CC BY-NC-ND 4.0 · Joints 2018; 06(02): 122-127
DOI: 10.1055/s-0038-1660790
DOI: 10.1055/s-0038-1660790
Review Article
Osteoporosis: Current Concepts
Further Information
Publication History
03 September 2017
02 May 2018
Publication Date:
14 June 2018 (online)
Abstract
Osteoporosis is a worldwide disease characterized by reduction of bone mass and alteration of bone architecture resulting in increased bone fragility and increased fracture risk. Causes of osteoporosis include increasing age, female sex, postmenopausal status, hypogonadism or premature ovarian failure, low body mass index, ethnic background, rheumatoid arthritis, low bone mineral density (BMD), vitamin D deficiency, low calcium intake, hyperkyphosis, current smoking, alcohol abuse, immobilization, and long-term use of certain medications. The diagnosis of osteoporosis is established by measurement of BMD of the hip and spine using dual energy X-ray absorptiometry. According to the World Health Organization criteria, osteoporosis is defined as a BMD that lies 2.5 standard deviation or more below the average value for young healthy women. Bone turnover biomarker detection may be useful in monitoring osteoporosis treatment and assessing fracture risk but not for diagnosis of osteoporosis. Management of osteoporosis consists of nonpharmacological interventions, which are recommended for all subjects, and pharmacological therapy in all postmenopausal women who have had an osteoporotic fracture or have BMD values consistent with osteoporosis.
References
- 1 Dunnewind T, Dvortsin EP, Smeets HM. , et al. Economic consequences and potentially preventable costs related to osteoporosis in the Netherlands. Value Health 2017; 20 (06) 762-768
- 2 Ensrud KE, Crandall CJ. Osteoporosis. Ann Intern Med 2017; 167 (03) ITC17-ITC32
- 3 Fukumoto S, Matsumoto T. Recent advances in the management of osteoporosis. F1000 Res 2017; 6: 625
- 4 Qaseem A, Forciea MA, McLean RM, Denberg TD. ; Clinical Guidelines Committee of the American College of Physicians. Treatment of low bone density or osteoporosis to prevent fractures in men and women: a clinical practice guideline update from the American College of Physicians. Ann Intern Med 2017; 166 (11) 818-839
- 5 Kuo TR, Chen CH. Bone biomarker for the clinical assessment of osteoporosis: recent developments and future perspectives. Biomark Res 2017; 5: 18
- 6 Hernlund E, Svedbom A, Ivergård M. , et al. Osteoporosis in the European Union: medical management, epidemiology and economic burden. A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos 2013; 8: 136
- 7 Minisola S, Cipriani C, Occhiuto M, Pepe J. New anabolic therapies for osteoporosis. Intern Emerg Med 2017; 12 (07) 915-921
- 8 O'Neill TW, Roy DK. How many people develop fractures with what outcome?. Best Pract Res Clin Rheumatol 2005; 19 (06) 879-895
- 9 Lorentzon M, Cummings SR. Osteoporosis: the evolution of a diagnosis. J Intern Med 2015; 277 (06) 650-661
- 10 Cosman F, de Beur SJ, LeBoff MS. , et al; National Osteoporosis Foundation. Clinician's guide to prevention and treatment of osteoporosis. Osteoporos Int 2014; 25 (10) 2359-2381
- 11 Rossini M, Adami S, Bertoldo F. , et al. Guidelines for the diagnosis, prevention and management of osteoporosis. Reumatismo 2016; 68 (01) 1-39
- 12 Management of osteoporosis in postmenopausal women: 2010 position statement of The North American Menopause Society. Menopause 2010; 17 (01) 25-54 , quiz 55–56
- 13 Ramírez J, Nieto-González JC, Curbelo Rodríguez R, Castañeda S, Carmona L. Prevalence and risk factors for osteoporosis and fractures in axial spondyloarthritis: a systematic review and meta-analysis. Semin Arthritis Rheum 2017; pii: S0049-0172(17)30649-2
- 14 Tawaratsumida H, Setoguchi T, Arishima Y. , et al. Risk factors for bone loss in patients with rheumatoid arthritis treated with biologic disease-modifying anti-rheumatic drugs. BMC Res Notes 2017; 10 (01) 765
- 15 U.S. Preventive Services Task Force. Screening for osteoporosis: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 2011; 154 (05) 356-364
- 16 Gourlay ML, Fine JP, Preisser JS. , et al; Study of Osteoporotic Fractures Research Group. Bone-density testing interval and transition to osteoporosis in older women. N Engl J Med 2012; 366 (03) 225-233
- 17 Vasikaran SD. Utility of biochemical markers of bone turnover and bone mineral density in management of osteoporosis. Crit Rev Clin Lab Sci 2008; 45 (02) 221-258
