Fracture risk following intermission of osteoporosis therapy
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| Titel: | Fracture risk following intermission of osteoporosis therapy |
|---|---|
| Autoren: | Cyrus Cooper, Eugene V. McCloskey, Olivier Bruyère, Bo Abrahamsen, Elaine M. Dennison, John A. Kanis, Daniel Prieto-Alhambra, Serge Ferrari, Stuart L. Silverman |
| Quelle: | Dennison, E M, Cooper, C, Kanis, J A, Bruyère, O, Silverman, S, McCloskey, E, Abrahamsen, B, Prieto-Alhambra, D, Ferrari, S & On behalf of the IOF Epidemiology/Quality of Life Working Group 2019, ' Fracture risk following intermission of osteoporosis therapy ', Osteoporosis International, vol. 30, no. 9, pp. 1733-1743 . https://doi.org/10.1007/s00198-019-05002-w |
| Verlagsinformationen: | Springer Science and Business Media LLC, 2019. |
| Publikationsjahr: | 2019 |
| Schlagwörter: | drug holiday, Clinical Decision-Making/methods, Public health, health care sciences & services, Clinical Decision-Making, Sciences de la santé humaine, Risk Assessment, Santé publique, services médicaux & soins de santé, Drug Administration Schedule, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, Bone Density, Risk Factors, atypical fracture, Humans, Bone Density Conservation Agents/administration & dosage, Gériatrie, Postmenopausal/drug therapy, Drug holiday, Denosumab/administration & dosage, Human health sciences, Risk Assessment/methods, bisphosphonates, Bisphosphonate-Associated Osteonecrosis of the Jaw/epidemiology, Osteoporosis, Postmenopausal, Bone Density Conservation Agents, Diphosphonates, Age Factors, denosumab, Bisphosphonates, Osteoporotic Fractures/epidemiology, 3. Good health, Diphosphonates/administration & dosage, Rhumatologie, Withholding Treatment, Geriatrics, Osteoporosis, Bisphosphonate-Associated Osteonecrosis of the Jaw, Bone Density/physiology, Denosumab, Atypical fracture, Osteoporotic Fractures |
| Beschreibung: | Given the widespread practice of recommending drug holidays, we reviewed the impact of medication discontinuation of two common anti-osteoporosis therapies (bisphosphonates and denosumab). Trial evidence suggests the risk of new clinical fractures, and vertebral fracture increases when osteoporosis treatment with bisphosphonates or denosumab is stopped.The aim of this paper was to review the available literature to assess what evidence exists to inform clinical decision-making with regard to drug holidays following treatment with bisphosphonates (BiP) or denosumab.Systematic review.Differing pharmacokinetics lead to varying outcomes on stopping therapy. Prospective and retrospective analyses report that the risk of new clinical fractures was 20-40% higher in subjects who stopped BiP treatment, and vertebral fracture risk was approximately doubled. Rapid bone loss has been well described following denosumab discontinuation with an incidence of multiple vertebral fractures around 5%. Studies have not identified risk factors for fracture after stopping treatment other than those that provide an indication for treatment (e.g. prior fracture and low BMD). Studies that considered long-term continuation did not identify increased fracture risk, and reported only very low rates of adverse skeletal events such as atypical femoral fracture.The view that patients on long-term treatment with bisphosphonates or denosumab should always be offered a drug holiday is not supported by the existing evidence. Different pharmacokinetic properties for different therapies require different strategies to manage drug intermission. In contrast, long-term treatment with anti-resorptives is not associated with increased risk of fragility fractures and skeletal adverse events remain rare. |
| Publikationsart: | Article |
| Dateibeschreibung: | application/pdf; text |
| Sprache: | English |
| ISSN: | 1433-2965 0937-941X |
| DOI: | 10.1007/s00198-019-05002-w |
| Zugangs-URL: | https://eprints.soton.ac.uk/429724/1/IOF_WG_Interruption_accepted_March_2019.docx https://pubmed.ncbi.nlm.nih.gov/31175404 https://researchbank.acu.edu.au/cgi/viewcontent.cgi?article=12318&context=fhs_pub https://link.springer.com/article/10.1007/s00198-019-05002-w https://www.ndorms.ox.ac.uk/publications/986782 https://jglobal.jst.go.jp/en/detail?JGLOBAL_ID=201902265591626689 https://archive-ouverte.unige.ch/unige:134040 https://acuresearchbank.acu.edu.au/item/86z76/fracture-risk-following-intermission-of-osteoporosis-therapy https://ora.ox.ac.uk/objects/uuid:cd690930-08f5-4c3b-8411-419b638331d9 https://doi.org/10.1007/s00198-019-05002-w https://archive-ouverte.unige.ch/unige:134040 https://doi.org/10.1007/s00198-019-05002-w https://findresearcher.sdu.dk:8443/ws/files/170258735/IOF_WG_Interruption_accepted_March_2019_1_.pdf https://portal.findresearcher.sdu.dk/da/publications/a096eeb2-b735-4217-b419-e8709e97a8fc https://doi.org/10.1007/s00198-019-05002-w https://acuresearchbank.acu.edu.au/item/86z76/fracture-risk-following-intermission-of-osteoporosis-therapy https://eprints.soton.ac.uk/429724/ |
| Rights: | Springer TDM |
| Dokumentencode: | edsair.doi.dedup.....7103f1bed6e00f15b0298d79faac64c8 |
| Datenbank: | OpenAIRE |
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Nájsť tento článok vo Web of Science | Abstract: | Given the widespread practice of recommending drug holidays, we reviewed the impact of medication discontinuation of two common anti-osteoporosis therapies (bisphosphonates and denosumab). Trial evidence suggests the risk of new clinical fractures, and vertebral fracture increases when osteoporosis treatment with bisphosphonates or denosumab is stopped.The aim of this paper was to review the available literature to assess what evidence exists to inform clinical decision-making with regard to drug holidays following treatment with bisphosphonates (BiP) or denosumab.Systematic review.Differing pharmacokinetics lead to varying outcomes on stopping therapy. Prospective and retrospective analyses report that the risk of new clinical fractures was 20-40% higher in subjects who stopped BiP treatment, and vertebral fracture risk was approximately doubled. Rapid bone loss has been well described following denosumab discontinuation with an incidence of multiple vertebral fractures around 5%. Studies have not identified risk factors for fracture after stopping treatment other than those that provide an indication for treatment (e.g. prior fracture and low BMD). Studies that considered long-term continuation did not identify increased fracture risk, and reported only very low rates of adverse skeletal events such as atypical femoral fracture.The view that patients on long-term treatment with bisphosphonates or denosumab should always be offered a drug holiday is not supported by the existing evidence. Different pharmacokinetic properties for different therapies require different strategies to manage drug intermission. In contrast, long-term treatment with anti-resorptives is not associated with increased risk of fragility fractures and skeletal adverse events remain rare. |
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| ISSN: | 14332965 0937941X |
| DOI: | 10.1007/s00198-019-05002-w |