Not exclusively for women!

*It is only for medical professionals to read for reference.
The disability rate and fatality rate of male osteoporotic fractures are significantly higher than that of women, but the treatment rate is only 0.
3%
.

With the acceleration of the aging process of the population, osteoporosis has become a common disease in the world, and its incidence rate is closely followed by cardiovascular disease and diabetes, ranking third in chronic diseases [1]
.

As one of the countries with the largest elderly population in the world, China is expected to have 120 million patients with osteoporosis by 2050 [2]
.

Osteoporosis and its complications have a heavy burden, which severely reduces the quality of life of patients
.

The concurrent hip fracture has a disability rate of up to 50% in the elderly, and the mortality rate within one year is as high as 20% to 30% [3], which is jokingly called the "last fracture in life" by folks
.

However, osteoporosis is generally regarded as a health problem for women, and its impact and harm on men are often overlooked [2]
.

The demand for osteoporosis treatment of male patients in China is not lost to females.
This year, a new study on the status of osteoporosis in mainland China was released [4].
It found that despite the sharp decline in estrogen after menopause, bone mass accelerated in women.
Loss, the prevalence of osteoporosis is higher in women 40 years and older
.

However, the incidence of fractures in men is actually slightly higher than in women
.

In addition, when osteoporosis patients and people with a history of fractures are seriously under-treated, the treatment rate for men is even more worrying (women: 1.
4%, men: 0.
3%)
.

This study is by far the largest of its kind
.

 In fact, Chinese academic institutions and experts and scholars in the field have been calling for attention to the problem of male osteoporosis for a long time
.

To this end, in 2020, the Osteoporosis and Bone Mineral Diseases Branch of the Chinese Medical Association officially issued the "Guidelines for the Diagnosis and Treatment of Male Osteoporosis" (hereinafter referred to as the "Guidelines"), emphasizing that up to 46.
9% of men need to prevent and treat bones.
For people with low bone mass and low bone mass, one in five men over the age of 50 will have osteoporotic fractures, and the disability and fatality rates of osteoporotic fractures in men are significantly higher than those in women-male hip fractures1 The annual mortality rate is 2 to 3 times that of women; 10 years after a vertebral fracture, the expected survival rate of men is less than 10%, which is significantly shorter than that of women [2]
.

 Male osteoporosis is in urgent need of treatment, but not all drugs suitable for female osteoporosis can be "expanded" for men
.

 The types of osteoporosis treatment drugs and treatment options The treatment of osteoporosis must be based on calcium and vitamin D supplementation with other drugs [5]
.

There are many anti-osteoporosis drugs, which can be divided into bone resorption inhibitors (bisphosphonates, calcitonin, estrogen, etc.
), bone formation promoters (parathyroid hormone analogs) and other mechanism drugs (active vitamins) D and its analogues, vitamin K2, strontium salt)
.

Among them, bisphosphonates are currently the most widely used anti-osteoporosis drugs in clinical practice, with good overall safety [6]
.

The bisphosphonates currently used to prevent and treat osteoporosis mainly include alendronate, zoledronic acid, risedronate sodium, ibandronate, etidronate disodium and clodronate disodium Etc.
[6]
.

 For most osteoporotic patients with high fracture risk, zoledronic acid, alendronate, risedronate and desulimab can effectively reduce the risk of hip, non-vertebral and vertebral fractures, suitable for As the initial treatment
.

For extremely high-risk fracture patients who cannot be treated with oral medications, zoledronic acid, disulimab, teriparatide, and abalotide can be considered [7]
.

 Directly hit the ideal choice for the treatment of male osteoporosis.
"There are differences between men and women.
" Looking at home and abroad, there are very few studies on the efficacy of anti-osteoporosis treatment in male patients
.

Bisphosphonate drugs are generally safe [2], but currently the only bisphosphonate drugs approved for the treatment of male osteoporosis in China are zoledronic acid and alendronate sodium [2]
.

