Zárate A, Basurto L, Hernández M, Saucedo R

Language: Spanish
References: 29
Page: 210-216
PDF size: 130.17 Kb.

ABSTRACT

It is now generally accepted that the primary goal of osteoporosis management is to prevent fractures, which is accomplished by stopping bone loss and improving bone strength. Elderly postmenopausal women show a high prevalence of osteoporosis which in turn increases the risk of fracture. Men suffer of osteoporosis when either cortisone therapy is used or long periods of immobility. Antiresorptive drugs and bone anabolic are the two types for pharmacologic treatment; calcium and vitamin D should be considered adjuvant therapy for all individuals. Choice of treatment depends of age, the presence of fractures, and the degree of bone mineral density measured at the spine and hip. The main inconvenient for the adherence of treatment is the high cost of the medicaments as well as the poor information given to the patients. Probably one of the single most important factor for administering therapy for a condition that is largely asymptomatic is the patients compliance with the regimen that has been selected.

REFERENCES

1. Kanis J. Diagnosis of osteoporosis and assessment of fracture risk. Lancet 2002;359:1929-36.

2. Seeman E, Delmas PD. Bone quality–the material and structural basis of bone strength and fragility. N Engl J Med 2006;354:2250-60.

3. McGarry KA, Kiel DP. Postmenopausal osteoporosis: strategies for preventing bone loss, avoiding fracture. Postgraduate Med 2000;108:79-91.

4. Kanis JA, Gluer CC. An update on the diagnosis and assessment of osteoporosis with densitometry. Osteoporos Int 2000;11:192-202.

5. Basurto L, Saucedo R, Zárate A. Marcadores bioquímicos de remodelación ósea. Rev Med IMSS 2002;40:193-6.

6. McClung MR, Lewiecki EM, Cohen SB, Bolognese MA, et al. Denosumab in postmenopausal women with low bone mineral density. N Engl J Med 2006;354:821-31.

7. 7 Frost HM. Emerging views about “osteoporosis” bone health strength fragility, and their determinants. J Bone Miner Metab 2002;20:319-25.

8. 8 Zárate A, MacGregor C, Basurto L. Fundamento del manejo de la osteoporosis en la menopausia para evitar el consumismo diagnóstico y terapéutico. Gac Med Mex 1999;135:535-9.

9. 9 Gold DT, Silverman S. Review of adherence to medications for the treatment of osteoporosis. Curr Osteoporos Rep 2006;4:21-27.

10. 10 Torgerson DJ, Bell-Syer SE. Hormone replacement therapy and prevention of nonvertebral fractures: a meta-analysis of randomized trials. JAMA 2002;285:2891-7.

11. Writing Group for the Women’s Health Initiative Investigators. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative Randomized Controlled Trial. JAMA 2002;288:321-33.

12. Riggs BL, Hartmann LC. Selective estrogen-receptor modulators. Mechanisms of action and application to clinical practice. N Eng J Med 2003;348:618-29.

13. Prestwood KM, Gunness M, Muchmore DB, Lu Y, et al. A comparison of the effects of raloxifene and estrogen on bone in postmenopausal women. J Clin Endocrinol Metab 2000;85:2197-202.

14. Speroff L, Clarkson TB. Is tibolone a viable alternative to hormone therapy? Contemporary Ob Gyn 2003;48:54-68.

15. Modelska K, Cummings S. Tibolone for postmenopausal women: systematic review of randomized trials. J Clin Endocrinol Metab 2002;87:16-23.

16. Black DM, Cummings SR, Karpf DB. Randomized trial of effect of alendronate on risk of fracture in women with existing vertebral fractures. Lancet 1996;348:1535-41.

17. Dunn CJ, Goa KL. Risedronate: a review of its pharmacological properties and clinical use in resorptive bone disease. Drugs 2001;61:685-712.

18. Prince RL, Devine A, Dhaliwal SS, Dick IM. Effects of calcium supplementation on clinical fracture and boen structure: results of a 5-year, double-blind, placebo-controlled trial in elderly women. Arch Intern Med 2006;166:869-75.

19. Chapuy MC, Arlot ME, Delmas PD, Meunier PU. Effect of calcium and cholecalciferol treatment for three years on hip fractures in elderly women. BMJ 1994;308:108l-82.

20. Chesnut CH, Silverman S, Andriano K, Genant H, et al. A randomized trial of nasal spray salmon calcitonin in postmenopausal women with established osteoporosis: the prevent recurrence of osteoporotic fractures study. Am J Med 2000;109:267-76.

21. LaCroix AZ, Cauley JA, Pettinger M, Hsia J, et al. Statin use,clinical fracture, and bone density in postmenopausal women: results from the Women’s Health Initiative Observational Study. Ann Intern Med 2003;139:97-101.

22. Jadhay SB, Jain GK. Osteoporosis: the new role for old drugs. J Pharm Pharmacol 2006;58:3-18.

23. Jiang Y, Zhao JJ, Mitlak BH, Wang O, et al. Recombinant human parathyroid hormone (1-34) [teriparatide] improves both cortical and cancellous bone structure. J Bone Miner Res 2003;18:1932-41.

24. Marcus R, Wong M, Stock JL. Antiresorptive treatment of postmenopausal osteoporosis: comparison of study designs and outcomes in large clinical trials with fracture as an endpoint. Endocrine Rev 2002;23:16-37.

25. Meunier PJ, Roux C, Seeman E, Ortolani S, et al. The effects of strontium ranelate on the risk of vertebral fracture in women with postmenopausal osteoporosis. N Engl J Med 2004;350:459-68.

26. Meunier PJ, Slosman DO, Delmas PD, Sebert JL, et al. Strontium ranelate: dose-dependent effects in stablished postmenopausal vertebral osteoporosis, a 2-year randomized placebo controlled trial. J Clin Endocrinol Metab 2002;87:2060-66.

27. Saucedo R, Fonseca ME, Basurto L, Ochoa R, et al. Decremento de los andrógenos circulantes en el hombre durante la senescencia. Gac Med Mex 2000;136:335-9.

28. Vanderschueren D, Vandenput L, Boonen S, Lindberg MK, et al. Androgens and bone. Endocrine Rev 2004;25:389-425.

29. Amin S, Zhang Y, Felson DT, Sawin CT, et al. Estradiol, testosterone, and the risk for hip fractures in elderly men from the Framingham Study. Am J Med 2006;119:426-33.