EPIDEMIOLOGY OF OSTEOPOROSIS - IMPLICATIONS FOR DRUG-THERAPY

Osteoporosis represents a major health problem, Fractures secondary to decreased bone mass and disrupted bone structure vastly increase morb idity in postmenopausal women, and morbidity as well as mortality in e lderly people of either sex, Prophylaxis is possible, and indeed appea rs to be vital to ensure a high peak bone mass. Peak bone mass is reac hed during, the second or third decade of life, i.e. 20 to 50 years be fore the appearance of osteoporotic fractures. Exercise and a sufficie nt calcium intake are possible measures in the early years, During men opause, estrogen replacement therapy will delay the accelerated bone l oss and, most likely, also osteoporotic fractures. In established oste oporosis. a number of well documented therapies are now available, Dep ending on the age of the patient, bisphosphonates. calcitriol or other vitamin D preparations, calcium and calcitonin may be employed, This article reviews the epidemiology of osteoporotic fractures with specia l reference to the therapeutic implications.