Document Detail


Implications for fracture healing of current and new osteoporosis treatments: an ESCEO consensus paper.
MedLine Citation:
PMID:  22451221     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Osteoporotic fracture healing is critical to clinical outcome in terms of functional recovery, morbidity, and quality of life. Osteoporosis treatments may affect bone repair, so insights into their impact on fracture healing are important. We reviewed the current evidence for an impact of osteoporosis treatments on bone repair. Treatment with bisphosphonate in experimental models is associated with increased callus size and mineralization, reduced callus remodeling, and improved mechanical strength. Local and systemic bisphosphonate treatment may improve implant fixation. No negative impact on fracture healing has been observed, even after major surgery or when administered immediately after fracture. Experimental data for denosumab and raloxifene suggest no negative implications for bone repair. The extensive experimental results for teriparatide indicate increased callus formation, improved biomechanical strength, and greater external callus volume and total bone mineral content and density. Case reports and a randomized trial have produced mixed results but are consistent with a positive impact of teriparatide on clinical fracture healing. Studies with strontium ranelate in models of fracture healing indicate that it is associated with improved bone microstructure, callus volume, and biomechanical properties. Finally, there is experimental evidence for a beneficial effect of some of the agents currently being developed for osteoporosis, notably sclerostin antibody and DKK1 antibody. There is currently no evidence that osteoporosis treatments are detrimental for bone repair and some promising experimental evidence for positive effects on healing, notably for agents with a bone-forming mode of action, which may translate into therapeutic applications.
Authors:
J Goldhahn; J-M Féron; J Kanis; S Papapoulos; J-Y Reginster; R Rizzoli; W Dere; B Mitlak; Y Tsouderos; S Boonen
Publication Detail:
Type:  Consensus Development Conference; Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-03-28
Journal Detail:
Title:  Calcified tissue international     Volume:  90     ISSN:  1432-0827     ISO Abbreviation:  Calcif. Tissue Int.     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-04-24     Completed Date:  2012-10-19     Revised Date:  2013-06-03    
Medline Journal Info:
Nlm Unique ID:  7905481     Medline TA:  Calcif Tissue Int     Country:  United States    
Other Details:
Languages:  eng     Pagination:  343-53     Citation Subset:  IM    
Affiliation:
AO Clinical Priority Program "Fracture Fixation in Osteoporotic Bone", Institute for Biomechanics of ETH, Zurich, Switzerland. jgoldhahn@ethz.ch
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MeSH Terms
Descriptor/Qualifier:
Animals
Antibodies, Monoclonal, Humanized / therapeutic use
Bone Density Conservation Agents / therapeutic use
Fracture Healing / drug effects*
Fractures, Bone / drug therapy,  etiology
Humans
Osteoporosis / drug therapy*
Teriparatide / therapeutic use
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal, Humanized; 0/Bone Density Conservation Agents; 4EQZ6YO2HI/denosumab; 52232-67-4/Teriparatide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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