Efficacy and safety of pharmacological agents in managing osteoporosis in the old old: Review of the evidence

Treatment of Osteoporosis in Australian Residential Aged Care Facilities: Update on Consensus Recommendations for Fracture Prevention

“…In this setting, intravenous bisphosphonates could become a useful alternative to oral bisphosphonates due to the lack of gastrointestinal side effects, prolonged dose intervals (1 year), and 100% adherence over 12 months at least. [63][64][65] Denosumab is another type of antiresorptive agent, which has demonstrated a strong antifracture effect in several populations. 66,67 Denosumab is a fully human monoclonal antibody, which is injected subcutaneously every 6 months.…”

“…Strontium ranelate (Table 7): A systematic review by Inderjeeth et al 63 on the safety and efficacy of pharmacological agents in managing osteoporosis in people 85 years and older concluded that there is good evidence for the benefit of current treatments in reducing vertebral fractures, but that data are limited for nonvertebral and hip fracture reduction. However, the use of strontium ranelate in clinical practice has been affected by recent evidence reporting a higher incidence of cardiovascular events in post-menopausal women receiving treatment for osteoporosis with this compound 71 ; therefore, its use in RACFs is not recommended.…”

New drugs for osteoporosis

“…19 A post hoc analysis showed it also reduces hip fractures in women aged 74 years and over with a T-score of -3.0 or less. 19 Strontium also reduces vertebral and non-vertebral fractures and improves quality of life in women aged over 80 years 20,21 and reduces vertebral fractures in postmenopausal women with or without prevalent fractures and osteopenia. 22 www.australianprescriber.com increases in bone mineral density after strontium treatment are related to fracture risk reduction.…”

Contralateral Prophylactic Reinforcement in Case of First Low-Energy Hip Fracture: First-in-Man Clinical Data of a New Percutaneous Internal Fixation Device

“…The adverse side effects of these treatments are often an obstacle to a long-term intake: Jaw necrosis, oesophageal and gastric complications, atypical fractures [9][10][11][12][13]. On the other hand some drug treatments are efficient to reduce the hip fracture rate only after 12 to 36 months of use [7]. Another study showed that the effectiveness of these treatments were limited (risk fracture reduction of…”

“…Secondly, the efficiency of the medication treatments for osteoporosis is limited, especially because the patient's compliance is very low [7,8]. The adverse side effects of these treatments are often an obstacle to a long-term intake: Jaw necrosis, oesophageal and gastric complications, atypical fractures [9][10][11][12][13].…”