Skip to main content

Advertisement

Log in

Osteoporosis: a clinical and pharmacological update

  • Review Article
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Abstract

Osteoporosis is characterized by the loss of bone mass, deterioration of the bone microarchitecture, and an increased risk of fractures; these later complications are associated with significant morbidity and mortality. The asymptomatic and progressive nature of osteoporosis underscores the importance of identifying this entity in early stages. Despite the various treatments available, the prevention of the disease represents the most important aspect of management. An adequate intake of calcium and vitamin D as well as a healthy lifestyle is the basis for maintaining bone health. When osteoporosis is diagnosed, the choice of medications must be individualized considering characteristics of the patient and the risk of fractures. In this article, we review the main causes of osteoporosis, when and how to start treatment, and appropriate therapy and monitoring.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Kanis JA (2007) WHO Technical Report, University of Sheffield, UK, p 66

  2. World Health Organization (1994) Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: report of a WHO study group [meeting held in Rome from 22 to 25 June 1992]

  3. NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy (2001) Osteoporosis prevention, diagnosis, and therapy. JAMA 285(6):785–795

    Article  Google Scholar 

  4. Camacho PM, Petak SM, Brinkley N, Clarke BL, Harris ST, Hurley DL et al (2016) AACE/ACE Guidelines-American Association of Clinical Endocrinologists and American College of endocrinology clinical practice guidelines for diagnosis and treatment of postmenopausal osteoporosis. Endocr Pract 22(4):1–42

    Article  PubMed  Google Scholar 

  5. Ballane G, Cauley JA, Luckey MM, Fuleihan GEH (2014) Secular trends in hip fractures worldwide: opposing trends East versus West. J Bone Miner Res 29(8):1745–1755

    Article  PubMed  Google Scholar 

  6. International Society for Clinical Densitometry (ISCD). Official Positions of the ISCD as updated in 2015. http://www.iscd.org/official-positions/2013-iscd-official-positions-adult/. Updated: August 15, 2013 (accedido el 14 de septiembre del 2018)

  7. Black DM, Rosen CJ (2016) Postmenopausal osteoporosis. N Engl J Med 374(3):254–262

    Article  CAS  PubMed  Google Scholar 

  8. Siris ES, Adler R, Bilezikian J, Bolognese M, Dawson-Hughes B, Favus MJ, Harris ST, Jan de Beur SM, Khosla S, Lane NE, Lindsay R, Nana AD, Orwoll ES, Saag K, Silverman S, Watts NB (2014) The clinical diagnosis of osteoporosis: a position statement from the National Bone Health Alliance Working Group. Osteoporos Int 25(5):1439–1443

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Lewiecki EM (2018) Osteoporosis: clinical evaluation. [Updated 2018 Apr 23] In: De Groot LJ, Chrousos G, Dungan K et al (eds) Endotext. South Dartmouth: MDText.com, Inc. https://www.ncbi.nlm.nih.gov/books/NBK279049/

  10. Sanfélix-Genovés J, Catalá-López F, Sanfélix-Gimeno G, Hurtado I, Baixauli C, Peiró S (2014) Variabilidad en las recomendaciones para el abordaje clínico de la osteoporosis. Med Clin (Barc) 142(1):15–22

    Article  Google Scholar 

  11. Lewiecki EM (2012) To treat or not to treat: reducing fracture risk in postmenopausal women. Female Patient 37:11–16

    Google Scholar 

  12. Compston J, Cooper A, Cooper C, Gittoes N, Gregson C, Harvey N et al (2017) UK clinical guideline for the prevention and treatment of osteoporosis. Arch Osteoporos 12(1):43

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Cosman F, De Beur SJ, LeBoff MS, Lewiecki EM, Tanner B, Randall S et al (2014) Clinician’s guide to prevention and treatment of osteoporosis. Osteoporos Int 25(10):2359–2381

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Compston J, Bowring C, Cooper A, Cooper C, Davies C, Francis R, Kanis JA, Marsh D, McCloskey E, Reid DM, Selby P, National Osteoporosis Guideline Group (2013) Diagnosis and management of osteoporosis in postmenopausal women and older men in the UK: National Osteoporosis Guideline Group (NOGG) update 2013. Maturitas 75(4):392–396

