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.