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New approaches to pharmacological treatment of osteoporosis.

Åkesson, Kristina LU (2003) In Bulletin of the World Health Organization 81(9). p.657-664
Abstract
Osteoporosis has been recognized as a major public health problem for less than two decades. The increasing incidence

of fragility fractures, such as vertebral, hip, and wrist fractures, first became apparent from epidemiological studies in the early and

mid-1980s, when effective treatment was virtually unavailable. Pharmacological therapies that effectively reduce the number of

fractures by improving bone mass are now available widely in countries around the world. Most current agents inhibit bone loss

by reducing bone resorption, but emerging therapies may increase bone mass by directly promoting bone formation — as is the

case with parathyroid hormone. Current treatment alternatives include... (More)
Osteoporosis has been recognized as a major public health problem for less than two decades. The increasing incidence

of fragility fractures, such as vertebral, hip, and wrist fractures, first became apparent from epidemiological studies in the early and

mid-1980s, when effective treatment was virtually unavailable. Pharmacological therapies that effectively reduce the number of

fractures by improving bone mass are now available widely in countries around the world. Most current agents inhibit bone loss

by reducing bone resorption, but emerging therapies may increase bone mass by directly promoting bone formation — as is the

case with parathyroid hormone. Current treatment alternatives include bisphosphonates, calcitonin, and selective estrogen receptor

modulators, but sufficient calcium and vitamin D are a prerequisite. The availability of evidence-based data that show reductions

in the incidence of fractures of 30–50% during treatment has been a major step forward in the pharmacological prevention

of fractures. With all agents, fracture reduction is most pronounced for vertebral fracture in high-risk individuals; alendronate and

risedronate also may protect against hip fracture in the elderly. New approaches to pharmacological treatment will include further

development of existing drugs, especially with regard to tolerance and frequency of dosing. New avenues for targeting the condition

will emerge as our knowledge of the regulatory mechanisms of bone remodelling increases, although issues of tissue specificity

may be difficult to solve. In the long term, information gained through knowledge of bone genetics may be used to adapt

pharmacological treatments more precisely to each individual. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Fractures: etiology, Female, Diphosphonates: therapeutic use, Calcium, Risk Factors, Vitamin D: therapeutic use, Bone and Bones: metabolism, Calcitonin: therapeutic use, Dietary: therapeutic use, Postmenopausal: drug therapy, Osteoporosis, Postmenopausal: complications, Human
in
Bulletin of the World Health Organization
volume
81
issue
9
pages
657 - 664
publisher
World Health Organization
external identifiers
  • pmid:14710507
  • wos:000185876300007
  • scopus:0141989663
ISSN
0042-9686
language
English
LU publication?
yes
id
f9b19b53-59bb-49f0-a3ff-225fdc8cb26c (old id 120273)
alternative location
http://www.who.int/bulletin/volumes/81/9/Akesson0903.pdf
date added to LUP
2007-07-09 16:17:50
date last changed
2018-02-18 03:40:03
@article{f9b19b53-59bb-49f0-a3ff-225fdc8cb26c,
  abstract     = {Osteoporosis has been recognized as a major public health problem for less than two decades. The increasing incidence<br/><br>
of fragility fractures, such as vertebral, hip, and wrist fractures, first became apparent from epidemiological studies in the early and<br/><br>
mid-1980s, when effective treatment was virtually unavailable. Pharmacological therapies that effectively reduce the number of<br/><br>
fractures by improving bone mass are now available widely in countries around the world. Most current agents inhibit bone loss<br/><br>
by reducing bone resorption, but emerging therapies may increase bone mass by directly promoting bone formation — as is the<br/><br>
case with parathyroid hormone. Current treatment alternatives include bisphosphonates, calcitonin, and selective estrogen receptor<br/><br>
modulators, but sufficient calcium and vitamin D are a prerequisite. The availability of evidence-based data that show reductions<br/><br>
in the incidence of fractures of 30–50% during treatment has been a major step forward in the pharmacological prevention<br/><br>
of fractures. With all agents, fracture reduction is most pronounced for vertebral fracture in high-risk individuals; alendronate and<br/><br>
risedronate also may protect against hip fracture in the elderly. New approaches to pharmacological treatment will include further<br/><br>
development of existing drugs, especially with regard to tolerance and frequency of dosing. New avenues for targeting the condition<br/><br>
will emerge as our knowledge of the regulatory mechanisms of bone remodelling increases, although issues of tissue specificity<br/><br>
may be difficult to solve. In the long term, information gained through knowledge of bone genetics may be used to adapt<br/><br>
pharmacological treatments more precisely to each individual.},
  author       = {Åkesson, Kristina},
  issn         = {0042-9686},
  keyword      = {Fractures: etiology,Female,Diphosphonates: therapeutic use,Calcium,Risk Factors,Vitamin D: therapeutic use,Bone and Bones: metabolism,Calcitonin: therapeutic use,Dietary: therapeutic use,Postmenopausal: drug therapy,Osteoporosis,Postmenopausal: complications,Human},
  language     = {eng},
  number       = {9},
  pages        = {657--664},
  publisher    = {World Health Organization},
  series       = {Bulletin of the World Health Organization},
  title        = {New approaches to pharmacological treatment of osteoporosis.},
  volume       = {81},
  year         = {2003},
}