ADVANTAGES

Fractures are an important cause of disability among postmenopausal women, and the costs of medical care associated with osteoporosis are estimated to be more than $18 billion annually in the United States alone. Bisphosphonates, the most commonly used treatment for established osteoporosis, inhibit osteoclast-mediated bone resorption and reduce the risk of vertebral fracture. Two bisphosphonates, alendronate and risedronate, also have been shown to reduce nonvertebral and hip fractures in women with osteoporosis. However, adherence to oral treatment is problematic, and about half of patients for whom oral treatment is prescribed do not adhere to it after 1 year. Poor adherence has been shown to compromise the effectiveness of treatment against fracture and to increase the costs of medical care.

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