Pharmacogenomics of Osteoporosis-Related Bone Fractures

  • Karen Rojo Venegas
  • Margarita Aguilera
  • Marisa Cañadas Garre
  • Miguel A. Calleja Hernández


Osteoporosis is a systemic skeletal disease characterised by low bone mass and deterioration in the microstructure of bone tissue, which causes bone fragility and consequent increase in fracture risk. The lifetime fracture risk of a patient with osteoporosis is as high as 40 %, and fractures most commonly occur in the hip, spine or wrist. From a patient’s perspective, a fracture and the subsequent loss of mobility and autonomy often represent a major drop in the quality of life. Additionally, osteoporotic fractures of the hip and spine carry a 12-month excess mortality of up to 20 %, because they require hospitalisation and they subsequently present enhanced risk of other complications, such as pneumonia or thromboembolic disease due to chronic immobilisation.

On the other hand, osteoporosis is a multifactorial and polygenic disease, so the individual likelihood of having a fracture depends on the combination of several risk factors such as low bone mineral density (BMD) and genetic predisposition.

This chapter will present the most interesting concerns related to pharmacogenetics of the pathologies most prevalent in the elderly population. It will identify fracture risk and estimation of the probability of major osteoporotic fracture by assessment tools. The genetics of osteoporosis will be approached by showing general pathways involved in bone homeostasis and polymorphisms of genes related with BMD and osteoporotic fractures. Genetic or genomic screening approaches that have been used and also potential benefits from other existing or emerging technologies/approaches will be discussed. In addition, the pharmacogenetics of osteoporosis will be discussed, in particular antiresorptive medications, reviewing efficacy limitations and adverse drug reactions associated with current osteoporosis treatments and how these could be attributed to genetic factors. Additionally, it will analyse the therapeutic targets in osteoporosis (bone anabolic and bone resorptive) and the development of new antiresorptive therapies. Furthermore, gene–environment, age and gender differences interactions known to affect response to osteoporosis treatment will be considered. Finally, the translation of pharmacogenetic findings to the clinical practice will be discussed.


Bone Mineral Density Fracture Risk Osteoporotic Fracture Zoledronic Acid Strontium Ranelate 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer India 2013

Authors and Affiliations

  • Karen Rojo Venegas
    • 1
  • Margarita Aguilera
    • 2
    • 3
  • Marisa Cañadas Garre
    • 1
  • Miguel A. Calleja Hernández
    • 1
  1. 1.Pharmacogenetics Unit, Pharmacy Service, University Hospital Virgen de las NievesGranadaSpain
  2. 2.Pharmacogenetics Unit, Pharmacy Service, Hospital Universitario Virgen de las NievesGranadaSpain
  3. 3.Instituto de Nutrición y Tecnología de los Alimentos “José Mataix Verdú” de la Universidad de Granada (INYTA)Centro de Investigación Biomédica (CIBM)GranadaSpain

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