Their role in the prevention and treatment of
osteoporosis
For individuals with osteoporosis, there is now a variety of drug
treatments available. The primary aim of drug treatments is to reduce fractures. Several of these drugs are
also used to prevent osteoporosis in individuals who are at high risk of developing the disease. The primary
aim of medications used as preventive measures is to prevent further loss of bone density.
How our bones work
Bone is a living tissue that is constantly renewed through a process in
which old bone is removed and replaced by new bone. Cells called osteoclasts erode the bone, creating small
cavities; bone-forming cells called osteoblasts then fill in the cavities with new bone. This is nature's way
of restoring bones and keeping them healthy.
In younger people with healthy bones, the osteoclasts and osteoblasts
work together, maintaining healthy bones. However, after our mid-30s the process is not as efficient, and we
begin to gradually lose bone. In someone with osteoporosis, bone loss occurs more rapidly, causing the bones
to become thinner and weaker over time. If you have osteoporosis, you have already lost a significant amount
of bone and may continue to do so unless you receive medication.
Finding the medication that's right for you
You and your physician need to review the drug treatment options,
assessing the risks and benefits each offers and choosing the best treatment for you, based on current
scientific evidence. You may also need to explore several treatment options, because each person is
different. Some people respond better to one drug than another. Some people have side effects on one and not
another. (Any side effects should be reported to your doctor immediately.)
Cost may also be a factor. Provincial drug plans may cover certain drugs
only for certain patients. Remember, treatment plans can be changed. The important thing is to find a drug
treatment that works for you.
Using therapies in combination
Drug therapies are sometimes combined (e.g. HRT and a bisphosphonate) to
increase the benefit to bones, particularly if an individual continues to lose bone density or suffers
fractures while on medication or receives steroids for three months or more. Because the different drugs work
in bones differently, combining them can be beneficial in these rare cases. However, combinations of
osteoporosis drugs have not been shown to reduce fracture risk any more than individual treatments, and two
therapies always cost more than one.
How long should I stay on my medication?
Your doctor may monitor how well your drug treatment is working by giving
you a bone density test. Usually you will have a test every two to three years. If you have been prescribed
osteoporosis drug therapy because you are using steroids, you will usually have a follow-up bone density test
in one year.
Calcium and vitamin D
No matter what drug therapy you choose, remember that a diet rich in
calcium and vitamin D is required to maintain healthy bones.
