The Experts below are selected from a list of 8838 Experts worldwide ranked by ideXlab platform

K E Naylor - One of the best experts on this subject based on the ideXlab platform.

  • diagnosis of endocrine disease bone turnover markers are they clinically useful
    European Journal of Endocrinology, 2018
    Co-Authors: Tom Pigott, F Gossiel, K E Naylor, Jennifer Walsh, Nicola Peel
    Abstract:

    Bone turnover markers (BTMs) are useful in clinical practice as they are inexpensive, and they have proven useful for treatment monitoring and identification of poor adherence. BTMs cannot be used in individual patients for identifying accelerated bone loss or an increase in fracture risk or in deciding on the optimal therapy. They are useful for monitoring both anti-resorptive and anabolic treatment. Response can be defined as a result that exceeds an absolute target, or by a change greater than the least significant change; if such a response is not present, then poor compliance or Secondary Osteoporosis are likely causes. A baseline BTM measurement is not always made; in that case, a value of BTM on anti-resorptive treatment that is low or low normal or above the reference interval for anabolic therapy may be taken to indicate a satisfactory response. We provide an approach to using these bone turnover markers in clinical practice by describing algorithms for anti-resorptive and anabolic therapy and describing the changes we observe in the clinical practice setting.

  • bone turnover markers use in Osteoporosis
    Nature Reviews Rheumatology, 2012
    Co-Authors: K E Naylor
    Abstract:

    Analyzing bone turnover markers—an approach boosted by the advent of automated analysis—can guide clinical decision making and the development of new therapies in Osteoporosis. How such markers are, ought to be, and might be, used to understand Osteoporosis and to optimize its treatment form the focus of this Review. Biochemical markers of bone turnover (bone turnover markers, BTMs) can be used to study changes in bone remodelling in Osteoporosis. Investigators and clinicians should be aware of the appropriate sample collection and storage conditions for optimum measurements of these markers. Improvements in the variability of BTM measurements have resulted from the development of assays for automated analysers, and from international consensus regarding their use. Appropriate reference intervals should be used for the optimum interpretation of results. BTMs can provide information that is useful for the management of patients with Osteoporosis, for both the initial clinical assessment and for guiding and monitoring of treatment. BTMs are clinically useful to determine possible causes of Secondary Osteoporosis by identifying patients with high bone turnover and rapid bone loss. In the follow-up of treatment response, BTM levels respond rapidly to both anabolic and antiresorptive treatments. BTM changes can also be used for understanding the mechanism of action of drugs in development and identifying the correct dose; they are also potentially useful as surrogate biomarkers for fracture.

Cristina L Sadowsky - One of the best experts on this subject based on the ideXlab platform.

Olivier Lamy - One of the best experts on this subject based on the ideXlab platform.

  • the trabecular bone score tbs complements dxa and the frax as a fracture risk assessment tool in routine clinical practice
    Current Osteoporosis Reports, 2017
    Co-Authors: Didier Hans, Emőke Steňova, Olivier Lamy
    Abstract:

    There is an increasing body of evidence that the trabecular bone score (TBS), a surrogate of bone microarchitecture extracted from spine DXA, could play an important role in the management of patients with Osteoporosis or at risk of fracture. The current paper reviews this published body of scientific literature on TBS and answers the most relevant clinical questions. TBS has repeatedly been proven to be predictive of fragility fractures, current and future, and this is largely independent of BMD, CRF, and the FRAX, and when used in conjunction with any one of these measures, it consistently enhances their accuracy. There also is a growing body of evidence indicating that the TBS has particular advantages over BMD for specific causes of increased fracture risk, like chronic corticosteroid excess, type-2 diabetes, and chronic kidney disease, and patients being treated with anti-aromatase and primary hyperparathyroidism, conditions wherein BMD readings are often misleading. TBS enhances performance of the FRAX tool, where its greatest utility appears to lie in its ability to accurately classify those patients whose BMD level lies close to the intervention threshold, aiding in decisions on whether treatment is warranted or not. Furthermore, TBS has also particular advantages over BMD in Secondary Osteoporosis. While the role of TBS with monitoring could be important as the different molecules impact logically TBS to various degrees, large clinical trials are still needed.

S Paul A Chubb - One of the best experts on this subject based on the ideXlab platform.

  • the use of biochemical markers of bone turnover in the clinical management of primary and Secondary Osteoporosis
    Endocrine, 2016
    Co-Authors: Samuel D Vasikaran, S Paul A Chubb
    Abstract:

    The purpose of the present study was to examine of the current role of bone turnover markers (BTMs) in the management of Osteoporosis. Perusal of the literature examines the available evidence for the utility of BTMs for decision to treat and for the monitoring of treatment for Osteoporosis. There is no evidence for the use of BTMs for fracture risk calculation, decision to treat or for treatment selection. A very abnormal BTM value may be a clue to the presence of bone pathology other than uncomplicated Osteoporosis. Whilst changes to BTMs following various Osteoporosis treatments are well defined, their utility in monitoring individual patients has been less well established. Some fracture outcome-based data exist for the use of u-NTX target of <21 nmol BCE/mmol for antiresorptive therapy; the equivalent s-CTX level is ~250 ng/L. Suboptimal BTM response to treatment may indicate non-compliance or the presence of Secondary causes of Osteoporosis which may need addressing. Studies are needed to establish treatment targets based on fracture outcomes for commonly used BTMs for each established Osteoporosis therapy.

Rene Rizzoli - One of the best experts on this subject based on the ideXlab platform.

  • Zoledronic Acid for the treatment and prevention of primary and Secondary Osteoporosis.
    Therapeutic Advances in Musculoskeletal Disease, 2010
    Co-Authors: Rene Rizzoli
    Abstract:

    There is increasing interest in therapies that can be administered less frequently and/or avoid gastrointestinal irritation. The efficacy of once-yearly zoledronic acid (5 mg) in the treatment and prevention of Osteoporosis has been evaluated in different patient populations. In the 3-year HORIZON-Pivotal Fracture Trial in postmenopausal women with Osteoporosis, zoledronic acid reduced the risk of vertebral and hip fracture by 70% and 41%, respectively, versus placebo. The efficacy of zoledronic acid in preventing subsequent fracture in patients with a hip fracture was evaluated in the HORIZON-Recurrent Fracture Trial. New vertebral and nonvertebral fractures were significantly reduced by treatment initiated within 90 days of incident hip fracture, without evidence of delayed fracture healing. Data from a 1-year study show that a single zoledronic acid 5-mg infusion is superior to oral risedronate 5 mg/day for treatment and prevention of glucocorticoid-induced Osteoporosis. Increases in bone mineral density and decreases in bone turnover markers were significantly greater with zoledronic acid than with risedronate. Two different treatment regimens of zoledronic acid were found to be more effective than placebo for prevention of bone loss in postmenopausal women and reducing markers of bone turnover after 2 years. In conclusion, zoledronic acid 5 mg once-yearly infusion has demonstrated marked efficacy in the treatment and prevention of primary and Secondary Osteoporosis, with a combination of fracture risk reduction and prevention of bone loss at key sites. It is the only agent shown to reduce the incidence of fracture and mortality in patients with a previous low-trauma hip fracture.