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Algorithm for the Use of Biochemical Markers of Bone Turnover in the Diagnosis, Assessment and Follow-Up of Treatment for Osteoporosis
M. Lorentzon, J. Branco, ML. Brandi, O. Bruyère, R. Chapurlat, C. Cooper, B. Cortet, A. Diez-Perez, S. Ferrari, A. Gasparik, M. Herrmann, NR. Jorgensen, J. Kanis, JM. Kaufman, A. Laslop, M. Locquet, R. Matijevic, E. McCloskey, S. Minisola, R....
Jazyk angličtina Země Spojené státy americké
Typ dokumentu časopisecké články, práce podpořená grantem
Grantová podpora
MC_U147585827
Medical Research Council - United Kingdom
MC_U147585819
Medical Research Council - United Kingdom
MC_UP_A620_1014
Medical Research Council - United Kingdom
MC_UU_12011/1
Medical Research Council - United Kingdom
G0400491
Medical Research Council - United Kingdom
MC_U147585824
Medical Research Council - United Kingdom
- MeSH
- algoritmy * MeSH
- biologické markery krev MeSH
- bisfosfonáty terapeutické užití MeSH
- inhibitory kostní resorpce terapeutické užití MeSH
- kostní denzita účinky léků MeSH
- lidé středního věku MeSH
- lidé MeSH
- následné studie MeSH
- postmenopauzální osteoporóza farmakoterapie MeSH
- referenční hodnoty MeSH
- remodelace kosti účinky léků MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
INTRODUCTION: Increased biochemical bone turnover markers (BTMs) measured in serum are associated with bone loss, increased fracture risk and poor treatment adherence, but their role in clinical practice is presently unclear. The aim of this consensus group report is to provide guidance to clinicians on how to use BTMs in patient evaluation in postmenopausal osteoporosis, in fracture risk prediction and in the monitoring of treatment efficacy and adherence to osteoporosis medication. METHODS: A working group with clinical scientists and osteoporosis specialists was invited by the Scientific Advisory Board of European Society on Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). RESULTS: Serum bone formation marker PINP and resorption marker βCTX-I are the preferred markers for evaluating bone turnover in the clinical setting due to their specificity to bone, performance in clinical studies, wide use and relatively low analytical variability. BTMs cannot be used to diagnose osteoporosis because of low sensitivity and specificity, but can be of value in patient evaluation where high values may indicate the need to investigate some causes of secondary osteoporosis. Assessing serum levels of βCTX-I and PINP can improve fracture prediction slightly, with a gradient of risk of about 1.2 per SD increase in the bone marker in addition to clinical risk factors and bone mineral density. For an individual patient, BTMs are not useful in projecting bone loss or treatment efficacy, but it is recommended that serum PINP and βCTX-I be used to monitor adherence to oral bisphosphonate treatment. Suppression of the BTMs greater than the least significant change or to levels in the lower half of the reference interval in young and healthy premenopausal women is closely related to treatment adherence. CONCLUSION: In conclusion, the currently available evidence indicates that the principal clinical utility of BTMs is for monitoring oral bisphosphonate therapy.
Department of Endocrinology Ghent University Hospital 9000 Ghent Belgium
Department of Internal Medicine and Medical Disciplines Rome University Sapienza Italy
Department of Pharmacology Medical Faculty Medical University Sofia 2 Zdrave Str 1431 Sofia Bulgaria
Department of Rheumatology and EA 44090 CHU Lille and University of Lille 59000 Lille France
FirmoLab Fondazione F 1 R M O University of Florence Florence Italy
INSERM UMR 1033 Université de Lyon Hôpital E Herriot 69437 Lyon Cedex 03 France
Citace poskytuje Crossref.org
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- $a Lorentzon, Mattias $u Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Region Västra Götaland, Geriatric Medicine Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden. Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia.
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- $a INTRODUCTION: Increased biochemical bone turnover markers (BTMs) measured in serum are associated with bone loss, increased fracture risk and poor treatment adherence, but their role in clinical practice is presently unclear. The aim of this consensus group report is to provide guidance to clinicians on how to use BTMs in patient evaluation in postmenopausal osteoporosis, in fracture risk prediction and in the monitoring of treatment efficacy and adherence to osteoporosis medication. METHODS: A working group with clinical scientists and osteoporosis specialists was invited by the Scientific Advisory Board of European Society on Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). RESULTS: Serum bone formation marker PINP and resorption marker βCTX-I are the preferred markers for evaluating bone turnover in the clinical setting due to their specificity to bone, performance in clinical studies, wide use and relatively low analytical variability. BTMs cannot be used to diagnose osteoporosis because of low sensitivity and specificity, but can be of value in patient evaluation where high values may indicate the need to investigate some causes of secondary osteoporosis. Assessing serum levels of βCTX-I and PINP can improve fracture prediction slightly, with a gradient of risk of about 1.2 per SD increase in the bone marker in addition to clinical risk factors and bone mineral density. For an individual patient, BTMs are not useful in projecting bone loss or treatment efficacy, but it is recommended that serum PINP and βCTX-I be used to monitor adherence to oral bisphosphonate treatment. Suppression of the BTMs greater than the least significant change or to levels in the lower half of the reference interval in young and healthy premenopausal women is closely related to treatment adherence. CONCLUSION: In conclusion, the currently available evidence indicates that the principal clinical utility of BTMs is for monitoring oral bisphosphonate therapy.
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- $a Jorgensen, Niklas Rye $u Department of Clinical Biochemistry, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark. OPEN, Odense Patient Data Explorative Network, Odense University Hospital/Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
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