Treatments for Osteoporosis

Lifestyle changes and medical treatment are part of a total program to prevent future fractures. A diet rich in calcium, daily exercise, and drug therapy are treatment options. Good posture and prevention of falls are important in reducing the chance of being injured.

Under FDA guidelines, drugs to treat osteoporosis must be shown to preserve or increase bone mass and maintain bone quality in order to reduce the risk of fractures. The following drugs are approved by the FDA for the treatment or prevention of osteoporosis:

• Alendronate (Fosamax®) – This drug belongs to a class of drugs called biophosphonates and is approved for both prevention and treatment of osteoporosis. It is used to treat bone loss from the long-term use of osteoporosis-causing medications and is used for osteoporosis in men. In postmenopausal women, it has shown to be effective at reducing bone loss, increasing bone density in the spine and hip, and reducing the risk of spine and hip fractures.

• Risedronate (Actonel®) – Like Alendronate, this drug also is a biophosphonate and is approved for both prevention and treatment of osteoporosis, for bone loss from the long-term use of osteoporosis-causing medications, and for osteoporosis in men. It has been shown to slow bone loss, increase bone density, and reduce the risk of spine and non-spine fractures.

• Calcitonin (Miacalcin®) - Calcitonin is a naturally occurring hormone involved in calcium regulation and bone metabolism. Calcitonin can be injected or taken as a nasal spray. In women who are at least five years beyond menopause, it slows bone loss and increases spinal bone density. Women report that it also eases pain associated with bone fractures.

• Raloxifene (Evista®) – This drug is a selective estrogen receptor modulator (SERM) that has many estrogen-like properties. It is approved for prevention and treatment of osteoporosis and can prevent bone loss at the spine, hip, and other areas of the body. Studies have shown that it can decrease the rate of vertebral fractures by 30-50%.

• Estrogen, Hormone Therapy (HT) or Estrogen Replacement Therapy (ERT), has also been used to prevent bone loss.  Recent studies suggest, however, that this might not be a good option for many women.

Other treatments are being studied. They include new biophosphonates and SERMs, Vitamin D metabolites, parathyroid hormone, and sodium fluoride. A woman and her doctor need to carefully weigh the risks and benefits of these treatment options.