Osteoporosis prevention and treatment. Pharmacological management and treatment implications.

In the current economic climate, osteoporosis is a major public health issue because of the high rate of fractures associated with the disease. Prevention of osteoporosis is a cost-effective approach, especially in aging populations. Encouraging moderate exercise and dietary supplementation with calcium and vitamin D, especially in institutionalised elderly people, are the major nonpharmacological management measures used to prevent and treat osteoporosis. Pharmacological measures have been developed in the last few years and extensive research is under way. Hormone replacement therapy results in increased bone mass, especially in postmenopausal patients, and its effect is currently being investigated in the elderly population. The bisphosphonates, especially alendronate, are promising and have few adverse effects, but the issue of cost needs to be addressed. Pharmacological agents that stimulate bone formation, such as sodium fluoride, growth hormone and other trophic factors, are being researched.