The year 2021 is marked by several articles aimed at better risk stratification of osteoporosis to define the groups of patients at very high risk of fractures or at imminent risk of fractures. This stratification determines who should benefit from a first line bone anabolic treatment. A review of the current state of osteoporosis was therefore essential; it shows that Switzerland is lagging. In terms of prevention of bone fragility, dairy products are probably a leading strategy, especially in the elderly. The practical management of denosumab discontinuation is finally better understood. Finally, with the arrival of a new treatment, Burosumab, we are experiencing a therapeutic revolution for rare hypophosphatemic diseases.