Introduction:
The National Osteoporosis Foundation1 (NOF) claim approximately 54 million Americans live with osteoporosis. According to the NOF, osteoporosis can be characterized as a disorder in which an individual’s body breaks down bone at a rate faster than it can be created and as a result bones lose density and weaken.1 Fracturing of bones occurs much easier, and individuals with osteoporosis often are forced to change their lifestyles in order to adapt to living with this disorder.1 Osteoporosis is most commonly diagnosed in individuals older than 50 years of age, postmenopausal women, and those taking steroid treatments.1 Certain criterion exist to evaluate the efficacy of osteoporosis medications: bone mineral density (BMD), bone
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Although evidence has provided that HRT increases BMD and reduces the incidence of fracture, this treatment has also been associated with additional serious side effects.7,8 Higher rates of breast cancer, heart disease, and stroke have been observed in postmenopausal women who use HRT.7,8 Therefore, because a vast majority of osteoporotic patients are postmenopausal women, HRT is not a viable treatment for most individuals with osteoporosis because the risk of serious adverse effects outweighs the benefits. SERM medications were developed to replace HRTs and have shown some limited success since they were created.6,8 Although SERM medications increased BMD, decreased BMT, and reduced the rate of vertebral fracture, they do not satisfy all the criterion.9 To be an efficacious osteoporosis medication a reduction in non-vertebral fractures should be observed; however, in the studies analyzed, no significant reduction of non-vertebral fracture rate was documented with the use of SERMs.9, Also in a study by Kendler et al,9 the use of a SERMs was associated with significantly (p24 months persistence compared to 12 months persistence. The study demonstrated the use of bisphosphonates does not …show more content…
The most important of these criteria is increasing BMD and decreasing fracture rates. Increasing BMD is crucial as a BMD within 1.5 standard deviations of the healthy mean strongly decreases fracture rates. The available research on bisphosphonates and denosumab did not provide strong evidence supporting that one medication was more efficacious than the other. In regards to vertebral fractures, both medications were effective in decreasing vertebral fracture rates. None of the studies provided numerical data regarding how much the vertebral fractures decreased so it can only be concluded both were effective in decreasing vertebral fracture rates. Regarding non-vertebral fractures, Papoulous et al18 and Ferrari et al19 documented that denosumab required at least 4 years to effectively reduce non-vertebral fracture rates. Meanwhile, bisphosphonates only required 2 years to significantly reduce non-vertebral fracture rates.15 Therefore, bisphosphonates display superior efficacy in reducing fractures than denosumab. Denosumab use resulted in a greater decreases in BTM levels than bisphosphonates. This indicates denosumab more effectively maintained mature bone than bisphosphonates. However, this criteria is not as important as fracture rates or BMD. Persistence to a medication is important because a patient needs to be persistent with a medication in order for it to work
Osteoporosis is a treatable disease, but not a curable one. There are different types of treatment for osteoporosis. Some of the medications that can be taken for treatment of osteoporosis are estrogen, bisphosphonates, calcitionin, raloxifene, parathyroid hormone, and testosterone replacement (UCSF Medical Center, 2010). Some of the more common names for bisphosphonates are Fosamax, Actonel, Boniva, and Reclast (Mayo Clinic, 2009). These treatments are taken orally once a week or once a month. In addition to the medications, there is also the treatment of exercise and diet. With a diet high in calcium, stopping unhealthy habits, like smoking and drinking, and regular exercise can reduce the likelihood of bone fractures in people with osteoporosis (The New York Times, 2010). In Ms. Duckworth’s incident, it would be recommended that she increase the amount of calcium in her diet and exercise, and depending on the severity of the osteoporosis, medication.
