The role of anti-osteoporosis drugs in fall risk

Osteoporosis is a common skeletal disease characterized by reduced bone mass and micro-architectural deterioration, which leads to an increased risk of fractures. A significant concern associated with osteoporosis is the risk of falls, which can result in fractures and other related complications. This review examines the role of anti-osteoporosis drugs in the prevention of falls, focusing on pharmacological interventions that have shown promise in reducing the incidence of falls in osteoporotic patients. Falls in older people often lead to fractures, decreased mobility and reduced quality of life. Given that individuals with osteoporosis are more susceptible to fractures, it is essential to explore therapeutic strategies aimed at mitigating fall risk in this population. Anti-osteoporosis drugs have been developed primarily to improve bone mineral density and strength. The most extensively explored in this sense is probably vitamin D. Several meta-analyses have indicated that vitamin D could reduce the risk of falling compared with placebo. For this nutrient, important in vitro and experimental research data are available showing, overall, a positive effect on muscle. However, there is emerging evidence that large bolus doses and/or high levels of vitamin D may increase the risk of falls. Denosumab, a monoclonal antibody against RANKL (receptor activator of nuclear factor-кB ligand), is widely used to treat osteoporosis, and its influence on falls, although supported by a recent systematic review, is currently under investigation. Understanding the relationship between anti-osteoporosis medications and fall prevention is critical in comprehensive management of osteoporosis. Although these drugs are primarily used to improve bone health, their influence on falls is an intriguing topic. KEY WORDS: Falls, denosumab, vitamin D, romosozumab.