    Article  CAS  PubMed  Google Scholar 

  15. North American Menopause Society (2010) NAMS continuing medical education activity; management of osteoporosis in postmenopausal women: 2010 position statement. Menopause 17(1):23–56

    Article  Google Scholar 

  16. Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Murad MH, Weaver CM, Endocrine Society (2011) Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocr Metab 96(7):1911–1930

    Article  CAS  PubMed  Google Scholar 

  17. Moreira MLM, de Paula FJA (2017) What value is there in assessing postmenopausal women for vitamin D deficiency? Rev Bras Ginecol Obstet 39(11):585–586

    Article  PubMed  Google Scholar 

  18. Dawson-Hughes B, Mithal A, Bonjour JP, Boonen S, Burckhardt P, Fuleihan GH et al (2010) IOF position statement: vitamin D recommendations for older adults. Osteoporos Int 21(7):1151–1154

    Article  CAS  PubMed  Google Scholar 

  19. Del Valle HB, Yaktine AL, Taylor CL, Ross AC (eds) (2011) Dietary reference intakes for calcium and vitamin D. National Academies Press

  20. Rizzoli R (2011) Bisphosphonates for post-menopausal osteoporosis: are they all the same? QJM-Int J Med 104(4):281–300

    Article  CAS  Google Scholar 

  21. Kanis JA, McCloskey EV, Johansson H, Cooper C, Rizzoli R, Reginster JY (2013) European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int 24(1):23–57

    Article  CAS  PubMed  Google Scholar 

  22. Body JJ, Bergmann P, Boonen S, Boutsen Y, Devogelaer JP, Goemaere S, Kaufman JM, Rozenberg S, Reginster JY (2010) Evidence-based guidelines for the pharmacological treatment of postmenopausal osteoporosis: a consensus document by the Belgian Bone Club. Osteoporos Int 21(10):1657–1680

    Article  PubMed  PubMed Central  Google Scholar 

  23. Papaioannou A, Morin S, Cheung AM, Atkinson S, Brown JP, Feldman S (2010) Collab; Scientific Advisory Council of Osteoporosis Canada. 2010 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada: summary. CMAJ 182(17):1864–1873

    Article  PubMed  PubMed Central  Google Scholar 

  24. Silverman S, Christiansen C (2012) Individualizing osteoporosis therapy. Osteoporos Int 23(3):797–809

    Article  CAS  PubMed  Google Scholar 

  25. Cosman F, Miller PD, Williams GC, Hattersley G, Hu MY, Valter I, Fitzpatrick LA, Riis BJ, Christiansen C, Bilezikian JP, Black D (2017) Eighteen months of treatment with subcutaneous abaloparatide followed by 6 months of treatment with alendronate in postmenopausal women with osteoporosis: results of the ACTIVExtend trial. Mayo Clin Proc 92(2):200–210

    Article  CAS  PubMed  Google Scholar 

  26. Miller PD, Hattersley G, Riis BJ, Williams GC, Lau E, Russo LA, Alexandersen P, Zerbini CAF, Hu MY, Harris AG, Fitzpatrick LA, Cosman F, Christiansen C, for the ACTIVE Study Investigators (2016) Effect of abaloparatide vs placebo on new vertebral fractures in postmenopausal women with osteoporosis: a randomized clinical trial. JAMA 316(7):722–733

    Article  CAS  PubMed  Google Scholar 

  27. Saag KG, Wagman RB, Geusens P, Adachi JD, Messina OD, Emkey R, Chapurlat R, Wang A, Pannacciulli N, Lems WF (2018) Denosumab versus risedronate in glucocorticoid-induced osteoporosis: a multicentre, randomised, double-blind, active-controlled, double-dummy, non-inferiority study. Lancet Diabetes Endocrinol 6(6):445–454. https://doi.org/10.1016/S2213-8587(18)30075-5

    Article  CAS  PubMed  Google Scholar 

  28. Mendoza N, Sánchez-Borrego R, Villero J, Baró F, Calaf J, Cancelo MJ, Coronado P, Estévez A, Fernández-Moya JM, González S, Llaneza P, Neyro JL, del Pino J, Rodríguez E, Ruiz E, Cano A, Spanish Menopause Society (2013) 2013 up-date of the consensus statement of the Spanish menopause society on postmenopausal osteoporosis. Maturitas 76(1):99–107