- 18 Kyd PA, Vooght KD, Kerkhoff F, Thomas E, Fairney A. Clinical usefulness of bone alkaline phosphatase in osteoporosis. Ann Clin Biochem 1998; 35 (Pt 6): 717-725
- 19 Kučukalić-Selimović E, Valjevac A, Hadžović-Džuvo A. The utility of procollagen type 1 N-terminal propeptide for the bone status assessment in postmenopausal women. Bosn J Basic Med Sci 2013; 13 (04) 259-265
- 20 Nenonen A, Cheng S, Ivaska KK. , et al. Serum TRACP 5b is a useful marker for monitoring alendronate treatment: comparison with other markers of bone turnover. J Bone Miner Res 2005; 20 (10) 1804-1812
- 21 Lee J, Vasikaran S. Current recommendations for laboratory testing and use of bone turnover markers in management of osteoporosis. Ann Lab Med 2012; 32 (02) 105-112
- 22 Kanis JA, Burlet N, Cooper C. , et al; European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int 2008; 19 (04) 399-428
- 23 Vasikaran S, Eastell R, Bruyère O. , et al; IOF-IFCC Bone Marker Standards Working Group. Markers of bone turnover for the prediction of fracture risk and monitoring of osteoporosis treatment: a need for international reference standards. Osteoporos Int 2011; 22 (02) 391-420
- 24 O'Neill S, MacLennan A, Bass S. , et al; Osteoporosis Australia Medical Scientific Committee. Guidelines for the management of postmenopausal osteoporosis for GPs. Aust Fam Physician 2004; 33 (11) 910-919
- 25 Kim SY, Zhang M, Bockman R. Bone mineral density response from teriparatide in patients with osteoporosis. HSS J 2017; 13 (02) 171-177
- 26 Kanis JA, McCloskey EV, Johansson H, Cooper C, Rizzoli R, Reginster JY. ; Scientific Advisory Board of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) and the Committee of Scientific Advisors of the International Osteoporosis Foundation (IOF). European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int 2013; 24 (01) 23-57
- 27 Feldstein AC, Black D, Perrin N. , et al. Incidence and demography of femur fractures with and without atypical features. J Bone Miner Res 2012; 27 (05) 977-986
- 28 Reid IR, Cornish J. Epidemiology and pathogenesis of osteonecrosis of the jaw. Nat Rev Rheumatol 2011; 8 (02) 90-96
- 29 Park-Wyllie LY, Mamdani MM, Juurlink DN. , et al. Bisphosphonate use and the risk of subtrochanteric or femoral shaft fractures in older women. JAMA 2011; 305 (08) 783-789
- 30 Galis B, Zajko J, Hirjak D. , et al. Is the prevalence of the medication-related osteonecrosis of the jaws underestimated, evaluation in oncological and non-oncological disease. Bratisl Lek Listy (Tlacene Vyd) 2017; 118 (12) 724-731
- 31 Dubois EA, Rissmann R, Cohen AF. Denosumab. Br J Clin Pharmacol 2011; 71 (06) 804-806
- 32 Tsourdi E, Langdahl B, Cohen-Solal M. , et al. Discontinuation of denosumab therapy for osteoporosis: a systematic review and position statement by ECTS. Bone 2017; 105: 11-17
- 33 Pilmane M, Salma-Ancane K, Loca D, Locs J, Berzina-Cimdina L. Strontium and strontium ranelate: historical review of some of their functions. Mater Sci Eng C 2017; 78: 1222-1230
- 34 Tabatabaei-Malazy O, Salari P, Khashayar P, Larijani B. New horizons in treatment of osteoporosis. Daru 2017; 25 (01) 2
- 35 Komm BS, Morgenstern D, , A Yamamoto L, Jenkins SN. The safety and tolerability profile of therapies for the prevention and treatment of osteoporosis in postmenopausal women. Expert Rev Clin Pharmacol 2015; 8 (06) 769-784
- 36 Muschitz C, Kocijan R, Fahrleitner-Pammer A, Lung S, Resch H. Antiresorptives overlapping ongoing teriparatide treatment result in additional increases in bone mineral density. J Bone Miner Res 2013; 28 (01) 196-205
- 37 Cosman F, Crittenden DB, Adachi JD. , et al. Romosozumab treatment in postmenopausal women with osteoporosis. N Engl J Med 2016; 375 (16) 1532-1543
- 38 Leder BZ, Tsai JN, Uihlein AV. , et al. Two years of denosumab and teriparatide administration in postmenopausal women with osteoporosis (The DATA Extension Study): a randomized controlled trial. J Clin Endocrinol Metab 2014; 99 (05) 1694-1700
- 39 Compston J. The use of combination therapy in the treatment of postmenopausal osteoporosis. Endocrine 2012; 41 (01) 11-18
- 40 Cosman F, Wermers RA, Recknor C. , et al. Effects of teriparatide in postmenopausal women with osteoporosis on prior alendronate or raloxifene: differences between stopping and continuing the antiresorptive agent. J Clin Endocrinol Metab 2009; 94 (10) 3772-3780
- 41 Finkelstein JS, Wyland JJ, Lee H, Neer RM. Effects of teriparatide, alendronate, or both in women with postmenopausal osteoporosis. J Clin Endocrinol Metab 2010; 95 (04) 1838-1845