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Exp Clin Endocrinol Diabetes 2014; 122(08): 437-444
DOI: 10.1055/s-0034-1374610
Review
© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

Current Controversies in Clinical Management of Postmenopausal Osteoporosis

K. Kerschan-Schindl
1   Department of Physical Medicine & Rehabilitation, Medical University of Vienna
,
P. Mikosch
2   1st Medical Department and Ludwig Boltzmann Institute of Osteology, Hanusch Hospital, Vienna
,
B. Obermayer-Pietsch
3   Department of Internal Medicine, Division of Endocrinology and Metabolism, Medical University of Graz
,
R. W. Gasser
4   Department of Internal Medicine I, Medical University of Innsbruck
,
H.-P. Dimai
3   Department of Internal Medicine, Division of Endocrinology and Metabolism, Medical University of Graz
,
A. Fahrleitner-Pammer
3   Department of Internal Medicine, Division of Endocrinology and Metabolism, Medical University of Graz
,
H. Dobnig
5   Schilddrüsen Endokrinologie Osteoporose Institut Dobnig GmbH, Graz
,
P. Roschger
2   1st Medical Department and Ludwig Boltzmann Institute of Osteology, Hanusch Hospital, Vienna
,
E. Preisinger
6   Institute for Physical Medicine and Rehabilitation, Krankenhaus Hietzing mit Neurologischem Zentrum Rosenhügel, Vienna
,
K. Klaushofer
2   1st Medical Department and Ludwig Boltzmann Institute of Osteology, Hanusch Hospital, Vienna
,
H. Resch
7   Department II Rheumatology/Osteology & Gastroenterology, St Vincent Hospital, Vienna
,
P. Pietschmann
8   Department of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna
› Author Affiliations
Further Information

Publication History

received 19 December 2013
first decision 03 March 2014

accepted 03 April 2014

Publication Date:
16 May 2014 (online)

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Abstract

Osteoporosis is a frequent disease in postmenopausal women. Despite the fact that fragility fractures cause many problems – a bio-psycho-social burden for the individual and an economic burden for the society – osteoporosis is still underdiagnosed and undertreated. Controversies exist concerning assessment with different tools for initiating a disease-specific treatment, patient monitoring with bone turnover markers, and treatment duration due to potential side effects in long-term treatment. This manuscript outlines and discusses these controversies and the presented cases, representatives for frequent clinical problems, may give guidance for the clinician in deciding how and how long to treat his/her patient. Re-evaluations of the patients on a regular basis are essential to warrant the necessity of treatment continuation and may improve patients’ compliance.

Key words

postmenopausal ­osteoporosis - bisphosphonate - long-term treatment - biomarkers - bone mineral density - bone mineralization density distribution
 

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