How to Manage Postmenopausal Osteoporosis?(Congress Paper) (Report‪)‬

INTRODUCTION Osteoporosis is characterized by reduced bone mass and disruption of bone architecture, resulting in enhanced bone fragility and increased fracture risk. Osteoporosis is widely recognized as a major public health concern causing about three million fractures annually in Europe. The cumulative lifetime fracture risk for a 50-year woman with osteoporosis is about 50% (1). Effective fracture prevention would have a major impact on women's morbidity and to a lesser extent mortality. The most common osteoporotic fractures are those at the hip, spine, forearm and humerus, but many other fractures after the age of 50 are related at least in part to low bone mineral density (BMD) and should be regarded as osteoporotic. The frequency of osteoporotic fractures is rising in many countries. Reasons for this relate in part to the increased longevity of the population but there is also an increase in age- and sex-specific incidence in many communities (2). Several drugs are now available to effectively prevent osteoporotic fractures but the general efficacy of therapy is compounded by poor adherence to anti-osteoporotic medications. Approximately 50% of patients do not follow their prescribed treatment regimen and/or discontinue treatment within 1 year (3). It is not yet known whether recently developed treatments given quarterly (intravenous ibandronate), 6-monthly (denosumab), or annually (zoledronic acid) are associated with further improvements in persistence over the long term.