[Autom. eng. transl.] The therapeutic armamentarium for the management of osteoporosis includes antiresorptive and osteoformative drugs. Among the former we find bisphosphonates, selective estrogen receptor modulators (SERMs) and hormone replacement therapy (TOS), while among the latter parathyroid hormone peptides. Instead strontium ranelate acts with a dual mechanism of action. All treatments based on these drugs have been shown to be effective in reducing the risk of vertebral fractures, while only in some cases a preventive capacity against non-vertebral and femoral fractures has been demonstrated. The efficacy with regard to the prevention of vertebral fractures, as well as of non-vertebral ones, would appear maximized in the case of use of the parathyroid hormone peptides and some bisphosphonates characterized by the possibility of delayed administration (ie ibandronate and, above all, zoledronate of which annual administration is possible with good levels of compliance). In such cases the preventive efficacy can even reach 70% for vertebral fractures. For femoral fractures the evidence is more scarce, although several clinical trials and meta-analyzes have shown how, with the bisphosphonate-based treatment, it is possible to have an efficacy higher than 40%. The efficacy data are summarized in Table 2. Bisphosphonates, strontium ranelate and SERMs constitute first line drugs. Parathyroid hormone peptides, given the high costs, are recommended to patients at high risk or not responsive to other anti-absorptive drugs, while HRT, for potential side effects, is not indicated as first choice and should be used for short periods . As regards safety, we can deduce from the literature analysis that the different products have an acceptable profile.
|Translated title of the contribution||[Autom. eng. transl.] Therapeutic approach to osteoporosis: efficacy and safety of available treatments|
|Number of pages||18|
|Journal||Italian Journal of Public Health|
|Publication status||Published - 2011|