• Xavier Nogués and Daniel Martinez-Laguna.
• Servicio de Medicina Interna, Hospital del Mar. URFOA-Unidad de Investigación Musculoesquelética, Instituto Hospital del Mar de Investigaciones Médicas, Barcelona, España; CIBER de Fragilidad y Envejecimiento Saludable (CIBERFES) Instituto Carlos III, Madrid, España; Universitat Autònoma de Barcelona, Barcelona, España. Electronic address: xnogues@hospitaldelmar.cat.
• Med Clin (Barc). 2018 Jun 22; 150 (12): 479-486.

AbstractTreatment of osteoporosis should be directed primarily towards secondary prevention of fractures. The occurrence of drug-related adverse effects for the treatment of osteoporosis has led to a reevaluation of the indications, the duration of treatment and even withdrawal of some drugs from the market. This review has been made from different patient profiles that practitioners will find in usual practice; from patients with hip fracture with cognitive impairment, limitation of their day-to-day living activities and comorbidities, to active patients without any limitations; patients with vertebral fractures and non-vertebral fractures where secondary prevention is highly important. In general, antiresorptive drugs (alendronate and risedronate) will be the first choice. Zoledronate or denosumab will be indicated in cases of digestive intolerance, poor adherence or an increased risk of hip fracture. Teriparatide will be indicated to patients with 2or more previous vertebral fractures or very low bone density.Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

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