The future of osteoporosis diagnosis and therapy.

Advancing the diagnosis and treatment of osteoporosis will require progress on several fronts: we must overcome the current widespread failure to fully employ the means already at our disposal for the evaluation, prevention and treatment of osteoporosis. Diagnostic testing must become more effective at characterizing the bone and mineral metabolism of the individual patient. Testing must do far more than identify candidates for treatment; it must permit monitoring of the response to therapy or progression of disease. New therapies should have well-characterized, very specific physiological effects. It is critical that they do not produce adverse effects on the bone remodeling mechanism. Gaps in our understanding of the relationships between the mechanical functions of the skeleton and the biology of bone tissue must be filled in order to provide a basis for evaluation and treatment of the skeleton as an integrated organ system.