Via practica 5/2010

Osteoporosis pharmacotherapy and adherence of patient

Osteoporosis is a chronic skeletal disorder characterized by compromised bone strength predisposing to an increased risk of fracture. Around the world, 1 in 3 women (more than for breast cancer) and 1 in 5 men (more than for prostate cancer) over the age of 50 will experience an osteoporotic fracture. Approximately 20-25% of women over the age of 50 have one or more vertebral fractures. The aim of treating osteoporosis is to reduce risk of fractures and to improve quality of life of patients with preexisting fractures. Several interventions to prevent and reduce fracture risk are being recommended. These include adequate intake of calcium, vitamin D, exercise, avoiding nicotine, alcohol-intake and other osteoporosis risk factors and treating disorders leading to osteoporosis. Antiresorptive osteoporotic drugs include bisphosphonates (alendronate, risedronate, ibandronate and zolendronate), selective estrogen receptor modulators (raloxifene), calcitonine and in the past also hormone replacement therapy. Teriparatide and parathormone are osteoanabolic drugs and strontium ralenate has dual antiresorptive and osteoanabolic effect. All these drugs have shown to reduce risk of vertebral and some also nonvertebral fractures. The average duration recommended for the treatment is 5 years, in osteoanabolics 18 - 32 months. Early conset of powerful treatment can effectively reduce the number of osteoporotic fractures.

Keywords: osteoporosis, treatment, adherence to treatment, compliance of patient