Treatment options for postmenopausal osteoporosis in Asia

Treatment of osteoporosis has advanced dramatically during the past decade, with more therapeutic options than ever now available. Large‐scale randomized placebo‐controlled trials have documented the efficacy of a number of agents in reducing vertebral and non‐vertebral fractures. Anti‐resorptive agents (hormone replacement therapy, selective estrogen‐receptor modulators, calcitonin and bisphosphonates) and bone‐forming anabolic agents (parathyroid horomone and strontium ranelate) act via different mechanisms to reduce fractures and improve bone strength. In view of the high prevalence of calcium and vitamin D insufficiency in Asia, calcium and vitamin D supplementation remains a fundamental part of any treatment regimen, especially among the elderly. Given the high cost of these agents, a global assessment of the fracture risk of the patient is essential to determine the need for pharmacological treatment versus life‐style modification and dietary supplementation in the management of postmenopausal osteoporosis in Asia.