[Evidenced based medicine and drugs approved for the treatment of osteoporosis. Role of calcium and vitamin D]. / La medicina basada en la evidencia y los fármacos aprobados para el tratamiento de la osteoporosis. Papel del calcio y la vitamina D.

Osteoporosis is a very common disease, which affects aged elderly people. Fractures are the main clinical manifestation of osteoporosis, being the more frequent fractures, vertebral fractures, distal forearm fractures and proximal femur fractures. The main objective in the treatment of osteoporosis is to avoid or to reduce new fractures. To obtain this, an integral approach should be done, including non-pharmacological measures, as a well balanced diet, the practising of regular exercise, avoiding or suppressing toxic habits (excess of alcohol and tobacco), and when indicated, patients should take a drug. There are several drugs available whose reduce the risk of fracture, all of them evaluated under the "Evidence-Based Medicine" criteria. Not all the drugs reduce the risk of all fracture. Thus, there are drugs that reduce only the risk of vertebral fractures, drugs that reduce the risk of non-vertebral fractures and finally, drugs that reduce the risk of hip fracture. All the studies performed on osteoporosis, the drugs have been always prescribed together with a supplement of calcium and Vitamin D. So, the correct prescription of a treatment for osteoporosis should include general measurements, the chosen drug and a supplement of calcium and Vitamin D.

[Influence of the different bisphosphonates dose regimens on its tolerability]. / Influencia de los diferentes regímenes de administración de los bifosfonatos sobre la tolerabilidad.

Osteoporosis is the most prevalent metabolic bone disease and fractures are its clinical complication. We have nowadays some drugs that reduce the incidence of new fractures: Bisphosphonates. Nevertheless, treatment must be taken properly in the long run to reduce the incidence of new fractures and a few months alter starting the treatment, a great number of patients stop it because of different reasons. The introduction of new bisphosphonates that can be taken weekly or even better monthly, has improved notably the adherence and compliance to osteoporosis treatment.