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06:59
Trabecular Bone Microarchitecture Evaluation in an Osteoporosis Mouse Model
Published on: September 8, 2023
Severely suppressed bone turnover and atypical skeletal fragility
Maja Visekruna1, Deborah Wilson, Fergus Eoin McKiernan
1Center for Bone Disease, Marshfield Clinic, 1000 North Oak Avenue, Marshfield, Wisconsin 54449, USA. visekruna.maja@marshfieldclinic.org
The Journal of Clinical Endocrinology and Metabolism
|June 5, 2008
Summary
Long-term bisphosphonate therapy can lead to atypical bone fractures. This severe suppression of bone turnover (SSBT) may cause skeletal harm, even with combined therapies.
Area of Science:
- Bone Biology
- Pharmacology
- Orthopedic Surgery
Background:
- Bisphosphonates are crucial in osteoporosis management.
- Long-term use of anti-remodeling agents can paradoxically cause skeletal harm.
Observation:
- Atypical femoral fractures (chalk-stick type) occurred in three patients on long-term bisphosphonate therapy.
- Fracture characteristics were unusual for postmenopausal osteoporosis, including bilaterality and delayed healing.
Findings:
- Patients had concomitant factors (estrogen, glucocorticoids, HRT, raloxifene) exacerbating bone remodeling suppression.
- Bone turnover markers were very low; bone biopsies confirmed severely suppressed bone turnover (SSBT).
Implications:
- Atypical skeletal fragility may indicate SSBT from combined long-term anti-remodeling therapy.
- Individual patient responses to bone suppression therapies can vary, potentially leading to harm.
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