    Article  PubMed  Google Scholar 

  29. McClung MR, Grauer A, Boonen S, Bolognese MA, Brown JP, Diez-Perez A et al (2014) Romosozumab in postmenopausal women with low bone mineral density. N Engl J Med 370(5):412–420

    Article  CAS  PubMed  Google Scholar 

  30. Saag KG, Petersen J, Brandi ML, Karaplis AC, Lorentzon M, Thomas T, Maddox J, Fan M, Meisner PD, Grauer A (2017) Romosozumab or alendronate for fracture prevention in women with osteoporosis. N Engl J Med 377(15):1417–1427

    Article  CAS  PubMed  Google Scholar 

  31. Zerbini CAF, McClung MR (2013) Odanacatib in postmenopausal women with low bone mineral density: a review of current clinical evidence. Ther Adv Musculoskelet Dis 5(4):199–209. https://doi.org/10.1177/1759720X13490860

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Bone HG, McClung MR, Roux C, Recker RR, Eisman JA, Verbruggen N, Hustad CM, DaSilva C, Santora AC, Ince BA (2010) Odanacatib, a cathepsin-K inhibitor for osteoporosis: a two-year study in postmenopausal women with low bone density. J Bone Miner Res 25(5):937–947

    PubMed  Google Scholar 

  33. Eisman JA, Bone HG, Hosking DJ, McClung MR, Reid IR, Rizzoli R et al (2011) Odanacatib in the treatment of postmenopausal women with low bone mineral density: three-year continued therapy and resolution of effect. J Bone Miner Res 26(2):242–251

    Article  CAS  PubMed  Google Scholar 

  34. Cosman F, Nieves JW, Dempster DW (2017) Treatment sequence matters: anabolic and antiresorptive therapy for osteoporosis. J Bone Miner Res 32(2):198–202

    Article  CAS  PubMed  Google Scholar 

  35. Tsai JN, Uihlein AV, Lee H, Kumbhani R, Siwila-Sackman E, McKay EA et al (2013) Teriparatide and denosumab, alone or combined, in women with postmenopausal osteoporosis: the DATA study randomised trial. Lancet 382(9886):50–56

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Nakamura Y, Suzuki T, Kamimura M, Ikegami S, Murakami K, Uchiyama S, Taguchi A, Kato H (2017) Two-year clinical outcome of denosumab treatment alone and in combination with teriparatide in Japanese treatment-naive postmenopausal osteoporotic women. Bone Res 5:16055

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Tsai JN, Uihlein AV, Burnett-Bowie SAM, Neer RM, Zhu Y, Derrico N, Lee H, Bouxsein ML, Leder BZ (2015) Comparative effects of teriparatide, denosumab, and combination therapy on peripheral compartmental bone density, microarchitecture, and estimated strength: the DATA-HRpQCT study. J Bone Miner Res 30(1):39–45

    Article  CAS  PubMed  Google Scholar 

  38. Leder BZ, Tsai JN, Uihlein AV, Wallace PM, Lee H, Neer RM, Burnett-Bowie SAM (2015) Denosumab and teriparatide transitions in postmenopausal osteoporosis (the DATA-Switch study): extension of a randomised controlled trial. Lancet 386(9999):1147–1155

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Tsai JN, Uihlein AV, Burnett-Bowie SM, Neer RM, Derrico NP, Lee H, Bouxsein ML, Leder BZ (2016) Effects of two years of teriparatide, denosumab, or both on bone microarchitecture and strength (DATA-HRpQCT study). J Clin Endocr Metab 101(5):2023–2030

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Wade SW, Strader C, Fitzpatrick LA, Anthony MS, O’Malley CD (2014) Estimating prevalence of osteoporosis: examples from industrialized countries. Arch Osteoporos 9(1):182

    Article  CAS  PubMed  Google Scholar 

  41. Giusti A, Bianchi G (2015) Treatment of primary osteoporosis in men. Clin Interv Aging 10:105

    CAS  PubMed  Google Scholar 

  42. Bliuc D, Nguyen ND, Milch VE, Nguyen TV, Eisman JA, Center JR (2009) Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women. JAMA 301:513–521

