A Strategy For The Prevention And Treatment Of Osteoporosis

Journal/Book: Z Rheumatol 1998; 57 Suppl. 1: 2 (H 5). 1998;

Abstract: JL Pettis VAMC and Loma Linda Univ. Two types of advances have led to our recent ability to make a therapeutic impact in the treatment of osteoporosis. 1) There has been the development of very precise instrumentation for the rapid measurement of bone density in patients at risk for osteoporosis and in patients with osteoporosis. This means that therapy can be instituted for fracture prevention prior to the development of a fracture. 2) There has been the development of several drugs which can be utilized to improve the skeletal status of individuals who either have osteoporosis or are losing bone. With our current therapeutic armamentarium and our ease of early diagnosis by bone densitometry we can now formulate strategies to optimize the prevention and treatment of osteoporosis. In the case of prevention once we identify a patient who has a low bone density we can institute antiresorptive therapy particularly since the majority of these patients show evidence of increased bone destruction. These antiresorptive agents include the bisphosphonates the estrogens and estrogen analogs and the calcitonins. In addition to antiresorptive therapy all patients are given the prescription of serious exercise for both upper and lower body. Another key feature in the prevention of osteoporosis is adequate calcium intake. Unfortunately many patients even with adequate calcium intake do not absorb calcium appropriately and develop secondary hyperparathyroidism. Some of these patients have vitamin D deficiency which is readily corrected by small physiologic doses of vitamin D. However other patients have calcium absorption that cannot be corrected by vitamin D and these patients must be treated with 1 25D or 1(D3. ... le

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