Osteoporosis & Its Management
Osteoporosis & Its Management
Osteoporosis & Its Management
Osteoporosis
Dr Subhajit Mitra
Assistant Professor of Medicine
Gauhati Medical College & Hospital
Osteoporosis: Global burden
The prevalence of osteoporosis increases with age, from 6% at 50
years to 50% after the age of 80.
Hyperparathyroidism
What is Osteoporosis?
Pathophysiology characterization –
· Reduced Bone Density
· Micro architectural deterioration
· Increase in bone fragility
· Susceptibility to fracture from
minor trauma
Difference between..
OSTEOPOROSIS ..defect
bone density
OSTEOPENIA..early stage
OSTEOMALACIA..defect
bone mineralisation in adults
RICKET…same as in children
PATHOPHYSIOLOGY cont..…
Bone mass increases during growth to reach a peak
between 20 -45 yrs of age and thereafter falls in both
gender with accelerated phase in women due to
estrogen def.
The loss of bone with ageing is caused by an
imbalance in the bone remodelling cycle, whereby the
amount of new bone formed by osteoblasts cannot keep
pace with the amount that is removed by osteoclasts
STAGES OF BONE REMODELLING
Clinical Features
Osteoporosis is a “silent disease” which does not
become clinically apparent until a fracture occurs.
The term ‘fragility fracture’ is used to describe a
fracture that occurs as the result of a fall from standing
height or less.
These are typical of osteoporosis
T score Inference
0 to -1 Normal
-1 to –2.5 Osteopenia
-2.5 OR Lesser Osteoporosis
<-2.5 with trauma Severe osteoporosis
Blood Investigations
Complication Complications
of Osteoporosis
Prevent fractures
Decrease pain
Maintain function
Management: Lifestyle Intervention
ManagementManagement
of Osteoporosis
Currently, no treatment can completely reverse established osteoporosis. Early
intervention can prevent osteoporosis in most people.
For patients with established osteoporosis, medical intervention can halt its
progression.
1. Antiresorptive agent
• Bisphosphonates eg Zolendronic acid, alendronate,
ibadronate
• RANKL Antibodies eg Denosumab
• Selective estrogen receptor modulators (SERMs)
• Calcitonin
• Among the various treatments for osteoporosis that are currently in use,
pharmacological therapy is the most efficient and accessible, and has
been rigorously studied