Role of biochemical markers of bone turnover as prognostic indicator of successful osteoporosis therapy

Abstract

This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and education use, including for instruction at the authors institution and sharing with colleagues.Other uses, including reproduction and distribution, or selling or licensing copies, or posting to personal, institutional or third party websites are prohibited. Author's personal copy EditorialRole of biochemical markers of bone turnover as prognostic indicator of successful osteoporosis therapy AbstractMost of the currently available anti-osteoporosis medications promptly and significantly influence the rate of bone turnover. Biochemical markers of bone turnover now provide a high sensitivity to change, allowing the detection of these bone turnover changes within a couple of weeks. Since the anti-fracture efficacy of inhibitors of bone resorption or stimulators of bone formation appears to be largely independent of baseline bone turnover, biochemical markers do not appear to play a significant role in the selection of one particular drug, for an individual patient. However, there are consistent data showing that short-term changes in biochemical markers of bone turnover may be significant predictors of future changes in bone mineral density or fracture reduction, hence suggesting that bone turnover markers play a significant role in the monitoring of anti-osteoporosis therapy. © 2008 Elsevier Inc. All rights reserved.Keywords: Osteoporosis; Monitoring; Treatment; Bone density; Markers of bone turnover IntroductionClinical trials, conducted since the early nineties, have unequivocally shown the ability of several anti-osteoporosis medications to reduce fracture occurrence at various skeletal sites, including but not exhaustively the spine and hip [1]. Whereas the operational definition of osteoporosis is still based on a low bone mineral density (BMD), because low BMD is known to contribute to increased fracture risk, changes in bone mass and density, in response to anti-resorptive therapy, account for only a small portion of the predicted fracture risk reduction [2], a picture which may, however, be significantly changed with the availability of new therapies stimulating bone formation [3] or uncoupling bone formation from bone resorption [4].During the last decade, biochemical markers of bone turnover (BTM) have been developed, that are more sensitive than conventional ones for detecting abnormalities or changes of bone turnover rate [5]. Increased levels of bone resorption, and short-term changes in BTM, have been shown to predict the risk of fracture, independently of the level of BMD in untreated individuals [6,7].Dynamic changes in bone turnover, estimated by measurement of bone biochemical markers, such as breakdown products of type I collagen and proteins secreted by osteoblasts and osteoclasts in blood and urine, can also account for a major portion of antifracture efficacy of anti-resorptive or bone-forming agents [8]. Most of the currently marketed anti-osteoporos...

Short-term bone marker responses to teriparatide and strontium ranelate in patients with osteoporosis previously treated with bisphosphonates

“…It has been well demonstrated how antiresorptive agents reduce the rate of bone remodeling with a decrease in bone resorption and bone formation markers (9)(10)(11)(12). In the present study we observed the changes in bone markers in patients who were taking two classes of anabolic agents and who had previously been on bisphosphonates.…”

Postmenopozal Osteoporozda FRAX ile Belirlenen Kırık Riski ve Kemik Döngüsü Belirteçleri Arasındaki İlişki

“…A significant association has been reported between the short-term decrease in markers of bone turnover with the use of different antiresorptive agents and gains in BMD. More importantly, significant associations have been reported between the short-term decrease in markers of bone turnover and the reduction in risk of vertebral and nonvertebral fractures with the use of antiresorptive agents (9,11). The correlation between old age and increased fracture risk is well documented in many epidemiologic studies (2,12).…”

Measurement of urinary N-telopeptides from type I collagen using a colloidal gold-based immunoassay

“…However, this method cannot discriminate between the predominance of bone resorption and formation processes at the microstructural level, and requires a long time to detect structural changes. Increased understanding of bone physiology has led to the discoveries of several bone turnover markers in urine and blood related to bone formation and resorption (Mora et al, 1998;Reginster et al, 2008;Vasikaran et al, 2006;Garnero, 2008;Blumsohn et al, 1994). These bone turnover markers can be used to detect biochemical changes before structural changes occur (Braga de Castro Machado et al, 1999;Raisz et al, 2000).…”