Osteoporosis - Introduction

Highlights

Osteoporosis Risk Factors

• Age is the main risk factor for osteoporosis. Aging causes bones to thin and weaken. Although osteoporosis affects mostly postmenopausal women, older men are also at risk.
• Osteoporosis is more common in people who have a small, thin body frame and bone structure.
• Dietary calcium and vitamin D deficiencies are important factors in the risk for osteoporosis.
• Women who smoke, particularly after menopause, have a significantly greater risk of spine and hip fractures than those who do not smoke. Men who smoke also have lower bone density.
• Excessive alcohol consumption increases osteoporosis risk.
• Lack of exercise and a sedentary lifestyle can increase the risk of osteoporosis. Engaging in regular weight-bearing and resistance exercises (such as walking or strength training) can help prevent it.

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Medications

• Bisphosphonates are the main drugs used for osteoporosis prevention and treatment. Alendronate (Fosamax), risedronate (Actonel), and ibandronate (Boniva) come in pills that are taken by mouth. Zoledronic acid (Reclast) is given by once-yearly injection. Ibandronate is also available as a four-times a year injection. Denosumab (Prolia) is a new type of antiresorptive medication that works differently than bisphosphonates.
• Other types of drugs used for osteoporosis treatment and prevention include raloxifene (Evista), calcitonin, and teriparatide (Forteo).

Drug Approval

In 2010, the FDA approved denosumab (Prolia) for treatment of osteoporosis in postmenopausal women who are at high risk for fracture. It may also be considered for women who cannot tolerate or who have not been helped by other osteoporosis treatments. Denosumab is the first biologic drug approved for osteoporosis treatment and prevention of fractures. It is given in a doctor’s office as a twice-yearly injection.

Drug Warning

In 2010, the FDA warned that long-term (more than 5 years) use of bisphosphonate drugs may increase the risk for thigh bone fracture.

Review Date: 10/21/2010
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).