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Bone Disorders

Bone Disorders

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.
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...

Bone Remodeling

Bone Remodeling

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.

Osteoclasts in Bone Remodeling

Osteoclasts in Bone Remodeling

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...

Fractures: Bone Repair

Fractures: Bone Repair

Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...

Role of Vitamins in Maintaining Bone Health

Role of Vitamins in Maintaining Bone Health

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.
Vitamin A
Vitamin A is involved in the process of bone remodeling. Retinoic acid, the active metabolite of Vitamin A, has nuclear receptors in osteoblasts and osteoclasts, which are involved in bone remodeling.
Vitamin B12
Vitamin B12 acts as a cofactor during the formation of osteoblast-related proteins, such as osteocalcin. Vitamin B12 plays a role...

Essential Minerals for Bone Health

Essential Minerals for Bone Health

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.
Calcium and Phosphorus
Calcium is a critical component of bones, especially in the form of calcium phosphate and calcium carbonate. Since the body cannot make calcium, it must be obtained from the diet. However, calcium cannot be absorbed from the small intestine without...

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Author Spotlight: Integrating Traditional Chinese Medicine with Modern Pharmacology and Genomics for Assessing Postmenopausal Osteoporosis in Mice

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Treatment Sequence for Osteoporosis.

Felicia Cosman¹, Bente Langdahl², Benjamin Z Leder³

¹Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York.

Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists

|February 4, 2024

Summary

This summary is machine-generated.

Sequencing osteoporosis treatments, like switching from bisphosphonates to denosumab or using osteoanabolic agents before antiresorptives, can improve bone mineral density and mitigate bone loss in postmenopausal women.

Keywords:

antiresorptive osteoanabolic osteoporosis treatment treatment sequence

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Area of Science:

Endocrinology
Geriatrics
Pharmacology

Background:

Osteoporosis management requires lifelong monitoring and treatment.
Sequential therapy maximizes benefits and minimizes risks of long-term single-agent use.

Purpose of the Study:

Review clinical trial data on sequential osteoporosis treatment in postmenopausal women.
Evaluate antiresorptive-antiresorptive, osteoanabolic-antiresorptive, and antiresorptive-osteoanabolic sequences.

Main Methods:

Literature review.
Discussion of clinical trial data.

Main Results:

Discontinuation of osteoporosis medications without sequential therapy leads to bone loss.
Stopping denosumab requires transition to bisphosphonates to prevent rapid bone loss.
Osteoanabolic agents followed by antiresorptives yield greater BMD gains than the reverse sequence, especially at the hip.

Conclusions:

Strategic sequencing of osteoporosis medications is crucial for effective long-term care.
Awareness of treatment sequences can optimize postmenopausal osteoporosis management.