Selecting appropriate pharmacotherapy for patients with osteoporosis: Holistic risk-benefit analysis

摘要: In the US, major pharmacotherapeutic approaches for pre- vention or treatment of osteoporosis in women are estrogen-based hormone replacement therapy, selective estrogen receptor modulators, salmon calcitonin, bisphosphonates, calcium, and vitamin D. All these treatments beneficial increasing bone mineral density reducing fractures patients with osteo- porosis. However, each therapies possesses a unique mechanism action other potential benefits side effects. Estrogen ther- apy may lower risk cardiovascular disease, but it increases venous thromboembolism (VTE) increase breast cancer. Unopposed therapy is associated increased endometrial cancer, addition progestins virtually eliminates this adverse event. The modulator raloxifene positive car- diovascular effects demonstrates protective effect against some types Like estrogen, VTE. Salmon cal- citonin has strong analgesic not any serious long- term events, individuals be able to tolerate nasal formulation. Bisphosphonates upper GI concomitant administration calcium D all being treat- ed generally recommended. Selecting optimal relies on an individualized risk-benefit analysis that takes into account patient's medical history, diseases, cur- rent medications, general physical mental well being, personal feelings about various therapies. Careful consideration options lead improved compliance more effective management osteoporosis.