Immobilization osteoporosis
40.1 Introduction Fuller Albright speculated that removal of the stress and strain on the skeleton would result in bone loss . Of the total noninstitutionalized population in the United States…
ENDOCRINOLOGY
Osteogenesis imperfecta and other defects of bone development as occasional causes of adult osteoporosis
48.1 Scope of the problem Although osteoporosis is primarily considered an issue for postmenopausal women and men over age 65 years, physicians are increasingly confronted with low bone mass or…
Glucocorticoid-induced osteoporosis and Cushing’s syndrome
45.1 Introduction More than 75 years ago, osteoporosis associated with endogenous glucocorticoid excess was described by Cushing . More common is the increased fracture risk associated with exogenous glucocorticoids, a…
Bisphosphonates pharmacology and use in the treatment of osteoporosis
74.1 Introduction and history Bisphosphonates are analogs of naturally occurring compounds, pyrophosphates (P–O–P). P–O–P are byproducts of adenosine triphosphate (ATP) metabolism but have little or no biological activity in healthy…
On the evolution and contemporary roles of bone remodeling
31.1 Introduction Dobzhansky’s quote, “Nothing in biology makes sense except in the light of evolution” provides a unique framework for contemplating the origins and contemporary roles of bone remodeling. There…
Long-term bisphosphonate treatment: continuation and interruption
Abbreviations AACE American Association of Clinical Endocrinologists ALN alendronate ALP alkaline phosphatase ASBMR American Society for Bone and Mineral Research AFF atypical femoral fractures BMD bone mineral density BP bisphosphonate…
Bone mineral acquisition in utero and during infancy and childhood
36.1 Introduction Bone mass, a composite measure of bone size and mineral density, is a determinant of bone strength and acquired during skeletal growth and development. Although up to 85%…
Teriparatide and abaloparatide treatment for osteoporosis
76.1 Introduction Teriparatide (TPTD), the aminoterminal (1-34)parathyroid hormone (PTH) peptide, is a proremodeling anabolic agent. When administered by daily subcutaneous injection, it first stimulates bone formation (primarily modeling based) and…
Long-term treatment strategies and goal-directed therapy
82.1 Introduction The primary goal of osteoporosis treatment is the prevention of fragility fractures, and several treatments have been shown to reduce this risk within 1 year for vertebral fractures,…
Romosozumab for the treatment of postmenopausal osteoporosis
80.1 Introduction Sclerostin is an osteocyte glycoprotein that was originally discovered in the rare genetic diseases of sclerosteosis and Van Buchem disease, both characterized by the absence of the sclerostin…
