Long-term strategy in the management of postmenopausal osteoporosis.

The lifetime fracture risk at 50 years of age is about 50% in women and 20% in men. Osteoporotic fractures are associated with severe morbidity, increased mortality, quality-of-life alterations, and high management costs, most notably in the oldest age groups. The steady increase in life expectancy is matched by a rise in the absolute fracture risk. Effective prevention is therefore crucial. The goal of prevention, which must be not only effective, but also safe, is to diminish the risk of vertebral, peripheral, and hip fractures. Several medications were effective in double-blind controlled trials in which the fracture incidence was the primary endpoint. Long-term data are available to confirm the good safety profile of these medications.