Recommendations for the optimal use of bone forming agents in osteoporosis.

Autor: Veronese N; Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Via del Vespro 141, 90127, Palermo, Italy. nicola.veronese@unipa.it.; Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, 11451, Riyadh, Kingdom of Saudi Arabia. nicola.veronese@unipa.it., Briot K; AP-HP, Department of Rheumatology, Cochin Hospital, Paris, France., Guañabens N; Rheumatology Department, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain., Albergaria BH; Department of Social Medicine (Clinical Epidemiology), Federal University of Espirito Santo, Vitória, Brazil., Alokail M; Protein Research Chair, Biochemistry Department, College of Science, King Saud University, 11451, Riyadh, Kingdom of Saudi Arabia., Al-Daghri N; Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, 11451, Riyadh, Kingdom of Saudi Arabia., Bemden AB; Global Patient Ambassador, Musculoskeletal Research International, Inc., Miami, FL, USA.; Patient Partner, Holiday, FL, USA.; EUPATI Fellow, Holiday, FL, USA.; Clinical Research Experts, LLC., Tampa, FL, USA., Bruyère O; Research Unit in Public Health, Epidemiology and Health Economics, Department Physical Activity and Rehabilitation Sciences, University of Liège, Liège, Belgium., Burlet N; Research Unit in Public Health, Epidemiology and Health Economics, Department Physical Activity and Rehabilitation Sciences, University of Liège, Liège, Belgium., Cooper C; MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK., Curtis EM; MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK., Ebeling PR; Department of Medicine, School of Clinical Sciences, Department of Endocrinology, Monash University, Clayton, VIC, Australia., Halbout P; International Osteoporosis Foundation, Geneva, Switzerland., Hesse E; Institute of Musculoskeletal Medicine, LMU University Hospital, LMU Munich, Munich, Germany.; Musculoskeletal University Center Munich, LMU University Hospital, LMU Munich, Munich, Germany., Hiligsmann M; Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands., Camargos BM; Department of Radiology - Densitometry, Rede Materdei de Saúde, Belo Horizonte, Minas Gerais, Brazil., Harvey NC; MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK., Perez AD; Department of Internal Medicine, Hospital del Mar-IMIM, Autonomous University of Barcelona and CIBERFES, Instituto Carlos III, Barcelona, Spain., Radermecker RP; Department of Diabetes, Nutrition and Metabolic Disorders, Clinical Pharmacology, University of Liege, CHU de Liège, Liège, Belgium., Reginster JY; Protein Research Chair, College of Science, King Saud University, Riyadh, Saudi Arabia., Rizzoli R; Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland., Siggelkow H; Department of Trauma, Orthopedics and Reconstructive Surgery, MVZ Endokrinologikum Göttingen, University Medical Center Goettingen, Von-Siebold-Straße 3, Robert-Koch-Straße 40, 37075, Goettingen, Germany., Cortet B; Department of Rheumatology and ULR 44490, University-Hospital of Lille, 59037, Lille Cedex, France., Brandi ML; University Vita-Salute San Raffaele, Milan, Italy.
Jazyk: angličtina
Zdroj: Aging clinical and experimental research [Aging Clin Exp Res] 2024 Aug 09; Vol. 36 (1), pp. 167. Date of Electronic Publication: 2024 Aug 09.
DOI: 10.1007/s40520-024-02826-3
Abstrakt: Bone forming agents, also known as anabolic therapies, are essential in managing osteoporosis, particularly for patients at very high-risk of fractures. Identifying candidates who will benefit the most from these treatments is crucial. For example, this group might include individuals with severe osteoporosis, multiple vertebral fractures, a recent fragility fracture or those unresponsive to antiresorptive treatments. Definitions of patients with a very high fracture risk vary across nations, are often based on fracture history, bone mineral density (BMD), and/or fracture risk calculated by FRAX® or other algorithms. However, for very high-risk patients, anabolic agents such as teriparatide, abaloparatide, or romosozumab are commonly recommended as first-line therapies due to their ability to stimulate new bone formation and improve bone microarchitecture, offering significant benefits in rapid fracture reduction over antiresorptive therapies. The cost-effectiveness of these agents is a critical consideration for decision-makers. Despite their higher costs, their effectiveness in significantly reducing fracture risk and improving quality of life can justify the investment, especially when long-term savings from reduced fracture rates and associated healthcare costs are considered. Additionally, after completing a course of anabolic therapy, transitioning to antiresorptive agents like bisphosphonates or denosumab is crucial to maintain the gains in bone density and minimize subsequent fracture risks. This sequential treatment approach ensures sustained protection and optimal resource utilization. In summary, the effective use of bone forming agents in osteoporosis requires a comprehensive strategy that includes accurate patient identification, consideration of cost-effectiveness, and implementation of appropriate sequential treatments, ultimately maximizing patient outcomes and healthcare efficiency.
(© 2024. The Author(s).)
Databáze: MEDLINE
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