Which class of drugs are recommended for starting therapy in men with clinically recognized osteoporosis?

The recommended first-line therapy for men with clinically recognized osteoporosis is bisphosphonates. This class of drugs is effective in inhibiting bone resorption, which helps to increase bone density and reduce the risk of fractures in osteoporotic patients. Bisphosphonates, such as alendronate and risedronate, have been studied extensively and have demonstrated significant benefits in improving bone mineral density and lowering fracture risk in men who have been diagnosed with osteoporosis.

Estrogen is primarily used in postmenopausal women for the treatment of osteoporosis rather than in men, as it can have different effects and risks in the male population. Raloxifene, a selective estrogen receptor modulator (SERM), is typically recommended for women and has not been established as a standard treatment for men. Calcium supplements, while important for bone health, should be seen as an adjunct to pharmacotherapy rather than a primary treatment for osteoporosis on their own. The main goal in managing osteoporosis is to prevent fractures, and bisphosphonates are recognized as the most effective option for initiating therapy in male patients.