Osteoporosis and fracture risk assessment: improving outcomes in postmenopausal women

Abstract

Osteoporosis is a skeletal disease characterized by impaired bone density, bone mineral density (BMD), and bone strength, resulting in bone fragility and an increased risk of fractures 1 .A fracture is the worst outcome for patients with osteoporosis, as it increases morbidity and mortality in addition to increasing the risk of new subsequent fractures.The main cause of osteoporosis in women is estrogen deficiency secondary to menopause 2,3 .Osteoporosis has a high prevalence and a social and financial impact.The prevalence of the diagnosis of osteopenia in postmenopausal women was present in 30-56.5% of the population, and osteoporosis enters the range of 14.7-43.4% 4 .Osteoporosis can lead to a major impact on public health, such as hospitalizations, surgeries with prostheses, temporary or permanent loss of mobility, and death 2,3 .Although BMD is a strong predictor of fracture risk, there are patients who may fracture even without presenting osteoporosis in the bone densitometry exam, making it necessary to evaluate risk factors other than bone density.In this context, the FRAX (Fracture Risk Assessment Tool) tool brings together other risk factors for fracture prediction independent of BMD, such as the presence of previous fragility fracture, hip fragility fracture in the parents, current smoking, use of glucocorticoids, rheumatoid arthritis, secondary osteoporosis, and use of three or more units of alcoholic beverage per day [1][2][3][4] .Interestingly, FRAX is an algorithm that analyzes all clinical risk factors together and finally calculates the absolute risk of fracture in 10 years.Patients diagnosed with osteoporosis or those at high risk of fracture by FRAX deserve drug treatment targeting bone mass gain and fracture prevention.Among the drug strategies are anti-resorptive drugs (bisphosphonates and denosumab) and anabolic agents (teriparatide and

Topics & Concepts