Understanding and Communicating the Benefits and Risks of Denosumab, Raloxifene, and Teriparatide for the Treatment of Osteoporosis
| Autor: | Douglas C. Bauer, Michael R. McClung, Paul D. Miller, Larry Dian, David A. Hanley, K. Shawn Davison, E. Michael Lewiecki, Chui K. Yuen, S. T. Harris, David L. Kendler |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
medicine.medical_specialty
Endocrinology Diabetes and Metabolism Osteoporosis Antibodies Monoclonal Humanized Risk Assessment Patient Education as Topic Teriparatide Humans Medicine Radiology Nuclear Medicine and imaging Orthopedics and Sports Medicine Raloxifene Intensive care medicine Adverse effect Stroke Osteoporosis Postmenopausal Physician-Patient Relations Bone Density Conservation Agents business.industry Number needed to harm medicine.disease Surgery Denosumab Raloxifene Hydrochloride Number needed to treat Female business Osteoporotic Fractures medicine.drug |
| Zdroj: | Journal of Clinical Densitometry. 17:490-495 |
| ISSN: | 1094-6950 |
| Popis: | The number needed to treat is a valuable metric to determine the benefit of therapy, but it must be viewed against the respective number needed to harm. Denosumab and teriparatide (TPTD) have proven antifracture efficacy at vertebral and nonvertebral sites, whereas raloxifene has proven antifracture efficacy at the spine only. Denosumab use has been associated with a small, yet statistically significant, increased incidence of eczema and serious cellulitis. Raloxifene use has been associated with statistically significant increases in the risk of venous thromboembolism and possibly deadly stroke, although not an increase in total strokes. No significant, nontransient adverse events have been reported with TPTD use. When used for the treatment of postmenopausal osteoporosis, denosumab, raloxifene, and TPTD all generally have favorable risk-to-benefit profiles, but therapy-specific contraindications necessitate thoughtful consideration of all available clinical information and individualization of treatment decisions. |
| Databáze: | OpenAIRE |
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