Osteoporosis is a frequent, multifactorial disease and represents a significant and increasing healthcare burden in Europe. For osteoporosis treatment several drugs groups (SERM: bisphosphonates, denosumab, teriparatide) have been approved with different biological effects and further are expected.
The question if every medication is suitable for all patients, is opened. We may stratify patients by individual fracture risk assessment but often there many others individual factors affecting medication choice.
Age, life expectancy, falls, kidney function are very important. Preparing individual treatment plans for each patient is the way how to handle with it.
In younger osteoporotic women we have to expect 20-25 years of care and sequential therapy, long term therapy with "drug holiday" is to be considered. This new strategy should be accompanied by more flexible reimbursement rules.