    Article  CAS  PubMed  Google Scholar 

  43. Cawthon PM (2011) Gender differences in osteoporosis and fractures. Clin Orthop Relat Res 469(7):1900–1905

    Article  PubMed  PubMed Central  Google Scholar 

  44. Bonjour JP, Chevalley T, Ferrari S, Rizzoli R (2009) The importance and relevance of peak bone mass in the prevalence of osteoporosis. Salud Publica Mex 51(Suppl 1):S5–S17

    PubMed  Google Scholar 

  45. Peris P, Martinez-Ferrer A, Monegal A, Martinez de Osaba MJ, Alvarez L, Ros I et al (2008) Aetiology and clinical characteristics of male osteoporosis. Have they changed in the last few years? Clin Exp Rheumatol 26(4):582–588

    CAS  PubMed  Google Scholar 

  46. Kanis JA, Johansson H, Johnell O, Oden A, De Laet C, Eisman JA et al (2005) Alcohol intake as a risk factor for fracture. Osteoporos Int 16:737–742

    Article  PubMed  Google Scholar 

  47. Zhang X, Yu Z, Yu M, Qu X (2015) Alcohol consumption and hip fracture risk. Osteoporos Int 26(2):531–542

    Article  CAS  PubMed  Google Scholar 

  48. Kanis JA, Johnell O, Odén A, Johansson H, De Laet C, Eisman JA et al (2005) Smoking and fracture risk: a meta-analysis. Osteoporos Int 16(2):155–162

    Article  CAS  PubMed  Google Scholar 

  49. Adler RA (2014) Osteoporosis in men: a review. Bone Res 2:14001

    Article  PubMed  PubMed Central  Google Scholar 

  50. Ebeling PR (2014) Osteoporosis in men: why change needs to happen. International Osteoporosis Foundation

  51. Orwoll ES, Miller PD, Adachi JD, Brown J, Adler RA, Kendler D, Bucci-Rechtweg C, Readie A, Mesenbrink P, Weinstein RS (2010) Efficacy and safety of a once-yearly i.v. infusion of zoledronic acid 5 mg versus a once-weekly 70-mg oral alendronate in the treatment of male osteoporosis: a randomized, multicenter, double-blind, active-controlled study. Journal of bone and mineral research. J Bone Miner Res 25:2239–2250

    Article  CAS  PubMed  Google Scholar 

  52. Orwoll E, Ettinger M, Weiss S, Miller P, Kendler D, Graham J, Adami S, Weber K, Lorenc R, Pietschmann P, Vandormael K, Lombardi A (2000) Alendronate for the treatment of osteoporosis in men. New Engl J Med 343:604–610

    Article  CAS  PubMed  Google Scholar 

  53. Willson T, Nelson SD, Newbold J, Nelson RE, LaFleur J (2015) The clinical epidemiology of male osteoporosis: a review of the recent literature. J Clin Epidemiol 7:65

    Google Scholar 

  54. McDonough AK, Curtis JR, Saag KG (2008) The epidemiology of glucocorticoid-associated adverse events. Curr Opin Rheumatol 20(2):131–137

    Article  PubMed  Google Scholar 

  55. Buckley L, Guyatt G, Fink HA, Cannon M, Grossman J, Hansen KE, Humphrey MB, Lane NE, Magrey M, Miller M, Morrison L, Rao M, Byun Robinson A, Saha S, Wolver S, Bannuru RR, Vaysbrot E, Osani M, Turgunbaev M, Miller AS, McAlindon T (2017) 2017 American College of Rheumatology Guideline for the prevention and treatment of glucocorticoid-induced osteoporosis. Arthritis Care Res 69(8):1095–1110

    Article  Google Scholar 

  56. Rossini M, Viapiana O, Vitiello M, Malavolta N, La Montagna G, Bongi SM et al (2017) Prevalence and incidence of osteoporotic fractures in patients on long-term glucocorticoid treatment for rheumatic diseases: the Glucocorticoid Induced OsTeoporosis TOol (GIOTTO) study. Reumatismo 69(1):30–39

    Article  CAS  PubMed  Google Scholar 

  57. Mitra R (2011) Adverse effects of corticosteroids on bone metabolism: a review. PM R 3(5):466–471

    Article  PubMed  Google Scholar 

  58. Lekamwasam S, Adachi JD, Agnusdei D, Bilezikian J, Boonen S, Borgström F et al (2012) A framework for the development of guidelines for the management of glucocorticoid-induced osteoporosis. Osteoporos Int 23(9):2257–2276

