A model to monitor the efficacy of alendronate treatment in women with osteoporosis using a biochemical marker of bone turnover

Garnero, Patrick; Darte, Claude; Delmas, Pierre D.

doi:10.1016/s8756-3282(99)00087-3

Cited by 74 publications

(43 citation statements)

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“…60 Garnero and Delmas found that both the B-ALP level and the percentage change from baseline at 6 months of alendronate treatment correlated with the increase in bone density 2 years after treatment. 63 They have suggested a model using both these parameters of B-ALP, whereby nonresponders can be identi®ed with 90% speci®city and 72% sensitivity. 63 Osteocalcin is often suggested to be a good marker of bone formation, especially in steroidinduced osteoporosis.…”

Section: ±37mentioning

confidence: 99%

“…63 They have suggested a model using both these parameters of B-ALP, whereby nonresponders can be identi®ed with 90% speci®city and 72% sensitivity. 63 Osteocalcin is often suggested to be a good marker of bone formation, especially in steroidinduced osteoporosis. However, steroids directly downregulate osteocalcin gene expression, and it is unclear how this confounds the utility of serum osteocalcin in this context.…”

Section: ±37mentioning

confidence: 99%

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Bisphosphonates: an overview with special reference to alendronate

Vasikaran¹

2001

Ann Clin Biochem

108

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Bisphosphonates, analogues of pyrophosphate, are potent inhibitors of osteoclast-mediated bone resorption. They are used in the treatment of Paget's disease of bone, hypercalcaemia and osteolytic bone disease of malignancy, primary and secondary hyperparathyroidism,and in osteoporosis. Bisphosphonate treatment causes an early reduction in bone resorption followed by a later reduction in bone formation. The early inhibition of bone resorption induces a reduction in serum calcium which leads to increased parathyroid hormone (PTH), and subsequently an increase in 1,25-dihydroxyvitamin D. The secondary hyperparathyroidism of bisphosphonate treatment also leads to urinary calcium conservation and phosphaturia, and a reduction in serum phosphate. The increase in the PTH following bisphosphonate therapy is a response to the change in serum calcium and can occur even when there is hypercalcaemia, and this can cause confusion in the interpretation of PTH results. The hypocalcaemic response to bisphosphonates is occasionally severe, especially in patients with hypoparathyroidism. The recent elucidation of bisphosphonate action at the cellular level on the mevalonate pathway has led to interest in its effects on lipoprotein metabolism, which may prove to be of clinical signi®cance. Newer and more potent bisphosphonates are currently undergoing clinical trials in malignant bone disease and osteoporosis, and will lead to further advances in the optimal management of these conditions.

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Section: ±37mentioning

confidence: 99%

Section: ±37mentioning

confidence: 99%

Bisphosphonates: an overview with special reference to alendronate

Vasikaran¹

2001

Ann Clin Biochem

108

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“…(2) Biomarkers of bone turnover predict fractures and changes in bone mineral density in adults, and can be used to monitor the effectiveness of therapy. (3,4) Skeletal modeling during growth and development results in new bone formation at a different location than the site of resorption, with alteration in bone shape and net bone accrual. In children, biomarkers of bone metabolism represent the aggregate effects of endochondral bone formation, longitudinal growth, and increases in bone circumference and thickness, as well as bone remodeling.…”

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confidence: 99%

Interpretation of Biomarkers of Bone Metabolism in Children: Impact of Growth Velocity and Body Size in Healthy Children and Chronic Disease

Tuchman

Thayu

Shults

et al. 2008

The Journal of Pediatrics

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Objectives-To determine the effects of growth, maturation, and whole body bone mineral content (WB-BMC) accrual on biomarkers of bone formation [bone specific alkaline phosphatase (BSAP)] and resorption [urine deoxypyridinoline/creatinine (DPD)] in healthy children and children with Crohn's disease.Study design-BSAP and DPD were measured at baseline, and growth and dual energy x-ray absorptiometry (DXA) WB-BMC were measured at baseline and six months in 202 controls and 110 subjects with Crohn's disease, ages 5 to 21 years. Multivariable linear regression identified determinants of biomarkers in controls and subjects with Crohn's disease.Results-In controls, BSAP and DPD were significantly and independently associated with sex, Tanner stage, WB-BMC, height velocity, and WB-BMC accrual rates; these covariates explained 77-80% of the variability in bone biomarkers. Subjects with Crohn's disease had lower height-forage (p < 0.001) and WB-BMC-for-height (p < 0.05), compared with controls. Crohn's disease was associated with lower BSAP (p < 0.001) and greater DPD (p < 0.001), independent of growth, maturation, baseline WB-BMC, and WB-BMC accrual, compared with controls.Conclusions-These data illustrate the potential confounding effects of growth and WB-BMC on bone metabolism biomarkers in children. After adjustment for these effects, Crohn's disease was associated with lower biomarkers of bone formation and greater bone resorption. KeywordsCrohn's disease; height velocity; bone-specific alkaline phosphatase; urine deoxypyridinoline; dual energy x-ray absorptiometry; bone mineral content Corresponding/Reprint request author: Shamir Tuchman MD, MPH, Division of Pediatric Nephrology, Department of Pediatrics, The Children' s Hospital of Philadelphia, 34 th and Civic Center Blvd., Philadelphia, PA 19104, pH: (215) 590-2449, fax: (215) 590-3705, email: E-mail: tuchman@email.chop.edu. Edited by TW and WFB Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.The authors declare no conflicts of interest. Serum levels of biomarkers of bone formation were significantly reduced in children with newly diagnosed Crohn's disease, and biomarkers of bone resorption were variably reduced in comparison with controls; thus, bone remodeling may be suppressed in incident Crohn's disease due to a primary impairment in bone formation. (9) The accompanying editorial suggested that these findings support the use of anabolic agents as opposed to anti-resorptive agents in childhood Crohn's disease.(10) However, low overall bone mass (i.e. reduced numbers of osteoblasts and osteoclasts) and reduced ...

