Osteoporosis : epidemiology and treatment

Osteoporosis is a systemic skeletal disease characterized by a low bone mineral density and microarchitectural deterioration of bone tissus, leading to an increase fracture risk. If untreated, almost half of white women 50 years of age will experience one or more osteoporotic fracture during their lifetime. Therefore, osteoporois represents a major public health problem. Bone mineral density measurement allows to quantify accurately the risk of fragility fractures. Hormonal replacement theraoy is the treatment of choice in the prevention of oeteoporois. Bisphosphonates (alendronate, risedronate) and the selective estrogen receptor modulator (raloxifene) have demonstrated, in large placebo-controlled studies, their efficacy to reduce the risk of oteoporotic fracture by about 30% to 50%. Among stimulators of bone formation, parathyroid hormone has been shown recentely to also reduce the risk of vertebral and non vertebral fractures.