Treatment strategies in osteoporosis - an analysis of practice guidelines
Main Article Content
Keywords
Key words: osteoporosis, monoclonal antibodies, fracture, sequential therapy
Abstract
The goal of this paper is to present the sequential therapies used in the treatment of osteoporosis, according to the new practice guidelines.Various specialized e-platforms have been searched (PubMed, Scopus, Web of Science), as well as forums specializing in the treatment of osteoporosis, American Association of Clinical Endocrinologists (AACE/ACE), National Osteoporosis Foundation (NOF) ACR (American College of Rheumatology) and ISCD (International Society for Clinical Densitometry) and the new osteoporosis treatment guidelines have been analysed.The therapeutic agents used in the treatment of osteoporosis have antiresorptive action or osteoforming action. The studies performed until the present did not show the superiority of associating the two types of medication as compared to each of them considered separately. When bisphosphonates are contraindicated, there is intolerance or the obtained results are minimum, human, anti-RANKL (denosumab) monoclonal antibodies may be administered, which inactivate the osteoclasts and their development. The hormone replacement therapy, as well as the selective estrogen receptor modulators (raloxifene), has very limited indications due to the severe adverse reactions (thromboembolism, endometrium cancer, breast cancer, cardiovascular diseases). At present, numerous preparations having antiresorptive action or osteoforming action are being studied: sclerostin inhibitors (romosozumab), Cathepsin K inhibitors (odanacatib), integrin inhibitors (proteins involved in osteoclasts’ adhesion), new parathormone derivates. The new administration methods of the existing preparations are equally possible future approaches of the osteoporosis treatment.
References
1. Ahmed SF, Elmantaser M. Secondary osteoporosis. Endocr Dev. 2009. 16:170-90 doi: 10.1159/000223695.
2. WHO Study Group Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. 1994 (WHO Technical Report Series, No. 843) (accessed, April 2020) https://apps.who.int/iris/handle/10665/39142
3.Majumdar SR, Lier DA, Beaupre LA, Hanley DA, Maksymowych WP, Juby AG, et al. Osteoporosis case manager for patients with hip fractures: results of a cost-effectiveness analysis conducted alongside a randomized trial. Arch Intern Med. 2009. 169(1):25-31. doi:10.1001/archinte.169.1.25
4. World Health Organization (WHO). WHO scientific group on the assessment of osteoporosis at primary health care level: summary meeting report. Available at: http://www.who.int/chp/topics/Osteoporosis.pdf. 2015 (accessed, April 2020)
5. The International Society for Clinical Densitometry (ISCD). Official Positions 2015: Adult & Pediatric. https://iscd.app.box.com/OP-ISCD-2015-Adult. 2016. (accessed, April 2020)
6. Florence A, Allen S, Benedict L, Compo R, Jensen A, et al. Health Care Guideline. Diagnosis and Treatment of Osteoporosis. Updated July 2013. Institute for Clinical Systems Improvement (ICSI) https://www.icsi.org/_asset/vnw0c3/Osteo.pdf. -2016.
7.The International Society for Clinical Densitometry (ISCD), International Osteoporosis Foundation (IOF). 2010 Official Positions on FRAX®. November 2010. https://iscd.app.box com/OP-ISCD-IOF-2010-Frax-Eng. 2016. (accessed, April 2020)
8. Grossman JM, Gordon R, Ranganath VK, Deal C, Kaplan L, et al. American College of Rheumatology 2010 recommendations for the prevention and treatment of glucocorticoid-induced osteoporosis. Arthritis Care Res (Hoboken) 2010;62(11):1515-1526.
DOI 10.1002/acr.20295
9. U.S. Preventive Services Task Force, Rockville, Maryland, United States Preventive Services Task Force. Screening for osteoporosis: U.S. preventive services task force recommendation statement. Ann Intern Med 2011;154(5):356-364. https://annals.org/aim/fullarticle/746858
10.https://www.nof.org (accessed, April 2020)
11.https://www.rheumatology.org (accessed, April 2020)
12. https://www.aace.com/publications/guidelines (accessed, April 2020)
14. Eric G Colman, The Food and Drug Administration’s Osteoporosis Guidance Document: Past, Present, and Future, JOURNAL OF BONE AND MINERAL RESEARCH,Volume 18, Number 6, 2009, doi.org/10.1359/jbmr.2003.18.6.1125
15. old.ms.ro/documente/1324 anexa 2_8732_6701.doc (accessed, April 2020)
16. Crandall CJ, Newberry SJ, Diamant A, et al. Comparative effectiveness of pharmacologic treatments to prevent fractures: an updated systematic review. Ann Intern Med. 2014;161(10):711–723. doi: 10.7326/M14-0317.