 The latter must be administered orally (1 time/day), while zoledronic acid is a bisphosphonate drug administered intravenously, injected once a year, 5 mg each time
.

 A multicenter, double-blind, placebo-controlled trial randomly assigned 1199 men with primary osteoporosis or hypogonadism-related osteoporosis between 50 and 85 years old to the zoledronic acid (5 mg) group or In the placebo group, it was found that after 24 months, the incidence of vertebral fractures in the zoledronic acid group and placebo group was 1.
6% and 4.
9%, respectively, suggesting that men receiving zoledronic acid had a 67% reduction in fracture risk (RR: 0.
33; 95%CI: 0.
16～0.
70; P=0.
002) [8], has clinical significance
.

In addition, men who received zoledronic acid had less height loss (P=0.
002), higher bone mineral density, and lower levels of bone turnover (P<0.
05) [8]
.

 Not only that, because of the convenience of use, most patients (78.
7%) prefer injections to oral bisphosphonates [9]
.

This ease of use also brings significant advantages in the context of the new coronary pneumonia pandemic, making it difficult for patients to cause rebound effects due to drug withdrawal or delay [10]
.

 Summary With the intensification of the aging of the social population in our country, the prevalence of osteoporosis in our country has risen significantly, bringing a heavy burden to patients, their families and society
.

The disability rate and fatality rate of osteoporotic fractures in men are significantly higher than those in women.
However, due to the long-term “neglect”, the rate of consultation and treatment is far lower than that of women[2].
It requires urgent attention and timely treatment.

.

At present, the only bisphosphonate drugs approved in China for the treatment of male osteoporosis are alendronate and zoledronic acid
.

Zoledronic acid can significantly reduce the incidence of fractures and is convenient to use.
It is an ideal choice for the treatment of osteoporosis in male patients
.

