Treatment of Osteoporosis

Types of treatment

While deciding treatment for Patients for Osteoporosis across the lifespan, age of the patient is a key determinant. Major Problem with all Current Osteoporosis Therapies are 2: 

  1. Adherence &
  2. Persistence

It has been observed that fewer than 50% of people remain on any of these therapies beyond one year. Patients who are not adherent and persistent to osteoporosis treatment do not have fracture prevention benefits.

It is important for the patient to try to take advantage of greatest potential benefits of specific medications and avoid risks:

Treatments can broadly be classified into two categories:

  • Anti-Resorptive (or anti-catabolic) and
  • Anabolic Agents

Anti-resorptive agents, include

  • Estrogen,
  • Selective estrogen receptor modulators and
  • Bisphosphonates. They reduce bone resorption (and subsequently bone formation), preserving Bone Mineral Density (BMD).


Anabolic agents, which include

  • Teriparatide (PTH1-34) stimulate bone formation (and subsequently bone resorption), thereby increasing BMD.

Risk factor reduction:

While treatment is important, equally important is reducing the risk factors towards Osteoporosis. Some of the important factors which can help to reduce the risk of factors are as follows:

  • Reduction of un-necessary medications- stop or reduce dose if possible
  • Smoking cessation/ reduction
  • Medications to prevent fractures
  • Environment
  • Balance training
  • Physical Activity/ Exercise
  • Optimal Nutrition
  • Regular Calcium & Vitamin D intake
  • BMD Testing at appropriate intervals.

FDA Approved Treatments of Osteoporosis

  • Calcitonins.
  • Estrogen/Estrogen-Progestin Combinations (HT greatest benefit and least risk early after menopause and for <5 years)
  • Raloxifene (During Mid 50’s to late 60s)
  • Antiresorptive Agents - Bisphosphonates (60s and beyond) e.g.: Alendronate, Risedronate, Ibandronate, Zoledronic Acid, ZOLVOID ® IV   (Visit for more detail.)

Anabolic Therapies

  • Teriparatide (ELEVOSTEO) Recombinant Para Thyroid Hormone.

Teriparatide can be used at any point along this continuous for more severe patients, but needs to be followed by an antiresorptive treatment (Like Zoledronic Acid Infusion-ZOLVOID) to maximize and maintain gains.