It is a well-established fact: osteoporosis is more common in women, especially after menopause. But this loss of bone mass which makes the skeleton more fragile don’t spare men. The latter are indeed 15% to have an osteoporotic fracture as they age, which is far from negligible.
As in women, lack of physical activity and thinness are risk factors. But we must add the harmful role of tobacco and alcohol, more often found in men, and certain diseases: hyperthyroidism, liver disease, chronic bronchitis… This is also the case for certain treatments: cortisone, medication for Prostate cancer. Osteoporosis is more severe in them. Once diagnosed, after questioning and examination (bone densitometry, etc.), it can benefit from the same care as in women.
The fight against a sedentary lifestyle and the maintenance of a good musculature are essential for, already, avoid falls. Preventive measures involve resuming or continuing physical activity (walking first and foremost, every day) and food high enough in protein, which tend to decrease in the plate after 70 years. “When this is not enough, the same treatments as for women can be offered”, explains Professor Martine Cohen-Solal, rheumatologist at Lariboisière Hospital (Paris). They are reserved for men with a high or very high risk of having a fracture. But they can also be indicated in those who reduce their activity because they are afraid of falling.
The main class of drugs used is represented by bisphosphonates, which act by limiting bone resorption. There are several, which can be administered in different forms (tablet, injection, annual infusion), which does not change their action. The choice is therefore made according to the patient’s preference. Knowing that a new bisphosphonate should arrive soon.
But the great novelty is the appearance of a therapeutic class that uses biotherapies and whose mode of action is very different. “For the first time, we may soon have drugs that rebuild bone”, rejoices Professor Cohen-Solal. The trials are well advanced and combination schemes, not necessarily at the same time, are already planned. The specialists thus hope to offer their patients more active treatments than those available to them today.
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