Selection of antiresorptive or anabolic treatments for postmenopausal osteoporosis

Nature Clinical Practice. Endocrinology & Metabolism
Socrates E Papapoulos, Polyzois Makras

Abstract

Osteoporosis is a common, chronic disease that can be treated effectively by pharmacological interventions. Antiosteoporotic drugs reduce fracture risk via different mechanisms of action. Available therapies are broadly distinguished into inhibitors of bone turnover, stimulators of bone formation, and therapies with as-yet unclear mechanisms of action. No direct comparison studies with fracture end points have yet been done, which makes selection of one drug over another difficult. Identification of individuals who might derive particular benefit from a specific therapy has been explored in post-hoc analyses of clinical studies with bisphosphonates and recombinant parathyroid hormone (PTH). Their findings showed that the efficacy of these therapies in reducing fracture risk was largely independent of the prevalent rates of bone turnover. Selection of a specific antiosteoporotic therapy should, therefore, be made according to the results of trials specifically designed to assess fracture risk, safety, tolerability, patient preference and cost-effectiveness rather than on characteristics specific to patients or the disease. Studies of sequential administration of PTH and bisphosphonates suggest advantages over single-therapy regi...Continue Reading

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May 26, 2017·Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research·Tony M KeavenyCesar Libanati
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Nov 19, 2020·International Journal of Molecular Sciences·Woojin NaYoung-Hee Kang
Oct 28, 2009·Current Opinion in Endocrinology, Diabetes, and Obesity

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