    Article  CAS  PubMed  Google Scholar 

  59. Van Staa TP, Leufkens HGM, Abenhaim L, Zhang B, Cooper C (2000) Oral corticosteroids and fracture risk: relationship to daily and cumulative doses. Rheumatology 39(12):1383–1389

    Article  PubMed  Google Scholar 

  60. Geusens P, Goemaere S, Pannacciulli N, Lane NE, Lespessailles E, Messina OD, Chapurlat R, Yin X, Wagman R, van den Bergh JPW (2018) Effect of denosumab versus risedronate on cortical and trabecular bone microarchitecture by high resolution peripheral quantitative computed tomography (HR-pQCT) in glucocorticoid-treated individuals. FRI-0906 Friday, September 28, 2018-ASBMR 2018 Annual Meeting, Montreal

  61. Vasikaran S, Eastell R, Bruyère O, Foldes AJ, Garnero P, Griesmacher A et al (2011) Markers of bone turnover for the prediction of fracture risk and monitoring of osteoporosis treatment: a need for international reference standards. Osteoporos Int 22(2):391–420

    Article  CAS  PubMed  Google Scholar 

  62. Romero Barco CM, Manrique Arija S, Rodríguez Pérez M (2012) Marcadores bioquímicos en osteoporosis. Utilidad en la práctica clínica. Reumatol Clin 8(3):149–152

    PubMed  Google Scholar 

  63. Diez-Perez A, Naylor KE, Abrahamsen B, Agnusdei D, Brandi ML, Cooper C et al (2017) International osteoporosis foundation and european calcified tissue society working group. Recommendations for the screening of adherence to oral bisphosphonates. Osteoporos Int 28(3):767–774

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  64. Carey JJ (2005) What is a ‘failure’ of bisphosphonate therapy for osteoporosis? Cleve Clin J Med 72(11):1033–1039

    Article  PubMed  Google Scholar 

  65. Diez-Perez A, Adachi JD, Agnusdei D, Bilezikian JP, Compston JE, Cummings SR et al (2012) Treatment failure in osteoporosis. Osteoporos Int 23(12):2769–2774

    Article  CAS  PubMed  Google Scholar 

  66. Gehlbach S, Saag KG, Adachi JD, Hooven FH, Flahive J, Boonen S, Chapurlat RD, Compston JE, Cooper C, Díez-Perez A, Greenspan SL, LaCroix AZ, Netelenbos JC, Pfeilschifter J, Rossini M, Roux C, Sambrook PN, Silverman S, Siris ES, Watts NB, Lindsay R (2012) Previous fractures at multiple sites increase the risk for subsequent fractures: the global longitudinal study of osteoporosis in women. J Bone Miner Res 27(3):645–653

    Article  PubMed  Google Scholar 

  67. Díez-Pérez A, Olmos JM, Nogués X, Sosa M, Díaz-Curiel M, Pérez-Castrillón JL, Pérez-Cano R, Muñoz-Torres M, Torrijos A, Jodar E, del Rio L, Caeiro-Rey JR, Farrerons J, Vila J, Arnaud C, González-Macías J (2012) Risk factors for prediction of inadequate response to antiresorptives. J Bone Moner Res 27(4):817–824

    Article  CAS  Google Scholar 

  68. Pasco JA, Seeman E, Henry MJ, Merriman EN, Nicholson GC, Kotowicz MA (2006) The population burden of fractures originates in women with osteopenia, not osteoporosis. Osteoporos Int 17(9):1404–1409

    Article  CAS  PubMed  Google Scholar 

  69. Vondracek SF, Minne P, McDermott MT (2008) Clinical challenges in the management of osteoporosis. Clin Interv Aging 3(2):315–329

    Article  PubMed  PubMed Central  Google Scholar 

  70. Hochberg MC, Greenspan S, Wasnich RD, Miller P, Thompson DE, Ross PD (2002) Changes in bone density and turnover explain the reductions in incidence of nonvertebral fractures that occur during treatment with antiresorptive agents. J Clin Endocr Metab 87(4):1586–1592

