What is the first-line treatment for osteoporosis?

Bisphosphonates are indeed considered the first-line treatment for osteoporosis. These medications work by inhibiting osteoclast activity, which decreases bone resorption and leads to an overall increase in bone density. This is particularly important in osteoporosis, where the balance between bone resorption and formation is disrupted, leading to a net loss of bone mass.

In clinical practice, bisphosphonates such as alendronate and risedronate are commonly prescribed due to their efficacy in reducing the risk of fractures associated with osteoporosis, both in postmenopausal women and in individuals with other risk factors for the disease.

In contrast, estrogen replacements can be effective for some patients, particularly postmenopausal women, but they are not usually the first-line therapy due to potential side effects and risks associated with hormone replacement therapy. Calcitonin has a role in treating osteoporosis, but it is generally considered less effective than bisphosphonates and is used more as a second-line option. Parathyroid hormone therapy is typically reserved for patients with severe osteoporosis or those who have not responded to other treatments, making it a less common first-line choice.

Therefore, bisphosphonates are favored initially because of their strong evidence base and favorable risk