Date: 20 Apr 2010

Genetics of Osteoporosis: Half-Full or Half-Empty?

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Osteoporosis is a common disorder in postmenopausal women and elderly men. Consequently, it is prevalent in developed countries with a long life expectancy. Bone fragility, related to low bone mass and other factors impairing bone quality, is the hallmark of osteoporosis and the cause of fractures, which represent its relevant consequence from a clinical point of view. The increased proportion of elderly subjects is expected to be associated with increasing rates of osteoporotic fractures, the so-called osteoporosis silent epidemics. However, several developments have brought some optimism onto this prediction.

During the last decade, new drugs have been developed which not only increase bone mineral density but also, most importantly, have been shown to reduce the risk of osteoporotic fractures by 30–70%. They include both anti-resorptive drugs (such as bisphosphonates, selective modulators of estrogen receptors and strontium ranelate) and anabolic drugs, particularly PTH. The identifi