Prevention of postmenopausal osteoporosis and associated fractures: Clinical evaluation of the choice between estrogen and bisphosphonates

Al‐Azzawi, Farook

doi:10.1080/09513590802296245

Cited by 16 publications

(14 citation statements)

References 132 publications

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“…However, as shown in Figure 11, fracture risk does continue to increase with age [20]. Other side effects corresponding to estrogen use include possible mastalgia, headaches, and dyspepsia [25].…”

Section: Osteoporosis Treatment Optionsmentioning

confidence: 99%

“…They have been shown to have long term effects after termination of treatment due to their potential sequestering by hydroxyapatite crystals. The release of the stored bisphosphonates occurs during the remodeling process inhibiting osteoclast function [25]. Bisphosphonates have been shown to inhibit the melavonic acid pathway which is critical for osteoclast function [26].…”

Section: Osteoporosis Treatment Optionsmentioning

confidence: 99%

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Seasonal and Anatomical Variation in Compact Bone Remodeling in the Adult Sheep

Calcagno¹

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SEASONAL AND ANATOMICAL VARIATION IN COMPACT BONE REMODELING IN THE ADULT SHEEP Joseph CalcagnoIn order to determine whether ovine compact bone is suitable for study of osteoporosis, the remodeling parameters of the untreated animal must be fully characterized. Ovine compact bone is an attractive large animal model due to its similarities in size and bone remodeling to humans. However hormonal, exercise, and dietary changes due to seasonal changes can cause treatment effects to be hidden or superimposed on existing changes in the bone. In order to determine if

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Section: Osteoporosis Treatment Optionsmentioning

confidence: 99%

Section: Osteoporosis Treatment Optionsmentioning

confidence: 99%

Seasonal and Anatomical Variation in Compact Bone Remodeling in the Adult Sheep

Calcagno¹

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“…But when that is not enough, there are two of main treatment options for osteoporosis which include increasing estrogen levels or delivering of bisphosphonates. Although both show decreased loss of BMD [8], estrogen has bad side effects for the patient [9] and bisphosphonates alter osteoclasts function negatively [10]. There has been some research done to show a positive effect combining both treatment options, but further research is needed [10].…”

Section: Treatment Options Of Osteoporosismentioning

confidence: 99%

“…Bisphosphonates work by suppressing bone resorption, or inhibiting osteoclasts [9]. They have shown to reduce vertebral and non-vertebral fractures so they are normally one of the first options in treating osteoporosis, especially in men where estrogen therapy is not an option [3].…”

Section: Treatment Options Of Osteoporosismentioning

confidence: 99%

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Effects of Ovariectomy and Anatomical Location on Osteonal Encroachment in Adult Cortical Ovine Bone

Ryan¹

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The purpose of this study is to further quantify adult ovine ovariectomized bone for new remodeling characteristics to obtain a better understanding of how remodeling is occurring and the effectiveness of this animal model for the study of postmenopausal osteoporosis.Postmenopausal osteoporosis is a major health concern and animal models to test new treatment options are needed. The ovine model is a good option because the ewes undergo Haversian remodeling, are a large sized animal, and have a similar hormone profile to humans. Ewes, however, do not undergo a natural menopause, so an ovariectomy surgery was conducted in the sheep to simulate the decreased levels in estrogen. Columbia-Rambouillet sheep were used in this study: some that have been ovariectomized as a model for postmenopausal osteoporosis and some that underwent a sham surgery to serve as a control. The sheep were sacrificed 12 months post operatively in the month of August, so the seasonal effects of remodeling were accounted for. The left radius was then processed into microradiographs of 6 regional cortical beams, where the cranial (tensile side) and caudal (compressive side) anatomical sections were analyzed in this study to determine regional differences in remodeling. Previous students' theses have analyzed the similar samples for basic bone remodeling histology measurements, resulting in some significant seasonal, anatomical, and treatment differences. However, most of the results showed no particular increase in the amount of remodeled area for the ovariectomized sheep compared to the sham sheep, even though an ovariectomy is believed to cause a burst of remodeling in bone due to the decreased levels in estrogen.v In this study, a new repeatable method was developed that further examines secondary bone by quantifying the extent to which secondary osteons encroach on previously-existing secondary osteons. Encroached and unencroached secondary osteons were quantified using two different methods: a point count method that measured the percentage of the area the encroached and unencroached secondary osteons inhabited and an osteon count method that measured the number of encroached and unencroached secondary osteons per area. These raw measurements were calculated into 18 parameters and 2-way repeated measures ANOVAs were run to determine the effects of surgery and anatomical region on each of the bone remodeling parameters. The results found significant effects from estrogen deletion which were different depending on if the bone region was predominately in compression or tension. The ovariectomy surgery caused an increase in remodeling, which was mostly confined on the compressive side to areas that have been previously remodeled, but on the tensile side, bone remodeling expanded into areas that used to be primary bone. The new secondary osteons, as a result of the ovariectomy surgery, were larger than in the control animals. There however, was not an increase in porosity from the ovariectomy surgery, which is one of the main characteristics o...

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