Treatment of osteoporosis with regard of evidence-based medicine

Definition and Socioeconomic Aspects: Osteoporosis is a disease characteriz ed by low bone mass and an increased susceptibility to fractures. It repres ents an enormous burden for the social security systems in developed countr ies. In Germany, approximately two million women and 800,000 men suffer fro m vertebral fractures and estimates for hip fracture incidence are in the r ange of 70,000-130,000 per year. The resulting;costs for hip fractures alon e could be calculated to 3-5 billion German marks. Therapy According to Evidence-Based Medicine (EBM): According to Sackett et al. 1996, evidence-based medicine is the conscientious, explicit, and judi cious use of current best evidence:in making decisions about the care of in dividual patients. The practice of evidence-based medicine means integratin g individual clinical expertise with the best available external evidence f rom systematic research. Osteoporosis Therapy: The goal of osteoporosis therapy is to prevent fractu res and several therapeutic options are available for this disease. With re spect to proven fracture benefit, however, the quality of evidence h-om ran domized clinical trials varies substantially among therapies. From systemat ic research the best external evidence is available for a supplementation w ith calcium and vitamin D and a therapy with the bisphosphonates alendronat e or risedronate, as well as the SERM raloxifene. For other therapeutic age nts Like fluorides, vitamin D metabolites, calcitonin, and etidronate the q uality of evidence is much lower. So far, there is no evidence: for other p harmaceutical therapies. Hip protectors are effective for the prevention of hip fractures.