MONITORING OF OSTEOPOROSIS TREATMENT

Abstract

Osteoporosis is far the most common metabolic bone disease and is often called the "silent" disease, because bone loss occurs without symptoms. People often don't know they have the disease until bone breaks, following trivial injury. The consequences of osteoporosis are financial, physical, and psychosocial, which significantly affect the individual as well as the family and community. Osteoporosis bone fractures are responsible for considerable pain, decreased quality of life, lost workdays, and disability. Notably, one in five patients is no longer living one year after sustaining an osteoporotic hip fracture. It is projected that the number of hip fractures worldwide will exceed six million by 2050. These facts make osteoporosis a critical health issue and entire world focus has shifted on to osteoporotic fractures.

Dual Energy X-ray Absorptiometry (DEXA) has become standard method for determining bone marrow density. By measuring BMD, it is possible to predict fracture risk in the same manner that measuring blood pressure can help predict the risk of stroke. Approximately 10 -15% of patients with osteoporosis fail to respond to treatment. As in most chronic diseases, compliance is usually poor in patients on long term treatment of osteoporosis. Thus, the aim of monitoring should be to increase adherence to treatment as well as to ascertain response to treatment. Because fracture events are uncommon, they cannot be used to monitor drug effectiveness. Repeat BMD measurement especially at the spine, is recommended once every two years to confirm treatment response.

Key Words: Osteoporosis, Bone mineral density, dual energy X-ray absorbtiometry.

Osteoporosis is far the most common metabolic bone disease and is often called the "silent" disease, because bone loss occurs without symptoms. People often don't know they have the disease until bone breaks, following trivial injury. The consequences of osteoporosis are financial, physical, and psychosocial, which significantly affect the individual as well as the family and community. Osteoporosis bone fractures are responsible for considerable pain, decreased quality of life, lost workdays, and disability. Notably, one in five patients is no longer living one year after sustaining an osteoporotic hip fracture. It is projected that the number of hip fractures worldwide will exceed six million by 2050. These facts make osteoporosis a critical health issue and entire world focus has shifted on to osteoporotic fractures.

Dual Energy X-ray Absorptiometry (DEXA) has become standard method for determining bone marrow density. By measuring BMD, it is possible to predict fracture risk in the same manner that measuring blood pressure can help predict the risk of stroke. Approximately 10 -15% of patients with osteoporosis fail to respond to treatment. As in most chronic diseases, compliance is usually poor in patients on long term treatment of osteoporosis. Thus, the aim of monitoring should be to increase adherence to treatment as well as to ascertain response to treatment. Because fracture events are uncommon, they cannot be used to monitor drug effectiveness. Repeat BMD measurement especially at the spine, is recommended once every two years to confirm treatment response.