METABOLIC BONE DISEASE: Edited by Kenneth G. SaagOsteoporosis in menEbeling, Peter R.Author Information Department of Endocrinology, Australian Institute of Musculoskeletal Science, North West Academic Centre, University of Melbourne, Western Health, Victoria, Australia Correspondence to Professor Peter R. Ebeling, MBBS, MD, FRACP, Australian Institute of Musculoskeletal Science, North West Academic Centre, University of Melbourne, Department of Endocrinology, Western Health, 176 Furlong Road, St Albans 3021, Victoria, Australia. Tel: +61 38 395 8065; e-mail: [email protected] Current Opinion in Rheumatology: July 2013 - Volume 25 - Issue 4 - p 542-552 doi: 10.1097/BOR.0b013e328362164d Buy Metrics Abstract Purpose of review Osteoporosis in men contributes to significant morbidity and mortality, yet is underrecognised. Hip fractures in men are associated with greater mortality (up to 37.5% in the first year) compared with women. Timely diagnosis and treatment of osteoporosis in men are therefore critical. Secondary causes for osteoporosis are common and need to be excluded. Absolute fracture risk assessment guides selection of men for anti-osteoporotic therapy. New findings Most studies of oral or intravenous (i.v.) bisphosphonate therapy in hypogonadal and eugonadal men with osteoporosis have reported effects on bone mineral density (BMD) and biochemical bone turnover markers, rather than fragility fractures. Intravenous zoledronic acid given to elderly men and women after hip fracture, reduced clinical, clinical vertebral and nonvertebral fractures, and mortality compared with placebo infusions. Recent studies in men with osteoporosis have reported reductions in vertebral fractures with oral or i.v. bisphosphonates. All studies have been underpowered to detect reductions of nonvertebral and hip fractures. Teriparatide treatment also reduces vertebral fractures. Denosumab increases BMD and reduces bone turnover markers, while strontium ranelate increases BMD in men with osteoporosis. Summary As evidence-based anti-osteoporosis treatment is available, family physicians and patients should recognize that osteoporosis can affect men, so that early diagnosis and treatment can be initiated. © 2013 Lippincott Williams & Wilkins, Inc.