Journal of Bone and Mineral Metabolism

, Volume 31, Issue 4, pp 367–380 | Cite as

Osteoporosis and treatments in Japan: management for preventing subsequent fractures

  • Shuko Nojiri
  • Russel T. Burge
  • Jennifer A. Flynn
  • Shonda A. Foster
  • Hideaki Sowa
Review Article


Prevalent fractures are major contributors to an increased risk of subsequent fractures, particularly in people with osteoporosis. While many studies have been conducted to assess the incidence of fracture in Japanese people with osteoporosis, far fewer have been conducted to assess the risk of subsequent fractures. This article reviews the morbidity, mortality, and risk of fracture in patients who are at high risk of subsequent fracture in Japan and the current treatment options available for these patients. Osteoporotic fractures in Japan are associated with high morbidity and mortality that result in significant financial and social costs. The rise in the proportion of elderly women in the Japanese population is contributing to a greater proportion of people with osteoporotic fractures and the high cost of osteoporosis. Although hip fractures have a significant effect on costs, a greater proportion of the Japanese population experience vertebral fractures. An increase in the incidence of vertebral fractures is concerning because preexisting vertebral fractures in older patients are associated with an increased risk of subsequent fractures. Hence, there is a clear rationale for pharmacological treatment of patients with prevalent vertebral fractures, or for those who are hospitalized or undergo surgery for osteoporotic fractures. Several pharmacological therapies are now available in Japan for the treatment of patients with osteoporosis. Understanding the consequences of subsequent fractures and the treatment options available for patients at high risk of subsequent fractures may contribute to clinical decision-making and improved outcomes for patients with osteoporosis.


Drug therapy Fracture risk Japan Osteoporosis 


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Copyright information

© The Japanese Society for Bone and Mineral Research and Springer Japan 2013

Authors and Affiliations

  • Shuko Nojiri
    • 1
  • Russel T. Burge
    • 2
  • Jennifer A. Flynn
    • 1
  • Shonda A. Foster
    • 2
  • Hideaki Sowa
    • 3
  1. 1.Japan Health Technology AssessmentEli Lilly Japan K.K.KobeJapan
  2. 2.Global Health OutcomesEli Lilly and CompanyIndianapolisUSA
  3. 3.Medical ScienceEli Lilly Japan K.K.KobeJapan

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