Drug therapy for osteoporosis in older adults

Reid, Ian R.; Billington, Emma O

doi:10.1016/s0140-6736(21)02646-5

Cited by 284 publications

(206 citation statements)

References 97 publications

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“…The reduction of cholesterol level will lead to the nuclear condensation of osteoclasts, reduce the activity of osteoclasts and induce the activation of Caspase-3, so as to induce osteoclast apoptosis ( Luegmayr et al, 2004 ), which may be similar to the mechanism of statins potentially reducing the risk of fracture. The only SERM recommended by JAMA for anti-osteoporosis treatment in 2019 is raloxifene (I. R. Reid & Billington, 2022 ). Among postmenopausal women with osteoporosis, raloxifene can increase the bone mineral density of spine and femoral neck and reduce the risk of vertebral fracture ( Delmas et al, 1997 ; Walsh et al, 1998 ).…”

Section: Introductionmentioning

confidence: 99%

“…Animal studies have shown that the continuous administration of PTH leads to bone loss ( Cosman, Shen, Herrington, & Lindsay, 1991 ), whereas intermittent administration leads to increased osteoblast numbers and osteogenesis ( Frolik et al, 2003 ). Currently, JAMA lists two PTH analogs for the treatment of OP: teriparatide and abaloparatide (I. R. Reid & Billington, 2022 ). Teriparatide induces bone formation by stimulating the proliferation and activity of osteoblasts.…”

Section: Introductionmentioning

confidence: 99%

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Advances in Our Understanding of the Mechanism of Action of Drugs (including Traditional Chinese Medicines) for the Intervention and Treatment of Osteoporosis

et al. 2022

Front. Pharmacol.

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Osteoporosis (OP) is known as a silent disease in which the loss of bone mass and bone density does not cause obvious symptoms, resulting in insufficient treatment and preventive measures. The losses of bone mass and bone density become more severe over time and an only small percentage of patients are diagnosed when OP-related fractures occur. The high disability and mortality rates of OP-related fractures cause great psychological and physical damage and impose a heavy economic burden on individuals and society. Therefore, early intervention and treatment must be emphasized to achieve the overall goal of reducing the fracture risk. Anti-OP drugs are currently divided into three classes: antiresorptive agents, anabolic agents, and drugs with other mechanisms. In this review, research progress related to common anti-OP drugs in these three classes as well as targeted therapies is summarized to help researchers and clinicians understand their mechanisms of action and to promote pharmacological research and novel drug development.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Advances in Our Understanding of the Mechanism of Action of Drugs (including Traditional Chinese Medicines) for the Intervention and Treatment of Osteoporosis

et al. 2022

Front. Pharmacol.

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“…Denosumab is a fully human monoclonal antibody approved for the treatment of osteoporosis both in women and men [1,2]. This anti-bone resorption agent is administered as a single 60 mg subcutaneous injection every 6 months [1].…”

Section: Introductionmentioning

confidence: 99%

“…As a consequence, denosumab withdrawal is associated with a 3-to fivefold higher risk for vertebral, major osteoporotic, and hip fractures [7][8][9]. The risk of rebound fractures is reported as early as 4-8 weeks after interruption in injection schedule, and therefore, it is recommended that injections of denosumab should not be delayed by more than 7 months after the previous dose [1,10].…”

Section: Introductionmentioning

confidence: 99%

COVID-19 lockdown negatively impacted on adherence to denosumab therapy: incidence of non-traumatic fractures and role of telemedicine

