Risks vs. benefits of switching therapy in patients with postmenopausal osteoporosis.

Published on Jul 26, 2021in Expert Review of Endocrinology & Metabolism
· DOI :10.1080/17446651.2021.1956902
Hotaka Ishizu1
Estimated H-index: 1
(Hokkaido University),
Kosuke Arita (Hokkaido University)+ 2 AuthorsNorimasa Iwasaki45
Estimated H-index: 45
(Hokkaido University)
Sources
Abstract
Introduction: Osteoporosis is characterized by the fragility of bones, leading to fractures and, consequently, the deterioration of functional capacity and quality of life. Postmenopausal women, in particular, are prone to osteoporosis and often require anti-osteoporosis treatment. In the last few decades, various anti-osteoporosis drugs have been approved for clinical use. In an aging society, osteoporosis cannot be treated using a single agent; therefore, switching therapy is an important treatment strategy.Areas covered: This review covers switching therapy in patients with postmenopausal osteoporosis. It's extremely important to understand the characteristics of each drug including; limitations on the duration of use, side effects due to long-term use (such as atypical femur fracture and osteonecrosis of the jaw) or discontinuation (such as rebound phenomenon), compliance, and ability to prevent fractures. We review and summarize the risks and benefits of switching therapy.Expert opinion: When switching therapy, the order of drug administration is important. Routine monitoring should be continued after switching treatments. We recommend first using osteoanabolic agents in postmenopausal women with severe osteoporosis. In addition, identifying predictors of the efficacy and side effects of treatment may help prevent the inappropriate use of drugs for the treatment of osteoporosis.
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#1Kosuke Ebina (Osaka University)H-Index: 18
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Objectives: To clarify the effects of follow-on therapy after denosumab (DMAb) discontinuation.Methods: In this retrospective, multicenter study, postmenopausal patients with osteoporosis who were ...
Source
#1J. Everts-GraberH-Index: 2
#2Stephan Reichenbach (University of Bern)H-Index: 46
Last. T. LehmannH-Index: 1
view all 6 authors...
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Source
#1Akimitsu MiyauchiH-Index: 29
#2Etsuro Hamaya (Amgen)H-Index: 1
Last. Junichiro Shimauchi (Amgen)H-Index: 1
view all 7 authors...
This post-hoc analysis of the FRAME study investigated the long-term efficacy and safety of romosozumab followed by denosumab in postmenopausal Japanese women with osteoporosis at high fracture risk. Data from Japanese women with a high fracture risk participating in the international, randomised, double-blind, placebo-controlled, phase 3 FRAME study were analysed. High risk of fracture was defined as ≥ 1 fragility fracture with bone mineral density (BMD) ≤ − 2.5 standard deviations [SD], > 2 pr...
Source
#1Felicia Cosman (Columbia University)H-Index: 71
#2David W. Dempster (Columbia University)H-Index: 79
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Source
#1Kaleen N Hayes (U of T: University of Toronto)H-Index: 4
#2N. He (U of T: University of Toronto)H-Index: 1
Last. Suzanne M. CadaretteH-Index: 36
view all 6 authors...
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Source
#1Emma SöreskogH-Index: 2
#2I. LindbergH-Index: 1
Last. F. Borgström (KI: Karolinska Institutet)H-Index: 26
view all 9 authors...
Romosozumab is a novel bone-building drug that reduces fracture risk. This health economic analysis indicates that sequential romosozumab-to-alendronate can be a cost-effective treatment option for postmenopausal women with severe osteoporosis at high risk of fracture. Purpose To estimate the cost-effectiveness of sequential treatment with romosozumab followed by alendronate ("romosozumab-to-alendronate") compared with alendronate alone in patients with severe osteoporosis at high risk of fractu...
Source
#2Polyzois Makras (Hellenic Air Force)H-Index: 27
Last. Andrea PalermoH-Index: 24
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Denosumab is a potent antiresorptive agent that substantially increases bone mineral density and reduces fracture rates at all skeletal sites for as long as it is administered. However, its favorable skeletal effects reverse quickly upon its discontinuation, because of a vast increase of osteoclast number and activity, which leads to a subsequent profound increase of bone turnover above pre-treatment values, a phenomenon commonly described as "rebound phenomenon". More importantly, most patients...
Source
#1Toshio Matsumoto (University of Tokushima)H-Index: 76
#2Itsuro Endo (University of Tokushima)H-Index: 17
Osteoporosis is characterized by compromised bone strength, predisposing to an increased risk of fracture. Because bone is constantly remodeled, and bone mass and structure are determined by the balance between bone resorption and bone formation, it is important to maintain normal bone turnover. Therefore, therapies that reduce bone resorption have been the mainstream of osteoporosis treatment. Receptor activator of nuclear factor-kappa B ligand (RANKL)-RANK signaling was found to play a pivotal...
Source
#1Chan Ho Park (Yeungnam University)H-Index: 7
#2Jun-Il Yoo (Gyeongsang National University)H-Index: 10
Last. You-Sung Suh (SCH: Soonchunhyang University)H-Index: 3
view all 4 authors...
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Source
#1Houchen Lyu (Brigham and Women's Hospital)H-Index: 8
#2Kazuki Yoshida (Brigham and Women's Hospital)H-Index: 33
Last. Daniel H. Solomon (Brigham and Women's Hospital)H-Index: 116
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