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osteoporosis, bone mineral density, bisphosphonates, denosumab, fragility fracture
Osteoporosis is a common disease that increases fracture risk. Fragility fractures bring heavy conse-quences in terms of mortality and disability, with burdensome health and social costs. In subjects with clinical bone fragility, the first goal is to identify the secondary forms of osteoporosis, especially in young subjects, in males and in patients who recently experienced a fragility fracture. In addition, before con-sidering any sort of treatment, it is fundamental to check for adequate calcium and vitamin D intake, since their deficiency is the most common reason for drug failure.
In the last decade of the 20th century, several molecules have been developed and proved to be effective in achieving the true goal of any antiosteoporotic drug: fracture prevention.
In this article, we considered the most commonly prescribed antiresorptive drugs (hormonal therapy, bisphosphonates, and denosumab), the anabolic agents (teriparatide), the dual-action drugs (romo-sozumab), and the drugs characterized by an unclear mechanism of action (strontium ranelate) to pro-vide physicians with useful insights for their clinical practice. We discussed the main criteria for the appropriate choice selection and management of each treatment. Finally, we addressed the current con-troversies related to treatment discontinuation, sequential, and combination therapy.
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