Osteoporosis: Pathogenesis, Treatment and Opportunities

The term Osteoporosis is a combination of two words osteo and porosis which means bone and porous respectively, so osteoporosis literally means porous bone. It makes the bone more fragile and easily susceptible to fracture. It may be due to an abnormal increase in bone loss, which results in the loss of normal bone strength. Bone loss increases in women after menopause, due to lower levels of estrogen. On the other hand, men also undergo gradual bone loss with aging, which results into fragile bones. The root cause is the reduction of free testosterone. Osteoporosis may also occur due to a number of diseases (cancer, diabetes), medication (steroids) or treatment. The porosity in this disease may weaken the bone to such a degree, a break may occur with minor stress (fall) and spontaneously. It leads to various types of fractures i. e. , vertebral, nonvertebral and hip fractures. In fact, a fracture is typically the first outward sign of the disease, and advanced osteoporosis is potentially very painful and disabling. There is imbalance between the bone cells i. e. , osteoclasts and osteoblasts, which effect the bone remodeling process, which plays a major contribution in the development of osteoporosis. The number of women with osteoporosis is increasing in India. Thus, osteoporosis is a major public health problem in Indian women. Different types of drugs are available in the market, but calcium, estrogen, vitamin D and bisphosphonates are the first-line drugs for the treatment of osteoporosis. Some drugs are antiresorptive i. e. , bisphosphosphonates, while the others are osteoanabolic by nature i. e. , teriparatide. In order to treat vertebral compression fractures (spine fracture), a surgical treatment (noninvasive) is carried out, which is known as vertebroplasty and kyphoplasty.