Sclerostin inhibitor (SERM): Romosozumab
Learning objectives • Understand bone turnover, its various components, and how they can be manipulated. • Recognize the role of sclerostin and romosozumab in bone turnover. • Identify patients who…
ENDOCRINOLOGY
Sclerostin inhibitor (SERM): Raloxifene
Learning objectives • Raloxifene: Therapeutic profile: efficacy and adverse effects. • Estrogen/progesterone: uses, limitations, adverse effects. The case study Reason for seeking medical help Mrs. KA, 65-year-old woman is concerned…
Receptor activator of nuclear factor kappa-B ligand (RANK-L) inhibitor—Denosumab
Learning objectives • Appreciate the mode of action of denosumab, its efficacy, and adverse effects. • Develop a management strategy to follow up patients on denosumab. The case study Reason…
Drug holidays
Learning objectives • “Drug holidays” refer to the discontinuation—temporary or permanent—of bisphosphonate therapy following a 3- to 5-year period of continuous therapy whether oral or IV. • Determine whether to…
Zoledronic acid—Annual infusions
Learning objectives • Osteoporosis is silent until a fracture is sustained. • Osteoporosis is underdiagnosed and undertreated. • The pharmacologic profile of zoledronic acid: efficacy and adverse effects. The case…
Oral bisphosphonates—Lack of response
Learning objectives • Evaluation of patients on long-term bisphosphonate therapy for drug resistance. • Recognize lifestyle habits that can interfere with bisphosphonate efficacy. The case study Reasons for seeking medical…
Oral bisphosphonates—Long term: 13 years
Learning objectives • Evaluation of patients on long-term antiresorptive therapy. • When and how to discontinue long-term bisphosphonate therapy. The case study Reasons for seeking medical help • VP is…
Oral bisphosphonates—Drug holidays and discontinuing therapy
Learning objectives • Monitor patients on long-term antiresorptive therapy. • Determine whether to continue or discontinue long-term antiresorptive therapy. • Determine whether a “Drug holiday” is appropriate in the management…
Oral bisphosphonates—Initiating and maintaining treatment
Learning objectives • The pharmacology profile of orally administered bisphosphonates. • Initiating and maintaining pharmacologic treatment with oral bisphosphonates. The case study Reason for seeking medical help • BJ, a…
Screening for osteoporosis
Learning objectives • The importance of screening for osteoporosis. • Risk factors predisposing to osteoporosis. • Who, when, and how to screen for osteoporosis. • Unnecessary laboratory and imaging studies…
