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Feature Article

Treatment options for men with osteoporosis

Terry Diamond, Peter R Ebeling

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An updated version is available in the linked supplement

Abstract

About one-third of men in Australia aged over 60 years will suffer an osteoporotic fracture yet many will not receive osteoporosis-relevant investigation or treatment. Antiosteoporotic therapies appropriate for men include bisphosphonates, teriparatide and, in some, testosterone.

Key Points

  • About one in three men in Australia aged over 60 years will suffer an osteoporotic fracture, yet about 80% of those admitted to hospital with major fractures will be discharged without appropriate or osteoporosis-relevant investigation or treatment.
  • The gold standard of care for men with osteoporosis includes preventative therapies for those at high risk of fracture and pharmacotherapies for those who sustain fractures.
  • Oral alendronate and risedronate are effective antiosteoporotic agents in men.
  • Intravenous zoledronic acid is also an effective antiosteoporotic agent in men and may have the additional benefits of improving drug compliance and reducing mortality in the elderly after hip fractures.
  • Subcutaneous injections of teriparatide are reserved for men with severe osteoporosis (T-score, -3.0 or less) who continue to sustain fractures despite adequate antifracture therapies.
  • Therapy with testosterone is likely to be beneficial in hypogonadal men presenting with osteoporosis.

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