17. MacLean C, Newberry S, Maglione M, et al. Systematic review: comparative effectiveness of treatments to prevent fractures in men and women with low bone density or osteoporosis. Ann Intern Med. 2008;148(3):197–213. DOI:10.7326/0003-4819-148-3-200802050-00198
18. Ringe JD, Faber H, Farahmand P, Dorst A. Efficacy of risedronate in men with primary and secondary osteoporosis: results of a 1-year study. Rheumatol Int. 2006;26(5):427–431. DOI:10.1007/s00296-005-0004-4
19. Orwoll E, Ettinger M, Weiss S, et al. Alendronate for the treatment of osteoporosis in men. N Engl J Med. 2000;343(9):604–610. DOI: 10.1056/NEJM200008313430902
20. Adachi JD, Saag KG, Delmas PD, et al. Two-year effects of alendronate on bone mineral density and vertebral fracture in patients receiving glucocorticoids: a randomized, double-blind, placebo-controlled extension trial. Arthritis Rheum. 2001;44(1):202–211. DOI:10.1002/1529-0131(200101)44:1
21. Wallach S, Cohen S, Reid DM, et al. Effects of risedronate treatment on bone density and vertebral fracture in patients on corticosteroid therapy. Calcif Tissue Int. 2000;67(4):277–285. DOI https://doi.org/10.1007/s002230001146
22. Woo SB, Hellstein JW, Kalmar JR. Narrative [corrected] review: bisphosphonates and osteonecrosis of the jaws, Ann Intern Med. 2006;144(10):753–761. DOI:10.7326/0003-4819-144-10-200605160-00009
23. Meier RP, Perneger TV, Stern R, Rizzoli R, Peter RE. Increasing occurrence of atypical femoral fractures associated with bisphosphonate use. Arch Intern Med. 2012;172(12):930–936. doi:10.1001/archinternmed.2012.1796
24. Minisola S.Cipriani C.Della Grotta et.all, Update on the safety and efficacy of teriparatide in the treatment of osteoporosis, Therapeutic advances in musculoskeletal disease, vol.11, 2019, doi: 10.1177/1759720X19877994
25. Silverman SL, Azria M. The analgesic role of calcitonin following osteoporotic fracture. Osteoporos Int. 2002;13(11):858–867. DOI:10.1007/s001980200118
26. Overman RA, Borse M, Gourlay ML. Salmon calcitonin use and associated cancer risk. Ann Pharmacother. 2013;47(12):1675–1684. doi.org/10.1177/1060028013509233
27. Jamal SA, Ljunggren O, Stehman-Breen C, et al. Effects of denosumab on fracture and bone mineral density by level of kidney function. J Bone Miner Res. 2011;26(8):1829–1835. DOI:10.1002/jbmr.403
28.Barrionuevo, Patricia, Kapoor, Ekta et al. Efficacy of Pharmacological Therapies for the Prevention of Fractures in Postmenopausal Women: A Network Meta-Analysis,Lournal of clinical endocrinology and metabolism, Volume 104, Issue 5, May 2019, Pages 1623–1630, doi.org/10.1210/jc.2019-00192
29. L. Vignozzi,N. Malavolta,P. Villa,G. Mangili,S. Migliaccio, Consensus statement on the use of HRT in postmenopausal women in the management of osteoporosis by SIE, SIOMMMS and SIGO, Journal of Endocrinological Investigation,May 2019, Volume 42, Issue 5, pp 609–618, DOI:10.1007/s40618-018-0978-x
30.Kwon, Dae-Hui; Shin, Jung-Ho, Updated treatment guideline for hormone therapy in postmenopausal women, , J Korean Med Assoc. 2019 Mar;62(3):145-149. doi.org/10.5124/jkma.2019.62.3.145
31. Figurek, A., Rroji, M. & Spasovski, G. Sclerostin: a new biomarker of CKD–MBD. Int Urol Nephrol 52, 107–113 (2020). https://doi.org/10.1007/s11255-019-02290-
32. Michael R. McClung,Using Osteoporosis Therapies in Combination
Curr Osteoporos Rep. 2017 Aug; 15(4):343-352. doi: 10.1007/s11914-017-0376-x.
Article Sidebar
Article Details
How to Cite
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Transfer of Copyright and Permission to Reproduce Parts of Published Papers.
Authors retain the copyright for their published work. No formal permission will be required to reproduce parts (tables or illustrations) of published papers, provided the source is quoted appropriately and reproduction has no commercial intent. Reproductions with commercial intent will require written permission and payment of royalties.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
