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- Title
REVIEW Preventing osteoporotic fractures with antiresorptive therapy: implications of microarchitectural changes.
- Authors
Boonen, S.; Haentjens, P.; Vandenput, L.; Vanderschueren, D.
- Abstract
Boonen S, Haentjens P, Vandenput L, Vanderschueren D (Center for Metabolic Bone Diseases, Katholieke Universiteit Leuven, Leuven; and Vrije Universiteit Brussels, Brussels, Belgium). Preventing osteoporotic fractures with antiresorptive therapy: implications of microarchitectural changes (Review). J Intern Med 2004; 255: 1–12. Prospective studies have demonstrated that low bone mass correlates well with increased risk of osteoporotic fractures at various skeletal sites. Trials have likewise confirmed that enhancing bone mass with antiresorptive therapy reduces fracture incidence in individuals at risk. However, correlation of bone mineral density (BMD) increases with therapeutic risk reduction has proved less consistent than correlation of BMD decreases with greater fracture risk in the untreated. Indeed, various analyses have indicated that – even during treatment with potent bisphosphonates like alendronate and risedronate – BMD changes from baseline account for <30% of the reduction in vertebral fractures in treated women. It is clearly, therefore, that factors other than BMD are involved in the reduction of fracture risk achieved by antiresorptive therapies. According to recent micro-computed tomography imaging and other studies, antiresorptive therapy can help rebuild the microarchitecture of bone as well as strengthen the materials that go into it. When treating individuals with osteoporosis, these microarchitectural changes contribute to the reduction of fracture risk achieved by antiresorptive therapies.
- Subjects
OSTEOPOROSIS treatment; BONE fracture prevention; BONE injuries; RESORPTION (Physiology); BONE resorption; BONE diseases
- Publication
Journal of Internal Medicine, 2004, Vol 255, Issue 1, p1
- ISSN
0954-6820
- Publication type
Article
- DOI
10.1046/j.0954-6820.2003.01258.x