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Osteoclasts in Bone Remodeling01:31

Osteoclasts in Bone Remodeling

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Osteoclasts are cells responsible for bone resorption and remodeling. They originate from hematopoietic progenitor cells present in the bone marrow. Numerous progenitor cells fuse to form multinucleated cells, each with 10-20 nuclei. A single osteoclast has a diameter of 150 to 200 µM. These cells have ruffled borders that break down the underlying bone tissue and release minerals such as calcium into the blood in bone resorption. Osteoclasts cling to bones with their ruffled edges during...
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Bone Remodeling01:40

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Bone remodeling is a continuous and balanced process of bone resorption by osteoclasts and bone formation by osteoblasts. In adults, it helps maintain bone mass and calcium homeostasis. While mechanical stress can stimulate turnover as part of the normal maintenance and reparative process, several hormones also regulate bone remodeling.
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Bone Disorders01:29

Bone Disorders

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Aging and its effect on bone remodeling is the most common cause of bone disorders. In young and healthy people, bone deposition and resorption happen at an equal rate to maintain optimal bone health.
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Hormones and Bone Tissue01:17

Hormones and Bone Tissue

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The endocrine system produces and secretes hormones, which interact with the skeletal system. These hormones control bone growth, maintain bone once it is formed, and remodel it.
Hormones That Influence Osteoblasts and/or Maintain the Matrix
Several hormones are necessary for controlling bone growth and maintaining the bone matrix. The pituitary gland secretes growth hormone (GH), which, as its name implies, controls bone growth. This happens in several ways: first, it triggers chondrocyte...
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The growth and maintenance of bone are regulated by a combination of nutritional factors, including vitamins, such as vitamin A, B12, C, D, and K.
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The minerals contained in all of the food we consume are essential for our organ systems. However, certain essential minerals, such as calcium, phosphorus, magnesium, manganese, and fluoride, largely affect bone health.
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Update on osteoporosis treatment.

Xavier Nogués1, Daniel Martinez-Laguna2

  • 1Servicio de Medicina Interna, Hospital del Mar. URFOA-Unidad de Investigación Musculoesquelética, Instituto Hospital del Mar de Investigaciones Médicas, Barcelona, España; CIBER de Fragilidad y Envejecimiento Saludable (CIBERFES) Instituto Carlos III, Madrid, España; Universitat Autònoma de Barcelona, Barcelona, España.

Medicina Clinica
|November 29, 2017
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Summary

Effective osteoporosis treatment focuses on preventing fractures. This review guides drug selection for diverse patient profiles, considering efficacy and side effects for optimal fracture prevention.

Keywords:
Fracturas por fragilidadFragility fracturesOsteoporosisPrevención secundariaSecondary preventionTratamientoTreatment

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Area of Science:

  • Orthopedics
  • Geriatrics
  • Pharmacology

Background:

  • Osteoporosis treatment aims to prevent fractures, but drug side effects necessitate careful consideration of indications and duration.
  • Patient profiles vary significantly, from those with hip fractures and comorbidities to active individuals and those with vertebral or non-vertebral fractures.

Purpose of the Study:

  • To review osteoporosis treatment strategies for various patient profiles.
  • To guide clinicians in selecting appropriate pharmacotherapy for secondary fracture prevention.

Main Methods:

  • Review of current literature and clinical practice guidelines for osteoporosis management.
  • Analysis of different patient scenarios including hip fracture, vertebral fracture, and non-vertebral fracture patients.
  • Evaluation of drug-specific indications, contraindications, and adverse effect profiles.

Main Results:

  • Antiresorptive drugs like alendronate and risedronate are generally first-line treatments.
  • Zoledronate or denosumab are recommended for patients with digestive intolerance, poor adherence, or high hip fracture risk.
  • Teriparatide is indicated for patients with multiple vertebral fractures or very low bone density.

Conclusions:

  • Personalized pharmacotherapy selection is crucial for effective secondary fracture prevention in osteoporosis.
  • Balancing treatment efficacy with potential adverse effects is key to optimizing patient outcomes.
  • Antiresorptive agents, specific bisphosphonates, and teriparatide offer tailored options for different osteoporosis patient groups.