Feature Article

Rethinking osteoporosis: long-term treatment strategy and sequential therapy

KATHY FU, Terry Diamond



Osteoporosis is a common chronic condition that can be managed to prevent disabling fractures. The number of available treatments is increasing, in particular new therapies with anabolic effects on bone as well as antiresorptive therapies. There is emerging but incomplete evidence that the choice of drug, duration and sequence of treatment needs to be tailored across the disease course for maximum benefit.

Key Points

  • Antiresorptive drugs are the first-line treatment for mild osteoporosis, but there are important prescribing considerations.
  • PBS and TGA criteria for use of antiresorptive and anabolic drugs vary widely between agents.
  • Short courses of the anabolic treatment teriparatide are available for patients with severe osteoporosis but are underutilised; they should be used in sequence with other treatments.
  • Other anabolic agents have undergone phase 3 studies but have not yet been approved by the TGA for use in Australia.

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