Bone Strengthening Agents
- 1. Nonpharmacologic measures that are effective for prevention and treatment of osteoporosis include adequate calcium and vitamin D nutrition, regular exercise, fall prevention, smoking cessation, and limitation of alcohol and caffeine intake.
- 2. Pharmacologic therapy should be initiated in patients who have had a fragility fracture, a bone mineral density (BMD) T-score <–2.5, or a fracture risk assessment tool (FRAX)-derived 10-year risk of >3% for hip fractures and >20% for other major osteoporosis fractures.
- 3. There are two primary categories of effective medications for treating osteoporosis: antiresorptive agents and anabolic agents.
- 4. Osteonecrosis of the jaw (ONJ) and atypical femoral fractures (AFF) have been reported in some patients using antiresorptive medications but not anabolic medications.
- 5. BMD loss during osteoporosis therapy is most often due to therapy nonadherence, but affected patients should also be investigated for other causes of bone loss.
- 6. Bisphosphonates and teriparatide improve BMD and reduce fractures in patients with glucocorticoid (GC)-induced osteoporosis.
