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      The treatment gap: The missed opportunities for osteoporosis therapy

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          Abstract

          <p class="first" id="d3080288e155">Despite substantial advances in delineation of the epidemiology, pathophysiology, risk assessment and treatment of osteoporosis over the last three decades, a substantial proportion of men and women at high risk of fracture remain untreated - the so-called "treatment gap". This review summarises the important patient-, physician- and policyrelated causes of this treatment gap, before discussing in greater detail: (a) the evidence base for the efficacy of bisphosphonates in osteoporosis; (b) recent evidence relating to the adverse effects of this widely used therapeutic class, most notably atypical femoral fracture and osteonecrosis of the jaw; (c) available strategies to improve both secondary and primary prevention pathways for the management of this disorder. </p>

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          Author and article information

          Journal
          Bone
          Bone
          Elsevier BV
          87563282
          March 2021
          March 2021
          : 144
          : 115833
          Article
          10.1016/j.bone.2020.115833
          7116600
          33359889
          57704dee-746e-4c77-b1f8-62565c222108
          © 2021

          https://www.elsevier.com/tdm/userlicense/1.0/

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