Lege Artis Medicinae

[SOME FORMS OF SECONDARY OSTEOPOROSIS: DIAGNOSIS AND TREATMENT]

GENTI György, PÉNTEK Márta, LICKER-FÓRIS Edit

APRIL 21, 2006

Lege Artis Medicinae - 2006;16(04)

[Secondary causes of bone loss are not often considered in patients, who are diagnosed as having osteoporosis. There are many causes of secondary osteoporosis, including endocrine diseases, renal disorders, transplantation, glucocorticoid therapy, inflammatory rheumatic diseases etc. This article gives an overview on the most frequent and in the everyday practice important forms of secondary osteoporosis. The first principle is the correct diagnosis and the adequate treatment of the underlying disease. In the prevention and treatment of secondary bone loss similar principles are followed as in the primary forms. Calcium, Vitamin D, personalized, well-aimed physical therapy and continuous physical activity are the basic treatment of secondary osteoporosis. Active form of Vitamin D, which does not require calcium combination, has to be applied in advanced age, in impaired renal function, and in case of ineffective therapy with cholecalciferol. Evidence based data suggest that bisphosphonates (alendronate and risedronate) are the most effective antiresorptive agents in the prevention and treatment of glucocorticoid- induced osteoporosis and in osteoporosis associated with rheumatoid arthritis. To prevent secondary hyperthyreoidism during bisphosphonate treatment, a calcium intake of 1000 1500 mg/d and an 800 IU/d of cholecalciferol are recommended. Ibandronate (150 mg once a month), a new bisphosphonate will be available soon. Parathyroid hormone (teriparatide) is an anabolic agent, that enhances bone formation. Its recent introduction offers new options in the treatment of patients with established osteoporosis.]

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