Osteoporosis prevention and therapy: preserving and building strength through bone quality.
While bone mineral density measurements play a central role in osteoporosis management, the degree to which increases in this parameter contribute to bone fragility, fracture risk, and the therapeutic efficacy of osteoporosis agents is controversial. Indeed, bone strength is also significantly dependent upon bone turnover and bone quality, including microarchitecture, mineralization, and geometry. Given the critical role of these factors, it is essential to understand how they are affected by therapeutic agents. Even though a number of technological advances, such as microcomputed tomography, magnetic resonance imaging, and computerized analysis of radiographic patterns, help to provide critical information toward a more comprehensive assessment of bone turnover and bone quality, clinical trials addressing these factors are scarce. This article provides a review of studies relating to how osteoporosis therapies impact parameters of bone strength and quality.
Kleerekoper
M
M
Department of Internal Medicine, Saint Joseph Mercy Hospital, Ann Arbor, MI, USA. kleerekm@trinity-health.org
D015519:Bone Density / Q000502:physiology; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D001842:Bone and Bones / Q000503:physiopathology*; D002116:Calcitonin / Q000627:therapeutic use; D004164:Diphosphonates / Q000627:therapeutic use; D015914:Estrogen Replacement Therapy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D009942:Organometallic Compounds / Q000627:therapeutic use; D010024:Osteoporosis / Q000188:drug therapy* / Q000503:physiopathology / Q000517:prevention & control; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy / Q000517:prevention & control; D010281:Parathyroid Hormone / Q000627:therapeutic use; D020849:Raloxifene Hydrochloride / Q000627:therapeutic use; D020845:Selective Estrogen Receptor Modulators / Q000627:therapeutic use; D013876:Thiophenes / Q000627:therapeutic use
D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D009942:Organometallic Compounds; D010281:Parathyroid Hormone; D020845:Selective Estrogen Receptor Modulators; D013876:Thiophenes; C081587:strontium ranelate; D020849:Raloxifene Hydrochloride; D002116:Calcitonin