Osteoporosis at DRHC Dubai

Osteoporosis is a condition that causes bones to become weak and brittle, making them more prone to fractures and breaks. It is a common condition, especially among older adults, and can have serious consequences if left untreated. At Dr. Rami Hamed Medical Center, Dubai, our rheumatologist specializes in the diagnosis and treatment of osteoporosis. We are committed to providing our patients with personalized care and effective treatment options to help them manage their condition and reduce their risk of fractures.

Causes of Osteoporosis:

The exact cause of Osteoporosis is still not known. Its not only wear and tear of joint, but several factors can increase the risk of developing the condition, including:

• Age: Osteoporosis is more common in older adults, especially women after menopause.
• Gender: Women are more likely to develop osteoporosis than men.
• Family history: Having a family history of osteoporosis or fractures increases the risk of developing the condition.
• Hormonal changes: Hormonal changes, such as those that occur during menopause, can lead to bone loss.
• Medications: Certain medications, such as corticosteroids and some anticonvulsants, can increase the risk of osteoporosis.
• Lifestyle factors: Smoking, excessive alcohol consumption, and a sedentary lifestyle can increase the risk of osteoporosis.
• Vitamin D deficiency: is another common cause of osteoporosis. Vitamin D plays a crucial role in calcium absorption and bone health. Without enough vitamin D, the body cannot effectively absorb calcium, leading to weakened bones and an increased risk of fractures. 

Symptoms of Osteoporosis:

Osteoporosis often does not cause any symptoms until a fracture occurs. Common symptoms of osteoporosis include:

• Back pain, caused by a fractured Spine
• Loss of height over time
• A stooped posture
• A bone fracture that occurs with little or no trauma

Diagnosis of Osteoporosis:

Osteoporosis is diagnosed using a bone density test, also known as a DEXA scan. This test measures the density of the bones and can help determine if you have osteoporosis or are at risk of developing the condition.
Fragility fracture, particularly at the spine, hip, wrist, humerus, rib, and pelvis
T-score ≤-2.5  at any site based upon bone mineral density (BMD) measurement by dual-energy x-ray absorptiometry (DXA)
Repeat DXA 
1.In osteoporosis patients we usually repeat dxa after one year of treatment and if BMD is stable or increased without any fragility fracture we repeat dxa after 2 to 5 years 
2.if there is decreasing in BMD or presence of fragility fracture we repeat after 1to2 years
3.If T score is between -2.00to -2.49 or there is risk factors if ongoing bone loss we repeat dxa every 2 years
4.if T score is- 1.5to -1.99 without risk factors of ongoing bone loss we repeat dxa after 3to 5 years old
5.if T score is less -1.01to 1.49 with no risk factors of accelerated bone loss we repeat dxa after 10 to 15 years

Treatment of Osteoporosis:

Treatment for osteoporosis aims to prevent fractures and reduce the risk of falls. Treatment options may include:

• Medications: Several medications are available to help prevent bone loss and increase bone density.
• Lifestyle changes: Eating a healthy diet rich in calcium and vitamin D, exercising regularly, and avoiding smoking and excessive alcohol consumption can help prevent osteoporosis.
• Fall prevention: Taking steps to prevent falls, such as removing tripping hazards from your home and wearing shoes with good support, can help reduce the risk of fractures.
  Osteoporosis mostly ends up in fracture of bones, Prevention of fractures is ultimate goal for treating this condition some common factures caused by osteoporosis are:
  • Hip Fractures
  • Wrist Fracture
  • Shoulder Fracture
  • Spine Fracture

Pre-Treatment Assessment

• All patients should have normal serum calcium and 25-hydroxyvitamin D levels before starting pharmacotherapy.
• Supplemental calcium and vitamin D should be provided if dietary intake is inadequate.

Initial Treatment Options

• Oral Bisphosphonates:
  • Preferred initial treatment for most postmenopausal women with osteoporosis.
  • Alendronate is the preferred choice due to its efficacy in reducing vertebral and hip fracture.
  • They have a long track record of safety and effectiveness, with a relatively low cost compared to other medications.
• Zoledronic Acid:
  • Reserved for patients unable to take oral bisphosphonates.
• Denosumab:
  • Not considered initial therapy but an option for patients intolerant of or unresponsive to any bisphosphonate.
• Raloxifene:
  • Estrogen receptor modulator for postmenopausal women with osteoporosis and without history of fragility fractures who cannot take bisphosphonate or denosumab.
  • Suitable for women with increased risk of breast cancer.
• Estrogen-Progestogen Therapy:
  • May be used if postmenopausal women with osteoporosis have menopausal symptoms and do not tolerate any other antiresorptive therapy.
• Teriparatide:
  • Synthetic form of parathyroid hormone (PTH) administered through daily injections.
  • Reasonable treatment for women at very high risk for fracture or those unable to tolerate oral bisphosphonates.
• Romosozumab:
  • Anabolic agent approved by the US FDA in 2019.
  • Inhibits the activity of sclerostin, leading to increased bone formation and decreased bone breakdown, improving bone density and strength.

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