Antiresorptives and anabolic therapy in sequence or combination for postmenopausal osteoporosis

Climacteric : the Journal of the International Menopause Society
S Palacios, A Mejía

Abstract

Osteoporosis is a chronic disease which may require treatment for many years and requires not only individual management but often sequential or combination treatments. Monotherapy with antiresorptives is usually the first choice. Sometimes, it is necessary to modify this option for therapeutic failure or for the time of use and risk of side-effects. Due to their different mode of action, therapy with anabolic drugs has increased our options in the treatment of osteoporosis. Postmenopausal women and men with severe and progressive osteoporosis despite antiresorptive treatment ('therapeutic failure') should be evaluated for treatment with an anabolic option. Moreover, anabolic agents are indicated for 18-24 months in patients at high risk. Then, sequential antiresorptive therapy is recommended to maintain drug increases in bone mass and support secondary mineralization of the newly formed bone. Combination therapies of antiresorptives and anabolic agents have shown a significant increase in bone mineral density compared to monotherapies. However, none of the combinations have been studied for the prevention of fractures. Combination therapy may not be recommended because of the possible increase in cost.

References

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Citations

Sep 2, 2015·Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA·D KrishnamoorthyC T Rubin
Jun 2, 2018·Current Osteoporosis Reports·Shanmugam MuruganandanChristopher J Sinal
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May 11, 2020·International Immunopharmacology·Jinwei LuRongxin He
Aug 4, 2021·Climacteric : the Journal of the International Menopause Society·M R McClung, A L Clark
Aug 13, 2021·Climacteric : the Journal of the International Menopause Society·S Palacios

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