Recommendations for the optimal use of bone forming agents in osteoporosis
Veronese, Nicola (University of Palermo)
Briot, Karine (Cochin Hospital (París, França))
Guañabens, Nuria (Universitat de Barcelona)
Albergaria, Ben Hur (Federal University of Espirito Santo (Vitória, Brasil))
Alokail, Majed (King Saud University)
Al-Daghri, Nasser (King Saud University (Riyadh, Regne de l'Aràbia Saudita))
Bemden, Angie Botto-van (Musculoskeletal Research International (Miamim, Estats Units d'Amèrica))
Bruyère, Olivier (Université de Liège)
Burlet, Nansa (Université de Liège)
Cooper, Cyrus (University of Southampton)
Curtis, Elizabeth M. (University of Southampton)
Ebeling, Peter R. (Monash University)
Halbout, Philippe (International Osteoporosis Foundation (Ginebra, Suïssa))
Hesse, Eric (Musculoskeletal University Center Munich)
Hiligsmann, Mickaël (Maastricht University)
Camargos, Bruno Muzzi (Rede Materdei de Saúde (Minas Gerais, Brasil))
Harvey, Nicholas C. (University of Southampton)
Perez, Adolfo Diez (Hospital del Mar (Barcelona, Catalunya))
Radermecker, Régis Pierre (Université de Liège)
Reginster, Jean-Yves (King Saud University (Riyadh, Arabia Saudí))
Rizzoli, René (Geneva University Hospitals)
Siggelkow, Heide (University Medical Center Goettingen)
Cortet, Bernard (University-Hospital of Lille)
Brandi, Maria Luisa (University Vita-Salute San Raffaele (Milà, Itàlia))

Date:	2024
Abstract:	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.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Osteoporosis ; Anabolic treatment ; Teriparatide ; Abaloparatide ; Romosozumab ; Fragility fracture risk
Published in:	Aging Clinical and Experimental Research, Vol. 36 (august 2024) , ISSN 1720-8319

DOI: 10.1007/s40520-024-02826-3
PMID: 39120740

12 p, 494.6 KB

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