Drug-induced osteoporosis: from Fuller Albright to aromatase inhibitors.
Many commonly prescribed medications, such as selective serotonin reuptake inhibitors, proton pump inhibitors, thiazolidinediones, aromatase inhibitors, and androgen deprivation therapy, have been associated with adverse skeletal effects. The levels of evidence in support of a causal relationship between drug use and the development of bone loss and fractures are variable. For some drugs, a causal relationship is suspected (but not proven) based on observational studies, while in others causality is firmly established with randomized, controlled clinical trials. The mechanism of action for skeletal damage is poorly understood for some drugs and well known for others. Guidelines for managing bone health in patients taking some medications with potential skeletal toxicity have been developed using the best available evidence and expert opinion. This is a review of selected medications that have been associated with bone loss and fractures, with recommendations for clinical care.
a Division of Endocrinology and Metabolism, Department of Internal Medicine , University of New Mexico , Albuquerque, Albuquerque , New Mexico.
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Byreddy
a Division of Endocrinology and Metabolism, Department of Internal Medicine , University of New Mexico , Albuquerque, Albuquerque , New Mexico.
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Bouchonville
b New Mexico Clinical Research & Osteoporosis Center , University of New Mexico School of Medicine , Albuquerque , New Mexico , USA.
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Lewiecki
D000726:Androgen Antagonists / Q000009:adverse effects*; D044966:Anti-Retroviral Agents / Q000009:adverse effects*; D047072:Aromatase Inhibitors / Q000009:adverse effects*; D015519:Bone Density / Q000187:drug effects*; D005260:Female; D050723:Fractures, Bone / Q000209:etiology; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000139:chemically induced*; D045162:Thiazolidinediones / Q000009:adverse effects
D000726:Androgen Antagonists; D044966:Anti-Retroviral Agents; D047072:Aromatase Inhibitors; D045162:Thiazolidinediones
ANDROGEN DEPRIVATION THERAPY; AROMATASE INHIBITORS; FRACTURE; OSTEOPOROSIS; PROTON PUMP INHIBITORS; SELECTIVE SEROTONIN REUPTAKE INHIBITORS; THIAZOLIDINEDIONES