29th April 2024

Treatment

Non-pharmacological measures

• Adequate calcium and vitamin D intake
• Weight bearing exercises to increase bone mineral density
• Balance exercises to reduce falls risk
• Smoking cessation
• Reduction of alcohol consumption
• Home based fall prevention programmes

Pharmacological therapy

Who to treat:

• Patients with a history of fragility fracture or osteoporosis (BMD T score ≤-2.5)
• Patients with a T score between -1.0 and -2.5 with high risk on FRAX, i.e. a 10-year probability of hip fracture or combined major osteoporotic fracture of ≥3.0 or ≥20 percent, respectively.

Types of pharmacological therapy

• Bisphosphonates: Alendronate, Risedronate, Zoledronate, Ibrandonate
• Targeted monoclonal antibodies: Denosumab
• Selective oestrogen receptor modulators – Raloxifene, Tamoxifen
• Anabolic agents – Teriparatide, Abaloparatide, Romosozumab
• Others – Calcitonin, Strontium ranelate, Androgens