In regulatory terms "prevention" usually refers to preventing bone loss, whilst "treatment" refers to decreasing fracture risk. In clinical practise this distinction is less appropriate. It is most useful to consider the indication for intervention as prevention of osteoporotic fracture whether or not a fragility fracture has occurred.
There is increasing evidence for a relatively rapid rate of treatment onset and offset for many therapeutic interventions and there has been a move away from long-term preventative strategies towards the use of shorter-term therapy for high risk individuals. There is evidence to show significant reductions in fracture rate in osteoporotic women after one years treatment. There is also evidence that the greatest fracture reduction may be acheived in women with lower bone density.
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