Treatment of postmenopausal osteoporosis in women: a systematic review

Ruas, Cristina Mariano; Lima, Marina Guimarães; Silva, Anderson Lourenço da; Silva, Graziele Dias; Guerra, Augusto Afonso; Acúrcio, Francisco de Assis

doi:10.1590/s0102-311x2008001600011

Cited by 19 publications

(14 citation statements)

References 58 publications

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“…3,15 However, bisphosphonates are still the most widely used drugs for treating postmenopausal osteoporosis and have shown good efficacy in increasing bone mineral density and reducing the incidence of fractures. 9,22 In the cohort analyzed here, the most widely used medication was alendronate sodium, which is consistent with the guidelines.…”

Section: Discussionsupporting

confidence: 78%

Gastos publicos com medicamentos para o tratamento da osteoporose na pos-menopausa

et al. 2013

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OBJECTIVE:To analyze expenditure on treatment for postmenopausal osteoporosis and associated factors on mean per capita expenditure. METHODS:A probabilistic-deterministic linkage between the database of Authorizations for Highly Complex Procedures and the mortality information system was constructed, resulting in a historical cohort of patients using highcost medications for the treatment of postmenopausal osteoporosis, between 2000 and 2006.Mean monthly spending on medicines was stratifi ed by age group and described according to demographic and clinical characteristics and the type of drug used.A linear regression model was used to assess the impact of demographic and clinical characteristics on per capita mean monthly expenditure on medicines. RESULTS:We identifi ed 72,265 women who received drugs for the treatment of postmenopausal osteoporosis.The average monthly expenditure per capita in the fi rst year of treatment was $ 54.02 (sd $ 86.72).The population was predominantly composed of women aged 60-69 years old, who had started treatment in 2000, resident in the Southeast of Brazil, who had previously suffered osteoporotic fractures, and Alendronate sodium was the drug most commonly used at baseline.For most of the patients, the same active ingredient remained in use throughout the treatment period.During the program, 6,429 deaths were identifi ed among participants.More than a third of women remained in treatment for up to 12 months.Raloxifen and calcitonin were the therapeutic alternatives with the greatest impact on the average monthly expenditure on medicine using alendronate sodium as a reference standard. CONCLUSIONS:Due to the high impact of the type of drug used on expenditure on medication, it is recommended that criteria for prescribing and dispensing be established by prioritizing those with lower costs and greater effectiveness in order to optimize the process of pharmaceutical care and provide the population with a greater number of pharmaceutical units.

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Section: Discussionsupporting

confidence: 78%

Gastos publicos com medicamentos para o tratamento da osteoporose na pos-menopausa

et al. 2013

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“…Osteoporosis is a condition in which loss of bone mass leads to fragility fractures. Postmenopausal osteoporosis caused by estrogen deficiency is characterized by a high-turnover state in bone remodeling; that is, bone resorption and formation were all maintained at a high level, but the bone resorption rate was higher than the bone formation rate in postmenopausal women [2]. …”

Section: Introductionmentioning

confidence: 99%

Therapeutic effects of radix dipsaci, pyrola herb, and cynomorium songaricum on bone metabolism of ovariectomized rats

Liu

Xiao

Rong

et al. 2012

BMC Complement Altern Med

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BackgroundThe objective of this study was to evaluate the effects of herbal medicines, such as Radix Dipsaci (RDD), Pyrola Herb (PHD), and Cynomorium songaricum decoction (CSD), on osteoporotic rats induced by ovariectomy (OVX).MethodsOVX or sham operations were performed on 69 virgin Wistar rats that were divided into six groups: sham (sham, n = 12), OVX control group (OVX, n = 12), and OVX rats with treatments (diethylstilbestrol, E2, n = 12; RDD, n = 11, PHD, n = 11, and CSD, n = 11). Non-surgical rats served as normal control (NC, n = 12). The treatments began four weeks after surgery and lasted for 12 weeks. Bone mass and bone turnover were analyzed by histomorphometry. Levels of protein expression and mRNA of OPG and RANKL in osteoblasts (OB) and bone marrow stromal cells (bMSC) were evaluated by immunohistochemistry and in situ hybridization.ResultsCompared to NC and sham rats, trabecular bone formation was significantly reduced in OVX rats, but restored in E2-treated rats. Treatment with either RDD or PHD enhanced trabecular bone formation remarkably. No significant change of bone formation was observed in CSD-treated rats. OPG expression of protein and mRNA was reduced significantly in OB and bMSC of OVX control rats. RANKL expression of protein and mRNA was increased significantly in OB and bMSC of OVX control rats. These effects were substantially reversed (increased in OPG and decreased in RANKL) by treatment with E2, RDD, or PHD in OB and bMSC of OVX rats. No significant changes in either OPG or RANKL expression were observed in OB and bMSC of OVX rats treated with CSD.ConclusionsOur study showed that RDD and PHD increased bone formation by stimulating overexpression of OPG and downregulation of RANKL in OB and bMSC. This suggests that RDD and PHD may be used as alternative therapeutic agents for postmenopausal osteoporosis.

