Osteoporozda Güncel Tedavi

Düşük kemik mineral yoğunluğu ve kemik dokunun mikro yapısında bozulma ile karakterize, kemik frajilitesinde ve kırık riskinde artışa neden olan sistemik bir hastalık olarak tanımlanan osteoporoz dünyada ve ülkemizde önemli bir sağlık sorunu haline gelmiştir. Özellikle postmenopozal kadınlarda olmak üzere milyonlarca insanı etkilemektedir. Yol açtığı kırıklarla yaşam kalitesini düşürmekte, ekonomik ve sosyal yükün yanı sıra morbidite ve mortaliteyi de artırmaktadır. Ortalama yaşam süresinin artması kronik hastalıklarla beraber osteoporoz görülme sıklığını da arttırmaktadır. osteoporozun tanısı ve tedavi prensipleri gözden geçirilmiş ve son kılavuzlar ışığında osteoporoza güncel bir yaklaşım ele alınmaya çalışılmıştır

Current Treatments For Osteoporosis

Osteoporosis is a progressive bone disease that is characterized by decrease in bone mass and density, distortion of bone microstructure and increased fracture risk. It affects millions of people mainly post-menopausal women and has high socio-economic burden. Osteoporosis decreases quality of life, increase mortality and morbidty. Here we will focus on the recent guidelines of osteoporosis and summarize the therapeutic options

___

Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group. World Health Organ Tech Rep Ser 1994;843:1-129.

David W. Dempster DW. Osteoporosis and the Burden of Osteoporosis-Related Fractures. Am J Manag Care. 2011;17:164-9.

Osteoporosis: assessing the risk of fragility fracture guidance. nice. org.uk/cg146. 2012;2-24.

Burge R, Dawson-Hughes B, Solomon DH, Wong JB, King AB, Tosteson A. Incidence and economic burden of osteoporosis-related fractures in the United States, 2005-2025. J Bone Min Res. 2007;22:465-75.

Tuzun S, Eskiyurt N, Akarirmak U, Saridogan M, Senocak M, Johansson H, et al. Incidence of hip fracture and prevalence of osteoporosis in Turkey: the FRACTURK study. Osteoporos Int.2012;23:949-55.

Sambrook P, Cooper C. Osteoporosis. The Lancet. 2006;367:2010-18.

Irish Osteoporosis Society, Osteoporosis Guidelines 2 for Health Professionals, downloaded from www.irishosteoporosis.ie on 21st March 2013.

Lindsay R, Silverman SL, Cooper C, Hanley DA, Barton I, Broy SB, et al.Risk of new vertebral fracture in the year following a fracture. JAMA. 2001;285:320-3.

Kanis JA, on behalf of the World Health Organisation Scientific Group. Assessment of osteoporosis at the primary health care level. WHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield 2007.

Papaioannou A, Morin S, Cheung AM, Atkinson S, Brown JP, Feldman S,et al. 2010 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada: summary. CMAJ. 2010;182:1864-73.

Fitzpatrick LA.Secondary causes of osteoporosis.Mayo Clinic Proc.2002;77:453-68.

Krieg MA, Barkmann R, Gonnelli S, Stewart A, Bauer DC, Del Rio Barquero L, et al.Quantitative ultrasound in the management of osteoporosis: the 2007 ISCD Official Positions. J of Clin Densitom.2008;11:163-87.

Njeh CF, Fuerst T, Hans D, Blake GM, Genant HK. Radiation exposure in bone mineral density assessment. Appl Radiat Isot.1999;50:215-36.

Hoch AZ, Pajewski NM, Moraski LA, Carrera GF, Wilson CR, Raymond G. Hoffmann RG. Prevalence of the Female Athlete Triad in High School Athletes and Sedentary Students. Clin J Sport Med.2009;19:421–28.

Dionyssiotis Y. Management of osteoporotic vertebral fractures. Int J Gen Med. 2010;3:167-71.

Rossouw JE, Anderson GL, Prentice RL, LaCroix AZ, Kooperberg C, Stefanick ML, et al. 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.

Ettinger B, Black DM, Dawson-Hughes B, Pressman AR, Melton LJ 3rd. Updated fracture incidence rates for the US version of FRAX. Osteoporos Int. 2010;21:25-33.

Peacock M.Calcium Metabolism in Health and Disease. Clin J Am Soc Nephrol.2010;5:23–30.

European Food Safety Authority (EFSA). Scientific Opinion on the Tolerable Upper Intake Level of calcium. EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA).Palme,Italy. EFSA Journal. 2012;10:2814.

Aisenbrey JA. Exercise in the Prevention and Management of Osteoporosis. Phys Ther. 1987;67:1100-04.