Expert Profile Song Lige, Deputy Chief Physician, Associate Professor, and Doctoral Supervisor of the Department of Endocrinology and Metabolism, Tongji Hospital Affiliated to Tongji University, Deputy Director, Institute of Osteoporosis and Metabolic Bone Disease, Tongji University School of Medicine, Member of the Osteoporosis Specialist Branch of the Shanghai Medical Association Secretary of the Chinese Medical Association Osteoporosis and Bone Mineral Diseases Branch 5th Youth Member, International Chinese Osteology Society Life Member, Shanghai Medical Association Endocrinology Branch 10th Youth Member, Shanghai Medical Association Diabetes Branch Blood Glucose Monitoring and Treatment New The technical team members presided over 13 national, provincial, bureau, and school-level topics and won the second Shanghai "Medical Tree Award" Young Clinical Medical Science and Technology Innovation Award, Shanghai Municipal Health and Family Planning Commission "Outstanding Young Physician", Honorary references such as the "May Fourth Youth" Medal of Tongji University [1] Bai Bihui, et al.
The current situation of osteoporosis epidemiological research in China in the past 5 years.
Chinese Journal of Osteoporosis.
2018,24(2):253-258.
[2] Osteoporosis and Bone Mineral Diseases Branch of Chinese Medical Association.
Guidelines for diagnosis and treatment of male osteoporosis.
Chinese Journal of Endocrinology and Metabolism.
2020,16(10):817-827.
[3] Bethune Foundation of Trauma and Orthopedics Committee, et al.
Expert consensus on diagnosis and treatment of osteoporosis in elderly hip fractures.
Chinese Journal of Bone and Joint Surgery.
2021.
14(8):657-663.
[4]Linhong Wang,et al.
Prevalence of Osteoporosis and Fracture in China: The China Osteoporosis Prevalence Study.
JAMA Netw Open.
2021;4(8):e2121106.
[5] Chinese Medical Association.
Guidelines for Primary Osteoporosis Prevalence Diagnosis and Treatment (Practical Edition·2019).
Chinese Journal of General Practitioners.
2020 ,19(4):316-323.
[6] Osteoporosis and Bone Mineral Diseases Branch of Chinese Medical Association.
Guidelines for Diagnosis and Treatment of Primary Osteoporosis (2017).
Chinese Journal of Osteoporosis and Bone Mineral Diseases.
2017,10(5):413-443.
[7]Pauline M.
Camacho, et al.
American Association of Clinical Endocrinologists/American College of Endocrinology Clinical Practice Guidelines for the Diagnosis and Treatment of Postmenopausal Osteoporosis—2020 Update.
Endocrine Practice.
2020;26(Suppl 1):1-44.
[8] Boonen S,et al.
Fracture risk and zoledronic acid therapy in men with osteoporosis.
N Engl J Med.
2012,367(18):1714-1723.
[9]Michael McClung,et al.
Intravenous zoledronic acid 5 mg in the treatment of postmenopausal women with low bone density previously treated with alendronate.
Bone.
2007 Jul;41(1):122-8.
[10]B Stolnicki,et al.
Managing A Fls In A Brazilian Healthcare Provider During Covid's Pandemic.
WCO-IOF-ESCEO.
P299.
-End -"This article is only used to provide scientific information to medical and health professionals, and does not represent the platform's position.
" For submission/reprint/business cooperation, please contact: pengsanmei@yxj.
org.
cnEndocrine Practice.
2020;26(Suppl 1):1-44.
[8] Boonen S,et al.
Fracture risk and zoledronic acid therapy in men with osteoporosis.
N Engl J Med.
2012,367(18):1714-1723 .
[9]Michael McClung,et al.
Intravenous zoledronic acid 5 mg in the treatment of postmenopausal women with low bone density previously treated with alendronate.
Bone.
2007 Jul;41(1):122-8.
[10]B Stolnicki, et al.
Managing A Fls In A Brazilian Healthcare Provider During Covid's Pandemic.
WCO-IOF-ESCEO.
P299.
-End-"This article is only used to provide scientific information to medical and health professionals and does not represent the platform's position" For business cooperation, please contact: pengsanmei@yxj.
org.
cnEndocrine Practice.
2020;26(Suppl 1):1-44.
[8] Boonen S,et al.
Fracture risk and zoledronic acid therapy in men with osteoporosis.
N Engl J Med.
2012,367(18):1714-1723 .
[9]Michael McClung,et al.
Intravenous zoledronic acid 5 mg in the treatment of postmenopausal women with low bone density previously treated with alendronate.
Bone.
2007 Jul;41(1):122-8.
[10]B Stolnicki, et al.
Managing A Fls In A Brazilian Healthcare Provider During Covid's Pandemic.
WCO-IOF-ESCEO.
P299.
-End-"This article is only used to provide scientific information to medical and health professionals and does not represent the platform's position" For business cooperation, please contact: pengsanmei@yxj.
org.
cnIntravenous zoledronic acid 5 mg in the treatment of postmenopausal women with low bone density previously treated with alendronate.
Bone.
2007 Jul;41(1):122-8.
[10]B Stolnicki,et al.
Managing A Fls In A Brazilian Healthcare Provider During Covid's Pandemic.
WCO-IOF-ESCEO.
P299.
-End-"This article is only used to provide scientific information to medical and health professionals, and does not represent the position of the platform.
" For submission/reprint/business cooperation, please contact: pengsanmei@yxj.
org.
cnIntravenous zoledronic acid 5 mg in the treatment of postmenopausal women with low bone density previously treated with alendronate.
Bone.
2007 Jul;41(1):122-8.
[10]B Stolnicki,et al.
Managing A Fls In A Brazilian Healthcare Provider During Covid's Pandemic.
WCO-IOF-ESCEO.
P299.
-End-"This article is only used to provide scientific information to medical and health professionals, and does not represent the position of the platform.
" For submission/reprint/business cooperation, please contact: pengsanmei@yxj.
org.
cn