Management of patients at very high risk of osteoporotic fractures through sequential treatments
Journal article
Curtis, Elizabeth M., Reginster, Jean-Yves, Al-Daghri, Nasser, Biver, Emmanuel, Brandi, Maria Luisa, Cavalier, Etienne, Hadji, Peymann, Halbout, Philippe, Harvey, Nicholas C., Hiligsmann, Mickaël, Javaid, M. Kassim, Kanis, John A., Kaufman, Jean-Marc, Lamy, Olivier, Matijevic, Radmila, Perez, Adolfo Diez, Radermecker, Régis Pierre, Rosa, Mário Miguel, Thomas, Thierry, ... Cooper, Cyrus. (2022). Management of patients at very high risk of osteoporotic fractures through sequential treatments. Aging Clinical and Experimental Research. 34(4), pp. 695-714. https://doi.org/10.1007/s40520-022-02100-4
Authors | Curtis, Elizabeth M., Reginster, Jean-Yves, Al-Daghri, Nasser, Biver, Emmanuel, Brandi, Maria Luisa, Cavalier, Etienne, Hadji, Peymann, Halbout, Philippe, Harvey, Nicholas C., Hiligsmann, Mickaël, Javaid, M. Kassim, Kanis, John A., Kaufman, Jean-Marc, Lamy, Olivier, Matijevic, Radmila, Perez, Adolfo Diez, Radermecker, Régis Pierre, Rosa, Mário Miguel, Thomas, Thierry, Thomasius, Friederike, Vlaskovska, Mila, Rizzoli, René and Cooper, Cyrus |
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Abstract | Osteoporosis care has evolved markedly over the last 50 years, such that there are now an established clinical definition, validated methods of fracture risk assessment and a range of effective pharmacological agents. Currently, bone-forming (anabolic) agents, in many countries, are used in those patients who have continued to lose bone mineral density (BMD), patients with multiple subsequent fractures or those who have fractured despite treatment with antiresorptive agents. However, head-to-head data suggest that anabolic agents have greater rapidity and efficacy for fracture risk reduction than do antiresorptive therapies. The European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) convened an expert working group to discuss the tools available to identify patients at high risk of fracture, review the evidence for the use of anabolic agents as the initial intervention in patients at highest risk of fracture and consider the sequence of therapy following their use. This position paper sets out the findings of the group and the consequent recommendations. The key conclusion is that the current evidence base supports an “anabolic first” approach in patients found to be at very high risk of fracture, followed by maintenance therapy using an antiresorptive agent, and with the subsequent need for antiosteoporosis therapy addressed over a lifetime horizon. |
Keywords | osteoporosis; epidemiology; imminent; fracture; anabolic; antiresorptive |
Year | 2022 |
Journal | Aging Clinical and Experimental Research |
Journal citation | 34 (4), pp. 695-714 |
Publisher | Springer |
ISSN | 1594-0667 |
Digital Object Identifier (DOI) | https://doi.org/10.1007/s40520-022-02100-4 |
PubMed ID | 35332506 |
Scopus EID | 2-s2.0-85127550173 |
PubMed Central ID | PMC9076733 |
Open access | Published as ‘gold’ (paid) open access |
Page range | 695-714 |
Funder | European Society for Clinical and Economic Aspects of Osteoporosis (ESCEO) |
Publisher's version | License File Access Level Open |
Output status | Published |
Publication dates | |
Online | 24 Mar 2022 |
Publication process dates | |
Accepted | 18 Feb 2022 |
Deposited | 19 Oct 2022 |
https://acuresearchbank.acu.edu.au/item/8y5vw/management-of-patients-at-very-high-risk-of-osteoporotic-fractures-through-sequential-treatments
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Publisher's version
OA_Curtis_2022_Management_of_patients_at_very_high.pdf | |
License: CC BY 4.0 | |
File access level: Open |
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