    Article  CAS  PubMed  Google Scholar 

  71. Hlaing TT, Compston JE (2014) Biochemical markers of bone turnover–uses and limitations. Ann Clin Biochem 51(2):189–202

    Article  PubMed  Google Scholar 

  72. Chapurlat RD, Palermo L, Ramsay P, Cummings SR (2005) Risk of fracture among women who lose bone density during treatment with alendronate. The fracture intervention trial. Osteoporos Int 16(7):842–848

    Article  CAS  PubMed  Google Scholar 

  73. Caro JJ, Ishak KJ, Huybrechts KF, Raggio G, Naujoks C (2004) The impact of compliance with osteoporosis therapy on fracture rates in actual practice. Osteoporos Int 15(12):1003–1008

    Article  PubMed  Google Scholar 

  74. Siris E, Rosen CJ, Harris ST, Abbott TA, Barr CE, Silverman S (2005, April) Adherence to bisphosphonate therapy: relationship to bone fractures at 24 months in women with postmenopausal osteoporosis. In National Osteoporosis Foundation 6th International Symposium on Osteoporosis, pp 6–9

  75. McCombs JS, Thiebaud P, McLaughlin-Miley C, Shi J (2004) Compliance with drug therapies for the treatment and prevention of osteoporosis. Maturitas 48:271–287

    Article  CAS  PubMed  Google Scholar 

  76. Becker CB (2016) Osteoporosis: managing patients who fracture on osteoporosis treatment. Meet-the-professor: endocrine case management. https://doi.org/10.1210/MTP5.9781943550043.ch14

  77. Boonen S, Ferrari S, Miller PD, Eriksen EF, Sambrook PN, Compston J, Reid IR, Vanderschueren D, Cosman F (2012) Postmenopausal osteoporosis treatment with antiresorptives: effects of discontinuation or long-term continuation on bone turnover and fracture risk—a perspective. J Bone Miner Res 27(5):963–974

    Article  CAS  PubMed  Google Scholar 

  78. Eriksen EF, Díez-Pérez A, Boonen S (2014) Update on long-term treatment with bisphosphonates for postmenopausal osteoporosis: a systematic review. Bone 58:126–135

    Article  CAS  PubMed  Google Scholar 

  79. Yoneda T, Hagino H, Sugimoto T, Ohta H, Takahashi S, Soen S et al (2017) Anti-resorptive agent-related osteonecrosis of the jaw: Position Paper 2017 of the Japanese Allied Committee on Osteonecrosis of the Jaw. J Bone Miner Metab 35(1):6–19. https://doi.org/10.1007/s00774-016-0810-7

    Article  CAS  PubMed  Google Scholar 

  80. Svejda B, Muschitz C, Gruber R, Brandtner C, Svejda C, Gasser RW, Santler G, Dimai HP (2016) Position paper on medication-related osteonecrosis of the jaw (MRONJ). Wien Med Wochenschr 166(1–2):68–74

    Article  CAS  PubMed  Google Scholar 

  81. Khan AA, Morrison A, Hanley DA, Felsenberg D, McCauley LK (2015) Diagnosis and management of osteonecrosis of the jaw: a systematic review and international consensus. J Bone Min Res 30:3–23

    Article  Google Scholar 

  82. Adler RA, Fuleihan G, Bauer DC, Camacho PM, Clarke BL et al (2016) Managing osteoporosis in patients on long-term bisphosphonate treatment: report of a task force of the American Society for Bone and Mineral Research. J Bone Miner Res 31:16–35

    Article  CAS  PubMed  Google Scholar 

  83. Dell RM, Adams AL, Greene DF, Funahashi TD, Silverman SL, Eisemon EO et al (2012) Incidence of atypical nontraumatic diaphyseal fractures of the femur. J Bone Min Res 27:2544–2550

    Article  Google Scholar 

  84. Shane E, Burr D, Abrahamsen B, Adler RA, Brown TD, Cheung AM, Cosman F, Curtis JR, Dell R, Dempster DW, Ebeling PR, Einhorn TA, Genant HK, Geusens P, Klaushofer K, Lane JM, McKiernan F, McKinney R, Ng A, Nieves J, O'Keefe R, Papapoulos S, Howe TS, van der Meulen MCH, Weinstein RS, Whyte MP (2014) Atypical subtrochanteric and diaphyseal femoral fractures: second report of a task force of the American Society for Bone and Mineral Research. J Bone Miner Res 29(1):1–23

