is mandatory. Response to treatment is monitored by measuring bone turnover makers and Bone mineral Density. Despite all these measures the fracture risk is reduced only by 50 – 60%, thus still greater research is required in this field.


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