Current Osteoporosis Reports

, Volume 10, Issue 1, pp 56–63

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

Current Therapeutics (SL Silverman, Section Editor)


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.


Bone turnover markers Bone markers Bone resorption Bone formation Least significant change Monitoring osteoporosis therapy Monitoring fracture prevention therapy 

Clinical Trial Acronyms


Fracture Intervention Trial


Health Outcomes and Reduced Incidence with Zoledronic Acid Once Yearly


Improving Measurements of Persistence on Actonel Treatment


Monthly Oral Ibandronate in Ladies


Multiple Outcomes of Raloxifene Evaluation


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Park Nicollet Health Services, Division of Health Policy and ManagementUniversity of MinnesotaMinneapolisUSA
  2. 2.Departments of Medicine and Epidemiology & BiostatisticsUniversity of CaliforniaSan FranciscoUSA

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