Treatment of primary osteoporosis in men

Andrea Giusti,1 Gerolamo Bianchi2 1Bone Clinic, Department of Gerontology and Musculoskeletal Sciences, Galliera Hospital, 2Department of Rheumatology, La Colletta Hospital, ASL3, Arenzano, Genoa, Italy Abstract: With the aging of the population worldwide, osteoporosis and osteoporotic fra...

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Autores principales:	Giusti A, Bianchi G
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2014
Materias:	Osteoporosis Men Bisphosphonates Teriparatide Denosumab Strontium Ranelate Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/c83cdb2addd7488e92665ccf68c1842a
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spelling	oai:doaj.org-article:c83cdb2addd7488e92665ccf68c1842a2021-12-02T03:57:47ZTreatment of primary osteoporosis in men1178-1998https://doaj.org/article/c83cdb2addd7488e92665ccf68c1842a2014-12-01T00:00:00Zhttps://www.dovepress.com/treatment-of-primary-osteoporosis-in-men-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Andrea Giusti,1 Gerolamo Bianchi2 1Bone Clinic, Department of Gerontology and Musculoskeletal Sciences, Galliera Hospital, 2Department of Rheumatology, La Colletta Hospital, ASL3, Arenzano, Genoa, Italy Abstract: With the aging of the population worldwide, osteoporosis and osteoporotic fractures are becoming a serious health care issue in the Western world. Although less frequent than in women, osteoporosis in men is a relatively common problem. Hip and vertebral fractures are particularly relevant, being associated with significant mortality and disability. Since bone loss and fragility fractures in men have been recognized as serious medical conditions, several randomized controlled trials (RCTs) have been undertaken in males with osteoporosis to investigate the anti-fracture efficacy of the pharmacological agents commonly used to treat postmenopausal osteoporosis. Overall, treatments for osteoporosis in men are less defined than in women, mainly due to the fact that there are fewer RCTs performed in male populations, to the relatively smaller sample sizes, and to the lack of long-term extension studies. However, the key question is whether men are expected to respond differently to osteoporosis therapies than women. The pharmacological properties of bisphosphonates, teriparatide, denosumab, and strontium ranelate make such differentiation unlikely, and available clinical data support their efficacy in men with primary osteoporosis as well as in women. In a series of well-designed RCTs, alendronate, risedronate, zoledronic acid, and teriparatide were demonstrated to reduce the risk of new vertebral fractures in men presenting with primary osteoporosis (including osteoporosis associated with low testosterone levels) and to improve the bone mineral density (BMD). In preliminary studies, ibandronate, denosumab, and strontium ranelate also showed their beneficial effects on surrogate outcomes (BMD and markers of bone turnover) in men with osteoporosis. Although direct evidence about their non-vertebral anti-fracture efficacy are lacking, the effects of bisphosphonates, denosumab, teriparatide, and strontium ranelate on surrogate outcomes (BMD and markers of bone turnover) were similar to those reported in pivotal RCTs undertaken in postmenopausal women, in which vertebral and non-vertebral anti-fracture efficacy have been clearly demonstrated. In conclusion, sufficient data exist to support the use of these pharmacological agents in men with primary osteoporosis. Further RCTs are warranted to establish their long-term efficacy and safety. Keywords: bisphosphonates, teriparatide, denosumab, strontium ranelateGiusti ABianchi GDove Medical PressarticleOsteoporosisMenBisphosphonatesTeriparatideDenosumabStrontium RanelateGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 10, Pp 105-115 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Osteoporosis Men Bisphosphonates Teriparatide Denosumab Strontium Ranelate Geriatrics RC952-954.6
spellingShingle	Osteoporosis Men Bisphosphonates Teriparatide Denosumab Strontium Ranelate Geriatrics RC952-954.6 Giusti A Bianchi G Treatment of primary osteoporosis in men
description	Andrea Giusti,1 Gerolamo Bianchi2 1Bone Clinic, Department of Gerontology and Musculoskeletal Sciences, Galliera Hospital, 2Department of Rheumatology, La Colletta Hospital, ASL3, Arenzano, Genoa, Italy Abstract: With the aging of the population worldwide, osteoporosis and osteoporotic fractures are becoming a serious health care issue in the Western world. Although less frequent than in women, osteoporosis in men is a relatively common problem. Hip and vertebral fractures are particularly relevant, being associated with significant mortality and disability. Since bone loss and fragility fractures in men have been recognized as serious medical conditions, several randomized controlled trials (RCTs) have been undertaken in males with osteoporosis to investigate the anti-fracture efficacy of the pharmacological agents commonly used to treat postmenopausal osteoporosis. Overall, treatments for osteoporosis in men are less defined than in women, mainly due to the fact that there are fewer RCTs performed in male populations, to the relatively smaller sample sizes, and to the lack of long-term extension studies. However, the key question is whether men are expected to respond differently to osteoporosis therapies than women. The pharmacological properties of bisphosphonates, teriparatide, denosumab, and strontium ranelate make such differentiation unlikely, and available clinical data support their efficacy in men with primary osteoporosis as well as in women. In a series of well-designed RCTs, alendronate, risedronate, zoledronic acid, and teriparatide were demonstrated to reduce the risk of new vertebral fractures in men presenting with primary osteoporosis (including osteoporosis associated with low testosterone levels) and to improve the bone mineral density (BMD). In preliminary studies, ibandronate, denosumab, and strontium ranelate also showed their beneficial effects on surrogate outcomes (BMD and markers of bone turnover) in men with osteoporosis. Although direct evidence about their non-vertebral anti-fracture efficacy are lacking, the effects of bisphosphonates, denosumab, teriparatide, and strontium ranelate on surrogate outcomes (BMD and markers of bone turnover) were similar to those reported in pivotal RCTs undertaken in postmenopausal women, in which vertebral and non-vertebral anti-fracture efficacy have been clearly demonstrated. In conclusion, sufficient data exist to support the use of these pharmacological agents in men with primary osteoporosis. Further RCTs are warranted to establish their long-term efficacy and safety. Keywords: bisphosphonates, teriparatide, denosumab, strontium ranelate
format	article
author	Giusti A Bianchi G
author_facet	Giusti A Bianchi G
author_sort	Giusti A
title	Treatment of primary osteoporosis in men
title_short	Treatment of primary osteoporosis in men
title_full	Treatment of primary osteoporosis in men
title_fullStr	Treatment of primary osteoporosis in men
title_full_unstemmed	Treatment of primary osteoporosis in men
title_sort	treatment of primary osteoporosis in men
publisher	Dove Medical Press
publishDate	2014
url	https://doaj.org/article/c83cdb2addd7488e92665ccf68c1842a
work_keys_str_mv	AT giustia treatmentofprimaryosteoporosisinmen AT bianchig treatmentofprimaryosteoporosisinmen
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Treatment of primary osteoporosis in men

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