Osteoporosis: treatments

It is important to have the right treatment for osteoporosis when the diagnosis is made.
To treat osteoporosis, there are 3 main categories of drugs:

  • Against bone destruction.
The "anti-resorbers" fight against bone destruction: SERMs (selective modulators of estrogen receptors) and bisphosphonates. These treatments act on the sex hormones. But beware they are different from the hormonal treatment of menopause.

They slow down or block the activity of cells responsible for bone destruction (osteoclasts) and reduce the risk of fractures, vertebrae and hips for bisphosphonates.

Bisphosphonates are the standard treatments for osteoprosis. However, their benefits are now widely discussed.

SERMs (estrogen receptor analogs), such as raloxifene, are especially indicated for women after menopause. They reduce the risk of fracture of vertebrae. This treatment also decreases the risk of developing breast cancer.

  • For bone formation.
An anabolic drug promotes bone formation: teriparatide. It is administered by injection, once a day.

This drug stimulates the cells of bone formation (osteoblasts). This expensive drug is reimbursed only to women who have had two vertebral fractures, and its prescription is limited in time (18 months).

  • The two-in-one

Strontium ranelate is both anabolic and anti-resorptive. It would increase bone formation while decreasing its destruction. However, this drug is currently less and less used, because of these side effects, especially cardiovascular. Its beneficial effects are also considered insufficient by the High Authority of Health.

  • A new medicine
A monclonal antibody is now available for patients: denosumab (subcutaneous injection twice a year).

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