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“…Secara klinis, osteoporosis ditegakkan berdasarkan kejadian fraktur akibat trauma minimal pada vertebra, pinggul, proksimal humerus, serta femur. [1][2][3] Peningkatan ekonomi dan populasi lanjut usia akan meningkatkan frekuensi osteoporosis sehingga menjadi satu permasalahan kesehatan yang perlu diperhatikan. 4 Prevalensi osteoporosis di negara berkembang atau sedang berkembang tidak jelas terungkap karena sedikit penelitian.…”

Section: Pendahuluanunclassified

Karakteristik Atom Mineral pada Osteoporosis dengan Arsitektur Porosis dan Nonporosis

Noor¹,

Sumitro²,

Hidayat³

et al. 2013

mkb

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AbstrakTerdapat hasil yang bervariasi dalam peningkatan bone mineral density (BMD) akibat asupan kalsium mengindikasikan keterlibatan atom mineral lain dalam perkembangan struktur tulang. Kuantitas atom mineral tulang yaitu kadar atom mineral dalam struktur tulang. Penelitian ini bertujuan untuk membandingkan karakteristik atom mineral pada gambaran arsitektur (scanning electron microscope/SEM) porosis dibandingkan dengan nonporosis. Sepuluh penderita osteoporosis dengan gambaran SEM porosis dan tujuh penderita gambaran SEM nonporosis terlibat dalam penelitian ini. Tulang yang diambil ketika operasi fraktur dianalisis mikrostruktur dengan SEM dan karakter atom mineral tulang dengan X-ray fluorescence (XRF). Pemeriksaan SEM dan XRF dilaksanakan di Laboratorium Fisika Universitas Negeri Malang. Penelitian dilakukan mulai Agustus 2010 sampai Januari 2011. Uji t dilakukan untuk menentukan perbedaan kadar mineral tulang. Hasil SEM menunjukkan perbedaan porositas dan integritas trabekular antara SEM porosis dan SEM nonporosis. Analisis XRF didapatkan komposisi atom yang lebih tinggi pada tulang SEM nonporosis yaitu P, S, Fe, Ni, Cr, Pb, dan Si. Sebaliknya, komposisi atom yang lebih tinggi pada tulang SEM porosis adalah Cu, Zn, Ca, dan Mo. Perbedaan komposisi atom tersebut tidak berbeda secara bermakna (p>0,05). Simpulan, perkembangan porositas pada osteoporosis tidak didasari oleh kuantitas atom mineral tulang. [MKB. 2013;45(1):23-7] Kata kunci: Arsitektur, atom mineral, komposit, osteoporosis Mineral Atomic Characteristic on Porotic and Non Porotic Architecture of Osteoporosis AbstractThere was variance result in increased bone mineral density (BMD) due to calcium intake which indicates involvement of another mineral atomic in bone structure development. Bone mineral atomic quantity is the level or concentration of mineral atomic in bone structure. Aim of this study was to compare mineral atomic characteristic in architecture (scanning electron microscope/SEM) porotic and non porotic figure. Ten osteoporosis patients with porotic SEM and seven non porotic SEM patients were involved in this study. Bone which was obtained from fracture surgery was analyzed for microstructure by SEM and for bone atomic mineral characteristic by X-ray fluorescence (XRF). Analysis of SEM and XRF were done in Physics Laboratory State University of Malang. This study was done from August 2010 to January 2011. t-test was done to analyse the difference of atomic mineral level. Scanning electron microscope result showed the difference in porosity and trabecular integrity between porotic and non porotic SEM. Analysis of XRF showed atomic composition was higher in porotic SEM such as P, S, Fe, Ni, Cr, Pb and Si. Conversely atomic composition such as Cu, Zn, Ca, and Mo, was higher in non porotic SEM. There was no significant difference between each groups (p>0.05). In conclusion, the development of porocity in osteoporosis is not depend on bone mineral atomic quantity. [MKB. 2013;45(1):23-7]

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Treatment of postmenopausal osteoporosis in women: a systematic review

Cited by 19 publications

References 58 publications

Gastos publicos com medicamentos para o tratamento da osteoporose na pos-menopausa

Gastos publicos com medicamentos para o tratamento da osteoporose na pos-menopausa

Therapeutic effects of radix dipsaci, pyrola herb, and cynomorium songaricum on bone metabolism of ovariectomized rats

Karakteristik Atom Mineral pada Osteoporosis dengan Arsitektur Porosis dan Nonporosis

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