Monitoring of osteoporosis therapy
Olivier Bruyère1, Jean-Yves Reginster1
1Department of Public Health, Epidemiology and Health Economics, University of Liège, Belgium.
Abstract:
Over the past two decades, major advances have been made in the number and range of agents available for the treatment of osteoporosis, all with proven anti-fracture efficacy. Unfortunately, compliance with these treatments is not optimal, and a number of patients could be considered as non-responders. Consequently, monitoring anti-osteoporotic therapy could be part of successful osteoporosis management. Currently, no formal well-accepted clinical practice guidelines are available for monitoring anti-osteoporosis therapies. Changes in bone mineral density and bone turnover markers, while on therapy, have potential value in monitoring treatment but their assessment and, consequently, their benefits could be limited by metrological and clinical issues. Moreover, their effectiveness is probably drug dependant. Recommendation for the standardisation of the methodology when analysing the potential relevance of tools for the monitoring of osteoporosis therapy is needed.
Insights
Monitoring osteoporosis treatment is crucial due to suboptimal compliance and non-response. Standardized methods are needed to assess the effectiveness of anti-osteoporosis therapies and improve patient outcomes.
Area of Science:
- Endocrinology
- Bone Metabolism
- Pharmacology
Background:
- Osteoporosis treatments have advanced significantly, demonstrating anti-fracture efficacy.
- Suboptimal patient compliance and non-response to therapies present challenges in osteoporosis management.
- Current clinical practice lacks formal guidelines for monitoring anti-osteoporosis treatments.
Purpose of the Study:
- To highlight the need for effective monitoring of anti-osteoporosis therapies.
- To discuss the limitations of current monitoring tools, such as bone mineral density and bone turnover markers.
- To advocate for the standardization of methodologies for evaluating osteoporosis treatment monitoring tools.
Main Methods:
- Review of current literature on osteoporosis treatment monitoring.
- Analysis of the clinical utility and limitations of bone mineral density (BMD) and bone turnover markers (BTMs).
- Discussion of drug-dependency and metrological issues affecting monitoring accuracy.
Main Results:
- Existing anti-osteoporosis agents show proven anti-fracture efficacy.
- Bone mineral density and bone turnover markers have potential but limited value in monitoring treatment effectiveness.
- Assessment of monitoring tools is hampered by metrological and clinical issues, and effectiveness may be drug-dependent.
Conclusions:
- Monitoring anti-osteoporosis therapy is essential for successful osteoporosis management.
- There is a need for standardized methodologies to assess the relevance and reliability of monitoring tools.
- Development of clear guidelines for monitoring is required to optimize patient care and treatment outcomes.
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