Current Osteoporosis Reports

, Volume 10, Issue 1, pp 56–63

Clinical Use of Bone Turnover Markers to Monitor Pharmacologic Fracture Prevention Therapy

Authors

    • Park Nicollet Health Services, Division of Health Policy and ManagementUniversity of Minnesota
  • Douglas C. Bauer
    • Departments of Medicine and Epidemiology & BiostatisticsUniversity of California
Current Therapeutics (SL Silverman, Section Editor)

DOI: 10.1007/s11914-011-0091-y

Cite this article as:
Schousboe, J.T. & Bauer, D.C. Curr Osteoporos Rep (2012) 10: 56. doi:10.1007/s11914-011-0091-y

Abstract

Monitoring of drug therapies to prevent fractures is controversial. Measurement of bone turnover markers has the potential to identify those with a suboptimal response to fracture prevention medication within a few months of its commencement. However, given the imprecision of currently commercially available assays of bone turnover markers, many individual persons who are “suboptimal medication responders” are likely to be misclassified as “adequate responders” or vice versa, depending on the cut point chosen to define suboptimal and adequate response. Before bone turnover markers can be recommended for routine use in clinical practice to monitor fracture prevention therapies, three advances are needed: 1) bone marker assays with better precision; 2) research establishing optimal cut points of bone marker levels to distinguish “suboptimal responders” from “adequate responders”; and 3) research establishing the incremental fracture reduction benefit from clinical interventions for “suboptimal responders” identified from bone marker measurements.

Keywords

Bone turnover markersBone markersBone resorptionBone formationLeast significant changeMonitoring osteoporosis therapyMonitoring fracture prevention therapy

Clinical Trial Acronyms

FIT

Fracture Intervention Trial

HORIZON

Health Outcomes and Reduced Incidence with Zoledronic Acid Once Yearly

IMPACT

Improving Measurements of Persistence on Actonel Treatment

MOBILE

Monthly Oral Ibandronate in Ladies

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Copyright information

© Springer Science+Business Media, LLC 2012