Dontas IA, Yiannakopoulos CK. Risk factors and prevention of osteoporosis-related fractures. J Musculoskelet Neuronal Interact. 2007;7:268-72.

Gillespie WJ, Gillespie LD, Parker MJ. Hip protectors for preventing hip fractures in older people. Cochrane Database Syst Rev. 2010;10:CD001255.

Moyer VA. U.S. Preventive Services Task Force.Vitamin D and calcium supplementation to prevent fractures in adults: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2013;158:691-6.

Kulie T, Groff A, Redmer J, Hounshell J, Schrager S. Vitamin D: An Evidence-Based Review. J Am Board Fam Med. 2009;22:698-706.

Kennel AK, Drake MT. Adverse Effects Of Bisphosphonates:Implications For Osteoporosis Management. Mayo Clin Proc. 2009;84:632-38.

Cummings SR, Black DM, Thompson DE, Applegate WB,Barret- Connor E,Musliner TA, et al. Effect of alendronate on risk of fracture in women with low bone density but without vertebral fractures: results from the Fracture Intervention Trial. JAMA. 1998;280:2077–82.

Black DM, Schwartz AV, Ensrud KE, Cauley JA, Levis S, Quandt SA,et al.FLEX Research Group. Effects of continuing or stopping alendronate after 5 years of treatment: the Fracture Intervention Trial Long-term Extension (FLEX):a randomized trial. JAMA. 2006;296:2927-38.

Prinsloo PJJ, Hosking DJ. Alendronate Sodium in the Management of Osteoporosis. Ther Clin Risk Manag. 2006;2:235–49.

Reginster JY, Hiligsmann M, Rabenda V, Zegels B, Neuprez A, Bruyere O. Ibandronate in the Management of Postmenopausal Osteoporosis. Clinical Medicine: Therapeutics 2009;1:1409–21.

Borgström F, Carlsson A, Sintonen H, Boonen S, Haentjens P, Burge R,et al.The cost-effectiveness of risedronate in the treatment of osteoporosis: an international perspective. Osteoporos Int. 2006;17:996-1007

Carbonare LD, Zanatta M, Gasparetto A, Valenti MT. Safety and tolerability of zoledronic acid and other bisphosphonates in osteoporosis management. Drug Healthcare and Patient Saf. 2010;2:121–37.

Miller PD: Bisphophonates: Pharmacology and use in the treatment of osteoporosis; In: Marcus R, Feldman D, Nelson DA, Rosen CJ editors. Osteoporosis 3. Ed vol 2 ch 74. Elsevier American Pres, San Diego USA; 2008. p. 1725-41.

Ott SM. What is the optimal duration of bisphosphonate therapy? Cleveland Clinic Journal of Medicine. 2011;78:619-30.

Gedmintas L, Solomon DH, Kim SC. Bisphosphonates and Risk of Subtrochanteric, Femoral Shaft, and Atypical Femur Fracture: A Systematic Review and Metaanalysis. J Bone Miner Res. 2013;28:1729–37.

Chesnut CH 3rd, Silverman S, Andriano K, Genant H, Gimona A, Harris S, Kiel D,et al.A randomized trial of nasal spray salmon calcitonin in postmenopausal women with established osteoporosis: the prevent recurrence of osteoporotic fractures study.PROOF Study Group. Am J Med 2000;109;267-76.

Sun LM, Lin MC, Muo CH, Liang JA, Kao CH.Calcitonin Nasal Spray and Increased Cancer Risk: A Population-Based Nested Case-Control Study. J Clin Endocrinol Metab JCEM. (Early pres) Accepted August 14, 2014. doi: 10.1210/jc.2014-39

Rossouw JE, Anderson GL, Prentice RL, LaCroix AZ, Kooperberg C, Stefanick ML,et al; 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.

Muchmore DB.Raloxifene: A Selective Estrogen Receptor Modulator (SERM) with Multiple Target System Effects. The Oncologist. 2000;5:388-92.

Cusano NE, Costa AG, Silva BC, Bilezikian JP.Therapy of Osteoporosis in Men with Teriparatide. Journal of Osteoporosis. 2011;20011:1-7.

Cummings SR, San Martin J, McClung MR, Siris ES, Eastell R, Reid IR, et al. Denosumab for prevention of fractures in postmenopausal women with osteoporosis. N Engl J Med. 2009;361:756-65.

Paller CJ, Carducci MA, Philips GK. Management of bone metastases in refractory prostate cancer – role of denosumab. Clin Interv Aging. 2012;7:363–72.

Hurtel-Lemaire AS, Mentaverri R, Caudrillier A, Cournarie F, Wattel A, Kamel S, et al. The calcium-sensing receptor is involved in strontium ranelate-induced osteoclast apoptosis. New insights into the associated signaling pathways. J Biol Chem. 2009;284:575-84.