Osteoporosis can be detected by using dual-energy x-ray absorptiometry (DXA) scans. According to Rozental, Shah, Chacko and Zurakowski (2010), DXA is currently the gold standard for assessing bone mineral density. Once the elderly have found out they have osteoporosis, most turn to traditional therapies which include biphosphonates. Biphosphonates are the most widely used drug for treatment and prevention of osteoporosis. According to Mamtani and Kulkarni (2009), biphosphonates inhibit osteoclast actions that reduce bone resorption. In simpler terms, these drugs increase bone mineral density and decrease bone breakdown in individuals. It also reduces the risk of fractures and prevents
Osteoporosis is a devastating disease that causes deterioration of bone tissue and an increased risk of bone fractures. It is a major public health problem, affecting millions of elderly over age sixty-five. The disease is one of the most costly costing fourteen billion dollars a year in U.S. health expenditures. Osteoporosis is primarily thought of as a woman's disease, it affects over two million men annually. While there are less fragile fractures in men, if they do fracture, men are more likely to die from it. Today the lack of awareness for male osteoporosis is where it was for women fifty years ago. This is a frightening fact as the lifetime risk for osteoporosis is higher than that of prostate
Supplementation of vitamins A, C, and K as well as calcium goes a long way in treating and preventing this condition. Soy protein with isoflavones and phytoestrogen supplementation have shown remarkable improvement in bone health, especially in post-menopausal women. “A 6-month double blind and placebo-controlled study in 40 postmenopausal women reported that subjects consuming 90 mg/d of isoflavones contained in soy protein had a significant 2% increase in bone density in the lumbar spine…” (Yao et al, 2006). Asian women typically ingest these proteins as a regular part of their diet throughout their lifespans and therefore have a lower incidence of osteoporosis later in life. These should also be incorporated daily in American culture. In Traditional Chinese Medicine, herbs such as black cohosh is used as treatment and is becoming popular in Western society. “A randomized, double-blind clinical trial found that black cohosh (Cimicifugae rhizoma) exerted identical effects as those of conjugated estrogens in producing a statistically significant decrease in markers of bone resorption when compared to placebo-treated women…[and it] does not appear to be mutagenic, teratogenic, or carcinogenic” (Yao et al, 2006). Including this herb with regular diet and exercise can be very beneficial in reducing
Bisphosphonates (BPs) are the most commonly prescription for postmenopausal osteoporosis, however, difficult dosing regimens and multiple side effects can lead to low compliance [5]. A large proportion achieve adequate low adherence with BPs at 1year, resulting in an increasing risk of fracture [6,7]. Moreover, some concerns about bisphosphonates include gastrointestinal intolerability, musculoskeletal pain, ocular symptom, acute renal failure, atrial fibrillation, a possible increased risk of atypical femoral fractures and osteonecrosis of the jaw [8]. Efficacy, tolerability, and route of administration appear to be more important than frequency of dosing in determining adherence to anti-osteoporosis medications [9]. Nonetheless, there is
The word osteoporosis literally means “porous bones” where “osteo” means bones and “porosis” means porous. Osteoporosis is also called “silent” disease because it occurs without any symptoms and people come to know only after the first fracture. It has become a major global public health problem associated with mortality and socio- economic burden. It is a disease that thins and weakens the bone to a point where they become fragile and break easily. Although osteoporosis itself does not directly increase the risk of falls, people who have osteoporosis have a higher risk of breaking a bone if they fall. People with osteoporosis often breaks hip, spine, wrist and also other bones. Spine and hip fracture may lead to long-term pain, disability and even death, while Hip fractures are expensive to treat. In the US alone, health care costs from hip fractures is around $ 11 billion annually. The main goal of treating osteoporosis is to prevent such fractures in the first place as Osteoporosis has a huge medical impact and economic burden and it is of utmost importance to take steps to prevent by creating awareness among people there are many medications that would help to stop the bones from getting weaker. Recent research suggests that one year after the first major osteoporotic fracture the risk of second fracture goes up by three times when compared to the general population and the risk factor doubles in ten years (Harvey, 2016). This result suggest that
Two million osteoporosis-related fractures occur annually in the United States alone [1]. Besides the economic burden, these fractures cause significant morbidity, disability and sometimes premature death [2]. The introduction of bisphosphonates (BP) since the 1990s, has led to dramatic improvement in the outcomes of osteoporosis. As bone resorption inhibitors, they are the first-line treatment of osteoporosis with some additional indications of use in Paget’s disease, osteogenesis imperfecta, hypercalcemia of malignancy and bone metastasis. Osteoporosis treatment is offered to patients with either of following conditions: a) osteopenia and history of fragility fracture in hip or spine, b)