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“…CTX is a sensitive indicator of restrained bone resorption. When the CTX is measured, it more quickly reacts to BPs than other indicators of bone metabolism 31 . Normal value is 304±40 pg/ mL for males in the 50-70 year-old range, and 394±46 pg/ mL for males older than 70.…”

Section: Sei-kyoung Kim Et Al: Clinical Investigation Of Bisphosphonamentioning

confidence: 99%

Clinical investigation of bisphosphonate-related osteonecrosis of the jaws in patients with malignant tumors

Kim

Kwon

2012

J Korean Assoc Oral Maxillofac Surg

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(J Korean Assoc Oral Maxillofac Surg 2012;38:152-9) Objectives: This study evaluated bisphosphonate-related osteonecrosis of the jaws (BRONJ) in patients diagnosed with malignant bone tumors. Demographic findings, laboratory, and radiographic analyses were performed to characterize disease severity and progression. Materials and Methods: Patients who had been diagnosed with BRONJ (2005BRONJ ( -2010 at the authors' hospital according to the American Association of Oral and Maxillofacial Surgeons were investigated. Twenty-one patients (12 with multiple myelomas, 7 with breast cancer, and 2 with prostate cancer) who had been treated with bisphosphonates (BPs) for malignant bone tumors were included. Radiographic evaluations with a panorama, computed tomography, whole body bone scan, and laboratory findings were evaluated for erythrocyte sedimentation rate (ESR), c-reactive proteins (CRPs), and c-terminal cross-linked telopeptides (CTXs). Results: The average age of the patients was 64.3 (range 51-80), and they were treated with BPs for an average of 35±19 months before BRONJ was diagnosed. Types of BPs were zolendronic acid (81%, intravenous [IV]), pamidronate (4.8%, IV), zoledronic acid+pamidronate (4.8%, IV), alendronate (4.8%, per os [PO]), and ibadronate (4.75%, PO). Extraction (67%) and persistent irritation of dentures (20%) were the most common triggering factors. BRONJ in the mandible was reported in 62% of the cases, in the maxilla 24%, and both 14%. BRONJ occurred more frequently in patients with multiple myelomas (n=12, 57.1%). Most of the patients revealed an advanced BRONJ stage; Stage I (n=2, 9%), Stage II (n=13, 62%), and Stage III (n=6, 29%). Conclusion: The differences of the ESR, CRP, and CTX values between the BRONJ-recurring and non-recurring patients after the treatment were not evident. Later stage BRONJ patients showed lower CTX levels. A drug holiday after the diagnosis of BRONJ did not remarkably influence the surgical outcomes. However, the limited number of patients in the study should be considered.Key words: Bisphosphonates, Jaw, Necrosis, Malignant tumors [paper submitted 2012. 3. 29 / revised 2012. 5. 4 / accepted 2012. 5. 8] BPs is divided into the 1st generation (alkyl or halide side group), the 2nd generation (amino-terminal group) and the 3rd generation (imidazol ring group). The 3rd generation BPs is 100,000 times more effective than the 1st generation and 100 times more effective than the 2nd generation. If a patient with malignant tumor has a focus of bone metastasis, generally the 2nd generation pamidronate or the 3rd generation zoledronate is injected intravenously 3,4 . BPs is deposited on the surface of bone where bone generation is processed actively to restrain growth of osteoclast and prevent its function. Also, it prevents adhesion of osteoclast into the place of bone resorption and decreases generation of cytokine that facilitates bone resorption 5 , prevents invasion of tumor cells into bone matrix, leads to tumor cell death 5 and suppress growth factor...

show abstract

A model to monitor the efficacy of alendronate treatment in women with osteoporosis using a biochemical marker of bone turnover

Cited by 74 publications

References 13 publications

Bisphosphonates: an overview with special reference to alendronate

Bisphosphonates: an overview with special reference to alendronate

Interpretation of Biomarkers of Bone Metabolism in Children: Impact of Growth Velocity and Body Size in Healthy Children and Chronic Disease

Clinical investigation of bisphosphonate-related osteonecrosis of the jaws in patients with malignant tumors

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