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Disorders associated with acute rapid and severe bone loss
Solomon Epstein1, Angela M Inzerillo, John Caminis
1Mount Sinai Bone Program, Department of Medicine, Mount Sinai School of Medicine, New York, New York 10029, USA. bonedocsol@aol.com
Summary
This study highlights severe bone diseases causing rapid bone loss and fractures, often missed due to poor recognition. Early detection and prompt treatment with bisphosphonates or anabolic agents like rhPTH are crucial for fracture prevention.
Area of Science:
- Bone Diseases
- Metabolic Bone Disorders
- Pharmacology
Background:
- A group of poorly recognized bone diseases characterized by rapid bone loss and high fracture rates.
- These conditions are often secondary to systemic diseases, frailty, immobilization, or immunosuppressive drugs like glucocorticoids and calcineurin inhibitors.
- Delayed diagnosis and treatment lead to missed opportunities for fracture prevention.
Purpose of the Study:
- To describe a constellation of bone diseases with acute, severe bone loss and high fracture rates.
- To emphasize the importance of early identification and prompt preventative therapy.
- To discuss current and potential therapeutic strategies for these disorders.
Main Methods:
- Clinical observation and characterization of a specific group of bone diseases.
- Review of contributing factors including systemic diseases and medications.
- Evaluation of current and emerging therapeutic options.
Main Results:
- Bone diseases with rapid bone loss and dramatic fracture rates are often underdiagnosed.
- Early detection and intervention are critical to prevent fractures.
- Bisphosphonates are effective when bone resorption is dominant.
- Anabolic agents like recombinant human parathyroid hormone (rhPTH) may benefit severe forms with osteoblastic defects.
Conclusions:
- Prompt identification and treatment are essential for managing severe bone loss and preventing fractures.
- Bisphosphonates are a primary therapy, while anabolic agents show promise for more severe cases.
- Further research into these bone disorders and their treatments is warranted.