Italian association of clinical endocrinologists (AME) position statement: drug therapy of osteoporosis

Abstract

Treatment of osteoporosis is aimed to prevent fragility fractures and to stabilize or increase bone mineral density. Several drugs with different efficacy and safety profiles are available. The long-term therapeutic strategy should be planned, and the initial treatment should be selected according to the individual site-specific fracture risk and the need to give the maximal protection when the fracture risk is highest (i.e. in the late life). The present consensus focused on the strategies for the treatment of postmenopausal osteoporosis taking into consideration all the drugs available for this purpose. A short revision of the literature about treatment of secondary osteoporosis due both to androgen deprivation therapy for prostate cancer and to aromatase inhibitors for breast cancer was also performed. Also premenopausal females and males with osteoporosis are frequently seen in endocrine settings. Finally particular attention was paid to the tailoring of treatment as well as to its duration.Electronic supplementary materialThe online version of this article (doi:10.1007/s40618-016-0434-8) contains supplementary material, which is available to authorized users.

Linc02349 promotes osteogenesis of human umbilical cord‐derived stem cells by acting as a competing endogenous RNA for miR‐25‐3p and miR‐33b‐5p

“…However, drug treatment of osteoporosis is not ideal. Although it can delay the progress of osteoporosis, it cannot make up for the lost bone mass 28 . Using stem cell self‐renewal and differentiation ability to treat osteoporosis may be the most potential way of bone repair, which is expected to solve the medical problems of bone regeneration and repair 29 .…”

MANAGEMENT OF ENDOCRINE DISEASE: Atypical femoral fractures: risks and benefits of long-term treatment of osteoporosis with anti-resorptive therapy

“…The NOGG Guideline [31] agrees in general with the approach of the ASBMR task force on management up to 10 years. The Italian Association of Clinical Endocrinologists generally concurs as well [32].…”

Pharmacological Management of Osteoporosis in Postmenopausal Women: The Current State of the Art

“…31,32 LSX has been approved in Europe for the treatment of postmenopausal osteoporosis after a 5-year placebo-controlled randomized clinical trial (RCT) showed its efficacy in decreasing the risk of both new vertebral and nonvertebral fractures (but not hip fractures). 33 Similar to HRT, SERMs can increase the risk of venous thromboembolism (primarily deep vein thromboses), but, differently from HRT, due to their antagonist activity on the breast, SERMs may decrease the risk of breast cancer. 28 This was shown to be true particularly for RLX, which in the United States is also approved for the prevention of breast cancer.…”

“…28,34 No effect on endometrial proliferation is reported with RLX and BZA, whereas an increase of endometrial thickness, although without a real clinical significance, is associated with LSX. 33 In our opinion, SERMs are preferable to HRT due to their better safety profile in the long-term and can be considered a viable second-line treatment for patients AEs related to oral BPs, particularly for women under 65 years of age at risk for vertebral fractures and at some risk for breast cancer.…”