Pharmacologic therapy for the treatment and prevention of osteoporosis.

Clinicians have an expanding menu of attractive pharmacologic options for the prevention and treatment of postmenopausal and age-related osteoporosis. Moreover, there exists excellent data from well-designed clinical trials documenting the effectiveness and tolerability of these therapies. Bone loss can be prevented in postmenopausal women of any age. Fracture risk can be reduced substantially in men and women with previous vertebral fractures or bone density values consistent with osteoporosis. It is clear that therapy is warranted in patients at high fracture risk. Important clinical challenges include devising effective strategies to identify those patients for whom treatment is indicated and to enhance both the accepting and long-term adherence to therapy by patients.