    Article  PubMed  Google Scholar 

  85. Nguyen HH, van de Laarschot DM, Verkerk A, Milat F, Zillikens MC, Ebeling PR (2018) Genetic risk factors for atypical femoral fractures (AFFs): a systematic review. JBMR Plus 2:1–11

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  86. Xu XL, Gou WL, Wang AY, Wang Y, Guo QY, Lu Q, Lu SB, Peng J (2013) Basic research and clinical applications of bisphosphonates in bone disease: what have we learned over the last 40 years? J Transl Med 11(1):303

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  87. Compston JE, Bilezikian JP (2012) Bisphosphonate therapy for osteoporosis: the long and short of it. J Bone Miner Res 27(2):240–242

    Article  PubMed  Google Scholar 

  88. Curtis JR, Chen R, Li Z, Arora T, Saag KG, Wright NC et al (2018) The impact of the duration of bisphosphonate drug holidays on hip fracture rates. Ann Rheum Dis 77:58

    Article  CAS  Google Scholar 

  89. Anagnostis P, Paschou S, Mintziori G, Lambrinoudaki I, Goulis D (2017) Efficacy and safety of bisphosphonate discontinuation in postmenopausal osteoporosis: a systematic review. Endocr Abstr. https://doi.org/10.1530/endoabs.49.EP214

  90. Anagnostis P, Paschou SA, Mintziori G, Ceausu I, Depypere H et al (2017) Drug holidays from bisphosphonates and denosumab in postmenopausal osteoporosis: EMAS position statement. Maturitas 10:23–30

    Article  CAS  Google Scholar 

  91. Ott SM (2011) What is the optimal duration of bisphosphonate therapy? Cleve Clin J Med 78(9):619–630

    Article  PubMed  Google Scholar 

  92. Briot K, Trémollières F, Thomas T, Roux C (2007) How long should patients take medications for postmenopausal osteoporosis? Joint Bone Spine 74(1):24–31

    Article  PubMed  Google Scholar 

  93. Black DM, Bauer DC, Schwartz AV, Cummings SR, Rosen CJ (2012) Continuing bisphosphonate treatment for osteoporosis—for whom and for how long? N Engl J Med 366(22):2051–2053

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  94. Leder BZ, Tsai JN, Jiang LA, Lee H (2017) Importance of prompt antiresorptive therapy in postmenopausal women discontinuing teriparatide or denosumab: the Denosumab and Teriparatide Follow-up study (DATA-Follow-up). Bone 98:54–58

    Article  CAS  PubMed  Google Scholar 

  95. Tsourdi E, Langdahl B, Cohen-Solal M, Aubry-Rozier B, Eriksen EF (2017) Discontinuation of denosumab therapy for osteoporosis: a systematic review and position statement by ECTS. Bone 105:11–17

    Article  PubMed  Google Scholar 

  96. Anastasilakis AD, Polyzos SA, Makras P, Aubry-Rozier B, Kaouri S, Lamy O (2017) Clinical features of 24 patients with rebound-associated vertebral fractures after denosumab discontinuation: systematic review and additional cases. J Bone Miner Res 32:1291–1296

    Article  CAS  PubMed  Google Scholar 

  97. Gonzalez Rodriguez E, Delphine St, Aubry-Rozier B, Olivier L (2018) Thirty-one men and women with 145 spontaneous vertebral fractures after denosumab discontinuation: a single center observational study. In 20th European Congress of Endocrinology. Endocrine Abstracts. https://doi.org/10.1530/endoabs.56.GP59

  98. Albergaria BH, Chalem M, Clark P, Messina OD, Pereira RMR, Vidal LF (2018) Consensus statement: osteoporosis prevention and treatment in Latin America—current structure and future directions. Arch Osteoporos 13(1):90

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Maritza Vidal.

Ethics declarations

Disclosures

None.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Vidal, M., Thibodaux, R.J., Neira, L.F.V. et al. Osteoporosis: a clinical and pharmacological update. Clin Rheumatol 38, 385–395 (2019). https://doi.org/10.1007/s10067-018-4370-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-018-4370-1

Keywords

Navigation