The effect of antiresorptives on bone quality.
Background: Currently, antiresorptive therapy in the treatment and prevention of osteoporosis includes bisphosphonates, estrogen replacement, selective estrogen receptor modulators (raloxifene), and denosumab (a human antibody that inactivates RANKL). The original paradigm driving the development of...
| Publicado en: | Clinical Orthopaedics & Related Research® Vol. 469; no. 8; pp. 2207 - 2215 |
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| Autores principales: | , , , |
| Formato: | research review Journal Article |
| Publicado: |
Lippincott Williams & Wilkins
Aug2011
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104652793&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104652793 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 0009921X 23N jtl: Clinical Orthopaedics & Related Research® issn: 0009921X maglogo: N pubinfo: dt: Aug2011 vid: 469 iid: 8 pid: 433 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 104652793 104652793 NLM21562893 2011193565 10.1007/s11999-011-1909-8 NLM21562893 PMC3126968 104652793 ppf: 2207 ppct: 8 formats: tig: atl: The effect of antiresorptives on bone quality. aug: au: Recker RR Armas L Recker, Robert R Armas, Laura affil: Osteoporosis Research Center, Creighton University, 601 N 30th Street #5766, Omaha, NE 68131, USA sug: subj: Diphosphonates Pharmacodynamics Bone and Bones Drug Effects Antibodies, Monoclonal Drug Effects Antibodies, Monoclonal Pharmacodynamics Diphosphonates Therapeutic Use Bone Remodeling Physiology Bone and Bones Physiology Membrane Proteins Drug Effects Membrane Proteins Pharmacodynamics Selective Estrogen Receptor Modulators Pharmacodynamics Selective Estrogen Receptor Modulators Therapeutic Use ab: Background: Currently, antiresorptive therapy in the treatment and prevention of osteoporosis includes bisphosphonates, estrogen replacement, selective estrogen receptor modulators (raloxifene), and denosumab (a human antibody that inactivates RANKL). The original paradigm driving the development of antiresorptive therapy was that inhibition of bone resorption would allow bone formation to continue and correct the defect. However, it is now clear increases in bone density account for little of the antifracture effect of these treatments.Questions/purposes: We examined the antifracture benefit of antiresorptives deriving from bone quality changes.Methods: We searched the archive of nearly 30,000 articles accumulated over more than 40 years in our research center library using a software program (Refman™). Approximately 250 publications were identified in locating the 69 cited here.Results: The findings document antiresorptive agents are not primarily anabolic. All cause a modest increase in bone density due to a reduction in the bone remodeling space; however, the majority of their efficacy is due to suppression of the primary cause of osteoporosis, ie, excessive bone remodeling not driven by mechanical need. All of them improve some element(s) of bone quality.Conclusions: Antiresorptive therapy reduces risk of fracture by improving bone quality through halting removal of bone tissue and the resultant destruction of microarchitecture of bone and, perhaps to some extent, by improving the intrinsic material properties of bone tissue. Information presented here may help clinicians to improve selection of patients for antiresorptive therapy by avoiding them in cases clearly not due to excessive bone remodeling. pubtype: Academic Journal doctype: research review Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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