Osteoporosis is a skeletal disease characterised by decreased bone mass and deterioration of bone microarchitecture, leading to increased fragility and fracture risk — particularly at the hip, spine, and wrist. It affects primarily postmenopausal women (due to oestrogen loss accelerating bone resorption) but also occurs in men and can be caused by long-term corticosteroid use (glucocorticoid-induced osteoporosis) and other secondary causes. Diagnosis is confirmed by DEXA scan with a T-score of −2.5 or below. Pharmacological treatment is indicated for T-scores −2.5 and below, osteoporotic fracture history, or elevated FRAX fracture probability score.
Osteoporosis medications work primarily by either inhibiting osteoclast-mediated bone resorption (bisphosphonates, denosumab, SERMs) or by stimulating new bone formation (teriparatide, abaloparatide). Bisphosphonates remain the first-line standard of care for most patients due to their established long safety record, once-weekly oral dosing options, and demonstrated fracture reduction at both hip and spine sites. Adequate calcium and vitamin D supplementation is essential alongside all pharmacological therapy.
Osteoporosis Medications Available at Lucas Clinic
- Fosamax (Alendronate) — weekly oral bisphosphonate; first-line for postmenopausal and glucocorticoid-induced osteoporosis; daily or weekly tablets
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