Vincentis

Domenici

Ansaloni

et al. 2022

J Endocrinol Invest

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Purpose Coronavirus disease (COVID-19) lockdowns have impacted on management of osteoporosis and the use of telemedicine is increasingly widespread albeit supported by little evidence so far. The aim of the study is to assess adherence to denosumab and incidence of non-traumatic fractures during the lockdown compared to the pre-COVID-19 year and to explore the effectiveness of telemedicine in the management of osteoporotic patients. Methods Retrospective, longitudinal, single-center study on patients receiving subcutaneous denosumab therapy every 6 months. Each patient was scheduled to undergo 2 visits: one during the pre-COVID-19 period (March 2019-March 2020) and another visit during the lockdown period (March 2020-March 2021). Data on new fractures, adherence, risk factors for osteoporosis and the modality of visit (telemedicine or face-to-face) were collected. ResultsThe prevalence of non-adherent patients was higher during the lockdown (35 of 269 patients, 13.0%) than the pre-COVID-19 period (9 of 276 patients, 3.3%) (p < 0.0001). During the lockdown, the number of new non-traumatic fractures was higher than the pre-COVID-19 year (p < 0.0001): 10 patients out of 269 (3.7%) experienced a fragility fracture and 2 patients (0.7%) a probable rebound fracture during the lockdown period, whereas no patient had fragility/rebound fractures during the pre-COVID-19 period. No difference was found in the prevalence of non-adherence and new non-traumatic fractures comparing patients evaluated with tele-medicine to those evaluated with face-to-face visit. Conclusion Non-adherent patients and new non-traumatic fractures (including rebound fractures) were more prevalent during the lockdown in comparison to the pre-COVID-19 period, regardless of the modality of medical evaluation.

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“…The imbalance between bone formation of osteoblasts and bone resorption of osteoclasts is the underlying cause of OP 4 . The treatment of OP depends on drug therapy, including bisphosphonate, selective estrogen receptor modulator, mixed steroid receptor agonist, monoclonal antibody against RANKL, parathyroid hormone analogue and so on 5 . These drugs can alleviate bone loss and improve clinical symptoms to a certain extent, but their long-term clinical application is limited by low tolerance, severe side effects and high cost 6 .…”

Section: Introductionmentioning

confidence: 99%

Network pharmacology of iridoid glycosides from Eucommia ulmoides Oliver against osteoporosis

Wang

Fan

Feng

et al. 2022

Sci Rep

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Eucommia ulmoides Oliver is one of the commonly used traditional Chinese medicines for the treatment of osteoporosis, and iridoid glycosides are considered to be its active ingredients against osteoporosis. This study aims to clarify the chemical components and molecular mechanism of iridoid glycosides of Eucommia ulmoides Oliver in the treatment of osteoporosis by integrating network pharmacology and molecular simulations. The active iridoid glycosides and their potential targets were retrieved from text mining as well as Swiss Target Prediction, TargetNet database, and STITCH databases. At the same time, DisGeNET, GeneCards, and Therapeutic Target Database were used to search for the targets associated with osteoporosis. A protein–protein interaction network was built to analyze the interactions between targets. Then, DAVID bioinformatics resources and R 3.6.3 project were used to carry out Gene Ontology enrichment analysis and Kyoto Encyclopedia of Genes and Genomes pathway analysis. Moreover, interactions between active compounds and potential targets were investigated through molecular docking, molecular dynamic simulation, and binding free energy analysis. The results showed that a total of 12 iridoid glycosides were identified as the active iridoid glycosides of Eucommia ulmoides Oliver in the treatment of osteoporosis. Among them, aucubin, reptoside, geniposide and ajugoside were the core compounds. The enrichment analysis suggested iridoid glycosides of Eucommia ulmoides Oliver prevented osteoporosis mainly through PI3K-Akt signaling pathway, MAPK signaling pathway and Estrogen signaling pathway. Molecular docking results indicated that the 12 iridoid glycosides had good binding ability with 25 hub target proteins, which played a critical role in the treatment of osteoporosis. Molecular dynamic and molecular mechanics Poisson–Boltzmann surface area results revealed these compounds showed stable binding to the active sites of the target proteins during the simulations. In conclusion, our research demonstrated that iridoid glycosides of Eucommia ulmoides Oliver in the treatment of osteoporosis involved a multi-component, multi-target and multi-pathway mechanism, which provided new suggestions and theoretical support for treating osteoporosis.

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Drug therapy for osteoporosis in older adults

Cited by 284 publications

References 97 publications

Advances in Our Understanding of the Mechanism of Action of Drugs (including Traditional Chinese Medicines) for the Intervention and Treatment of Osteoporosis

Advances in Our Understanding of the Mechanism of Action of Drugs (including Traditional Chinese Medicines) for the Intervention and Treatment of Osteoporosis

COVID-19 lockdown negatively impacted on adherence to denosumab therapy: incidence of non-traumatic fractures and role of telemedicine

Network pharmacology of iridoid glycosides from Eucommia ulmoides Oliver against osteoporosis

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