A 24-Month Study Evaluating the Efficacy and Safety of Denosumab for the Treatment of Men With Low Bone Mineral Density: Results From the ADAMO Trial

IntroductionIn 2008, the UK National Osteoporosis Guideline Group (NOGG) produced a guideline on the prevention and treatment of osteoporosis, with an update in 2013. This paper presents a major update of the guideline, the scope of which is to review the assessment and management of osteoporosis and the prevention of fragility fractures in postmenopausal women and men age 50 years or over.MethodsWhere available, systematic reviews, meta-analyses and randomised controlled trials were used to provide the evidence base. Conclusions and recommendations were systematically graded according to the strength of the available evidence.ResultsReview of the evidence and recommendations are provided for the diagnosis of osteoporosis, fracture-risk assessment, lifestyle measures and pharmacological interventions, duration and monitoring of bisphosphonate therapy, glucocorticoid-induced osteoporosis, osteoporosis in men, postfracture care and intervention thresholds.ConclusionThe guideline, which has received accreditation from the National Institute of Health and Care Excellence (NICE), provides a comprehensive overview of the assessment and management of osteoporosis for all healthcare professionals who are involved in its management.

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“…Approval for its use in men with osteoporosis was granted on the basis of a BMD bridging study [88]. …”

Section: Pharmacological Interventionsmentioning

confidence: 99%

UK clinical guideline for the prevention and treatment of osteoporosis

et al. 2017

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“…There have been some studies showing the benefit of Denosumab and Teriparatide on BMD in the male population in general [154–158]. Teriparatide has also been observed to show significant reduction in vertebral fractures in males [159].…”

Section: Treatment Options and Responses In Male Hypogonadal Osteomentioning

confidence: 99%

Male Hypogonadism and Osteoporosis: The Effects, Clinical Consequences, and Treatment of Testosterone Deficiency in Bone Health

Golds

Houdek

Arnason

2017

International Journal of Endocrinology

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It is well recognized that bone loss accelerates in hypogonadal states, with female menopause being the classic example of sex hormones affecting the regulation of bone metabolism. Underrepresented is our knowledge of the clinical and metabolic consequences of overt male hypogonadism, as well as the more subtle age-related decline in testosterone on bone quality. While menopause and estrogen deficiency are well-known risk factors for osteoporosis in women, the effects of age-related testosterone decline in men on bone health are less well known. Much of our knowledge comes from observational studies and retrospective analysis on small groups of men with variable causes of primary or secondary hypogonadism and mild to overt testosterone deficiencies. This review aims to present the current knowledge of the consequences of adult male hypogonadism on bone metabolism. The direct and indirect effects of testosterone on bone cells will be explored as well as the important differences in male osteoporosis and assessment as compared to that in females. The clinical consequence of both primary and secondary hypogonadism, as well as testosterone decline in older males, on bone density and fracture risk in men will be summarized. Finally, the therapeutic options and their efficacy in male osteoporosis and hypogonadism will be discussed.

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“…Исследование было продолжено еще на 12 мес. [24], в течение которых отмечался про-грессивный рост МПК. К концу 2-го года лече-ния отмечен прирост МПК на 8 % в позвоночни-ке и на 3,4 % -в общем показателе бедра и в шейке бедра.…”

Section: деносумабunclassified

Current issues of diagnosis and treatment of osteoporosis in men in general practice

Lesnyak

2017

Rossiĭskiĭ semeĭnyĭ vrach

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Приводится обзор современного состояния проблемы диагностики и лечения остеопороза. У мужчин остеопороз представляет собой серьезную и недооцененную проблему. Каждый пятый мужчина в возрасте старше 50 лет в течение оставшейся жизни перенесет хотя бы один остеопорозный перелом. Ведущими факторами развития остеопороза у мужчин являются генетическая предрасположенность, снижение уровня половых гормонов и болезни, вызывающие вторичный остеопороз, который, по некоторым данным, может занимать до 40 % всех случаев заболевания у мужчин. Причинами вторич-ного остеопороза у мужчин чаще всего являются злоупотребление алкоголем, гиперкортицизм (эндо-генный или, чаще, экзогенный при приеме глюкокортикоидов) и гипогонадизм. Коррекция основного заболевания может привести к повышению минеральной плотности костной ткани (МПК) и, возможно, к снижению риска переломов. Для лечения остеопороза у мужчин зарегистрированы бисфосфонаты (алендронат, ризедронат и золедроновая кислота), деносумаб и терипаратид. Следует также не забывать о важности немедикаментозных методов лечения остеопороза, таких как отказ от вредных привычек, правильное питание и выполнение физических упражнений, направленных на снижение риска падений и переломов.Ключевые слова: остеопороз, мужской пол, диагностика, лечение. CURRENT ISSUES OF DIAGNOSIS AND TREATMENT OF OSTEOPOROSIS IN MEN IN GENERAL PRACTICEO.M. Lesnyak North-Western State Medical University named after I.I. Mechnikov, St Petersburg, Russia; Ural State Medical University, Ekaterinburg, RussiaThe author revises the latest evidence in the literature regarding managing of osteoporosis in men. Osteoporosis is an important under-recognized problem threatening men. Among people over 50 years of age, a fifth of men will suffer a fragility fracture during their remaining lifetime. The leading risk factors of male osteoporosis are genetic predisposition, low sex hormones and secondary osteoporosis. The latter comprises up to 40% of all male osteoporosis cases. The most common causes of secondary osteoporosis in men are alcohol abuse, endogenic and exogenic hypercortisolism and hypogonadism. Treatment of the underlying disease may result in BMD increase and probably fracture risk improvement. Bisphosphonates (alendronate, risedronate and zoledronic acid), denosumab and teriparatide are approved for treatment of male osteoporosis. Non-pharmacological treatment including avoiding smoking and excessive drinking, health lifestyle and a diet rich in bone-healthy nutrients should also be considered.

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A 24-Month Study Evaluating the Efficacy and Safety of Denosumab for the Treatment of Men With Low Bone Mineral Density: Results From the ADAMO Trial

Cited by 115 publications

References 8 publications

UK clinical guideline for the prevention and treatment of osteoporosis

UK clinical guideline for the prevention and treatment of osteoporosis

Male Hypogonadism and Osteoporosis: The Effects, Clinical Consequences, and Treatment of Testosterone Deficiency in Bone Health

Current issues of diagnosis and treatment of osteoporosis in men in general practice

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