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Biomarkers of Bisphosphonate Failure in Osteoporosis

  • Elisa CairoliEmail author
  • Iacopo ChiodiniEmail author
Reference work entry
  • 866 Downloads
Part of the Biomarkers in Disease: Methods, Discoveries and Applications book series (BDMDA)

Abstract

Bisphosphonates are the first-line agents for the management of osteoporosis. Through the suppression of bone turnover, they are able to significantly reduce fracture risk in patients with an adequate calcium and vitamin D supplementation. Bisphosphonate failure can be assumed when two or more fragility fractures occur in the course of treatment, but surrogate markers of the efficacy of bisphosphonate treatment are the variations of bone mineral density (BMD) and of bone turnover markers (BTM). Indeed, the demonstration of a significant decrease in BMD and the absence of a significant decrease in BTM while on therapy are considered as indicators of treatment failure. Moreover, other biochemical, clinical, and genetic parameters can be predictive of an inadequate response to bisphosphonate treatment.

Keywords

Osteoporosis Fracture Bisphosphonate Treatment failure Bone turnover Bone mineral density 

List of Abbreviations

AFF

Atypical femoral fracture

ALP

Alkaline phosphatase

BALP

Bone-specific alkaline phosphatase

BMD

Bone mineral density

BSP

Bone sialoprotein

BTM

Bone turnover marker

CTX

Carboxy-terminal cross-linking telopeptide of type I collagen

DPD

Deoxypyridinoline

FDFT1

Squalene synthase

FPPS

Farnesyl pyrophosphate synthase

GGPS

Geranylgeranyl diphosphate synthase

IFCC

International Federation of Clinical Chemistry and Laboratory Medicine

IOF

International Osteoporosis Foundation

LRP5

Low-density lipoprotein receptor-related protein

LSC

Least significant change

MVK

Mevalonate kinase

NTX

Amino-terminal cross-linking telopeptide of type I collagen

OC

Osteocalcin

ONJ

Osteonecrosis of the jaw

PINP

Amino-terminal propeptide of type I procollagen

VDR

Vitamin D receptor

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Copyright information

© Springer Science+Business Media Dordrecht 2017

Authors and Affiliations

  1. 1.Unit of Endocrinology and Metabolic DiseasesFondazione IRCCS Ca’ Granda – Ospedale Maggiore PoliclinicoMilanItaly
  2. 2.Department of Clinical Sciences and Community HealthUniversity of MilanMilanItaly

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