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Osteoporosis Research Paper

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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 …show more content…

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

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