Indications for initiation of drug therapy and modern therapy protocols in patients with osteoporosis

Introduction. Pharmacotherapy and physical therapy in patients with osteoporosis are aimed at increasing bone density reducing the risk of fall order to prevent fractures. Medications approved for treatment reduce fracture, either by resorption or stimulating formation. Bisphosphonates most widely used antiresorptive agents that lower turnover markers premenopausal levels fracture rates. bind minerals have a long-lasting effect. Long-term, continuous use oral bisphosphonates is usually interspersed drug breaks 1-2 years atypical femoral Denosumab monoclonal antibody also acts as an it targets receptor activators nuclear factor-?B ligand thus inhibiting formation function osteoclasts. administered subcutaneous injection every 6 months. Anti-fracture effects denosumab similar those bisphosphonates, but there marked loss effect 7 months after last dose, which may lead recurrent vertebral Anabolic drugs work Teriparatide abaloparatide parathyroid hormone-1 given daily up 2 years. Romosozumab sclerostin, stimulates inhibits resorption. The anabolics transient, so necessary switch medications. Conclusion. It matter great importance determine optimal strategy cycles anabolics, therapy-free periods.