Osteoporosis (meaning ‘porous bone’) is generally an influentially common disease amongst more than 1 million Australians. This disease influences issues that remain to be worked out fragile promoting a higher danger of breaks than in normal bones. Osteoporosis typically transpires when bones lose minerals, such as calcium, more rapidly than the body can replace them, causing the loss of bone thickness (bone thickness or mass). Osteoporosis is commonly referred to as a “silent” disease, as it typically has no symptoms and is occasionally diagnosed until the point when bones break or crack, leaving results of fractures. In Australia, the disease affects one in three women and one in five men aged over 50 years, particularly in the stages of menopause and lower levels of sex steroids hormones, for example,
Osteoporosis is a silent disease in which the bone mass is reduced, often the debilitating fracture happens (Anderson‐Wurf, Harding, & Seal, 2018); this means that a weakened bone mass results in disability and soreness (Sedlak, Doheny, & Jones, 2000). The osteoporosis risk can be decreased through improving bone mass in childhood, preserving bone mass in adulthood, and reducing bone mass damage in older age. A few ways to reduce osteoporosis risk are to follow healthy habits such as weight-bearing physical activity, consuming diets with high level of calcium and vitamin D, stopping smoking, and not drinking excessive amounts of alcohol or caffeine (Hernandez-Rauda & Martinez-Garcia, 2004).
Osteoporosis is described by the NHS as “a condition that weakens bones” and is fairly common, affecting roughly 3 million, with more than 300,000 people receiving treatment each year. Fractures are extremely common as the weakened bones are more susceptible to damage, even coughing may cause vertebral damage. Osteoporosis can be classified as type I or II, “both type I and type II osteoporosis occur through an imbalance between total skeletal bone formation and bone resorption which is sustained over many years” (Theobald, 2005), and are related to a lack of vitamin
Healthy diet and weight-bearing exercises can help prevent bone loss or strengthen already weak bones, but what other options are available? There is more and more clinical evidence showing that bioidentical hormone therapy and strontium supplementation are effective ways to fight the risk
This article was a study of how many women in primary care offices were prescribed medications that could be used in the prevention and treatment of osteoporosis; along with what type of physician would most likely prescribe a medication related to osteoporosis. These studies were to determine if in specific medications were often prescribed in order to help prevent or treat osteoporosis. The prescribed medications that were being looked for in the medical records were: estrogen, bisphosphonate, calcitonin, and calcium. The primary care offices that were studied were two family practice offices and three obstetrics/ gynecology offices. There were two groups of women examined: seven hundred and eighty-two were in the prevention group and thirty-one in the treatment group. The prevention group was composed of women who were not diagnosed with osteoporosis in their recent medical records; while in contrast the treatment group was composed of women who were specifically diagnosed with the disease.
Osteoporosis is a devastating bone disease in which bones become porous and brittle and are more susceptible to fractures; according to Johnell O and Kanis JA (2006), “Worldwide, osteoporosis causes more than 8.9 million fractures annually, resulting in an osteoporotic fracture every 3 seconds.” Osteoporosis is the result of several factors including diet and lifestyle choices, age, disease and medications, but the underlying cause is due to bone loss occurring faster than the body can replace it.
These mice had a high bone mass of the vertebrae and long bones and increased cortical thickness. Which is a bone closed to patients with pycnodysostosis. The author decided that mice are not like humans because humans have proteases that can degrade collagen during skeletal development. They decide to try blosozumab and romosozumab. Blosozumab and romosozumab work great together they strongly stimulate bone formation during the first six months of the treatments. At the same time bone resorption is suppressed at the baseline levels then decreases the levels for the remaining time of the treatment. This formula is to help avoid fractures in osteoporosis patients. At this moment this treatment is being considered if measurable targets can be identified for osteoporosis treatment. This treatment raises two new questions. If this target can be defined. Should this target be reached? And how the target should be maintained once it has been reached? Because this would mean patients’ needs repeated courses of anabolic
Osteoporosis is not a condition exclusive to the elderly – it can strike at any age.