Essay On Osteoporosis

Osteoporosis, or "porous bones", is a skeletal condition characterized by low bone mass and microarchitectural deterioration of bone tissue.1 It can lead to bone fragility and an increase in falls and fractures. Decreased bone mass in osteoporosis is classified into primary and secondary groups with primary osteoporosis further divided into Type 1 and Type 2. Type 2 refers to postmenopausal osteoporosis which usually occurs 3 to 6 years after reaching menopause. Postmenopausal osteoporosis affects approximately 10 million people in the United States, and 80% of the affected population are women 50 years of age and older. Every year, more than 1.5 million osteoporosis-related fractures occur in elderly Americans. Osteoporosis-related fracture

When RANKL and RANK interact, it induces bone resorption. Although the condition affects both men and women, postmenopausal women are more likely to have osteoporosis because of a 2-3% loss of bone mass resulting from a decline in 17βEstradiol concentrations, and because women generally have 30% less bone mass than men throughout life. Postmenopausal osteoporosis is associated with secondary causes such as estrogen deficiency, glucocorticorticoid induction, and hyperparathyroidism.2 Other risk factors include increasing age, race, family history, small stature, low weight, early menopause or oophorectomy, sedentary lifestyle, decrease mobility, low calcium uptake, excessive alcohol intake, and cigarette smoking.1 Osteoporosis has no clinical manifestations until there is a fracture, with vertebral fractures the most common.2 Approximately two-thirds of fractures are asymptomatic and are diagnosed as an incidental finding on chest radiograph. In contrast, approximately one-third of vertebral fractures are symptomatic with signs of acute back pain after bending, coughing, or

Patients with severe renal impairment, defined by a creatinine clearance of less than 30ml/min or if the patient is on dialysis, should be monitored closely because of the risk of hypocalcemia. Denosumab is FDA approved for postmenopausal osteoporosis in women and men who are at high risk for fracture, in men receiving androgen-deprivation therapy (ADT) for bone loss, in women who are receiving aromatase inhibitor (AI) for breast cancer, prophylactically for those with bone metastasis associated with solid tumors, unresectable or high risk surgery giant cell tumor of bone, and hypercalcemia of malignancy refractory to bisphosphate therapy. Off-Label use of denosumab includes bone destruction caused by rheumatoid