Algorithm for the Use of Biochemical Markers of Bone Turnover in the Diagnosis, Assessment and Follow-Up of Treatment for Osteoporosis

Introduction: Increased biochemical bone turnover markers (BTMs) measured in serum are associated with bone loss, increased fracture risk and poor treatment adherence, but their role in clinical practice is presently unclear. The aim of this consensus group report is to provide guidance to clinician...

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Autores: Lorentzon, Mattias|||0000-0003-0749-1431, Branco, Jaime|||0000-0001-7024-4375, Brandi, Maria Luisa|||0000-0002-8741-0592, Bruyère, Olivier|||0000-0003-4269-9393, Chapurlat, Roland|||0000-0001-8214-6385, Cooper, Cyrus|||0000-0003-3510-0709, Cortet, Bernard|||0000-0001-8912-0452, Díez Pérez, Adolfo|||0000-0001-8162-0209, Ferrari, Serge|||0000-0002-1372-4417, Gasparik, A., Herrmann, M., Jorgensen, N. R., Kanis, J., Kaufman, Jean-Marc, Laslop, A., Locquet, Medea, Matijevic, Radmila|||0000-0002-4993-9399, McCloskey, E., Minisola, S., Pikner, R., Reginster, Jean-Yves|||0000-0001-6290-752X, Rizzoli, R., Szulc, Pawel, Vlaskovska, M., Cavalier, Etienne|||0000-0003-0947-2226
Tipo de recurso: artículo
Fecha de publicación:2019
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:223295
Acceso en línea:https://ddd.uab.cat/record/223295
https://dx.doi.org/urn:doi:10.1007/s12325-019-01063-9
Access Level:acceso abierto
Palabra clave:Algorithm
Bone
Bone biomarker
CTX
Osteoporosis
P1NP
Rheumatology
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spelling Algorithm for the Use of Biochemical Markers of Bone Turnover in the Diagnosis, Assessment and Follow-Up of Treatment for OsteoporosisLorentzon, Mattias|||0000-0003-0749-1431Branco, Jaime|||0000-0001-7024-4375Brandi, Maria Luisa|||0000-0002-8741-0592Bruyère, Olivier|||0000-0003-4269-9393Chapurlat, Roland|||0000-0001-8214-6385Cooper, Cyrus|||0000-0003-3510-0709Cortet, Bernard|||0000-0001-8912-0452Díez Pérez, Adolfo|||0000-0001-8162-0209Ferrari, Serge|||0000-0002-1372-4417Gasparik, A.Herrmann, M.Jorgensen, N. R.Kanis, J.Kaufman, Jean-MarcLaslop, A.Locquet, MedeaMatijevic, Radmila|||0000-0002-4993-9399McCloskey, E.Minisola, S.Pikner, R.Reginster, Jean-Yves|||0000-0001-6290-752XRizzoli, R.Szulc, PawelVlaskovska, M.Cavalier, Etienne|||0000-0003-0947-2226AlgorithmBoneBone biomarkerCTXOsteoporosisP1NPRheumatologyIntroduction: Increased biochemical bone turnover markers (BTMs) measured in serum are associated with bone loss, increased fracture risk and poor treatment adherence, but their role in clinical practice is presently unclear. The aim of this consensus group report is to provide guidance to clinicians on how to use BTMs in patient evaluation in postmenopausal osteoporosis, in fracture risk prediction and in the monitoring of treatment efficacy and adherence to osteoporosis medication. Methods: A working group with clinical scientists and osteoporosis specialists was invited by the Scientific Advisory Board of European Society on Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). Results: Serum bone formation marker PINP and resorption marker βCTX-I are the preferred markers for evaluating bone turnover in the clinical setting due to their specificity to bone, performance in clinical studies, wide use and relatively low analytical variability. BTMs cannot be used to diagnose osteoporosis because of low sensitivity and specificity, but can be of value in patient evaluation where high values may indicate the need to investigate some causes of secondary osteoporosis. Assessing serum levels of βCTX-I and PINP can improve fracture prediction slightly, with a gradient of risk of about 1.2 per SD increase in the bone marker in addition to clinical risk factors and bone mineral density. For an individual patient, BTMs are not useful in projecting bone loss or treatment efficacy, but it is recommended that serum PINP and βCTX-I be used to monitor adherence to oral bisphosphonate treatment. Suppression of the BTMs greater than the least significant change or to levels in the lower half of the reference interval in young and healthy premenopausal women is closely related to treatment adherence. Conclusion: In conclusion, the currently available evidence indicates that the principal clinical utility of BTMs is for monitoring oral bisphosphonate therapy.Universitat Autònoma de Barcelona 22019-01-0120192019-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/223295https://dx.doi.org/urn:doi:10.1007/s12325-019-01063-9reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.https://creativecommons.org/licenses/by-nc/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:2232952026-06-06T12:50:31Z
dc.title.none.fl_str_mv Algorithm for the Use of Biochemical Markers of Bone Turnover in the Diagnosis, Assessment and Follow-Up of Treatment for Osteoporosis
title Algorithm for the Use of Biochemical Markers of Bone Turnover in the Diagnosis, Assessment and Follow-Up of Treatment for Osteoporosis
spellingShingle Algorithm for the Use of Biochemical Markers of Bone Turnover in the Diagnosis, Assessment and Follow-Up of Treatment for Osteoporosis
Lorentzon, Mattias|||0000-0003-0749-1431
Algorithm
Bone
Bone biomarker
CTX
Osteoporosis
P1NP
Rheumatology
title_short Algorithm for the Use of Biochemical Markers of Bone Turnover in the Diagnosis, Assessment and Follow-Up of Treatment for Osteoporosis
title_full Algorithm for the Use of Biochemical Markers of Bone Turnover in the Diagnosis, Assessment and Follow-Up of Treatment for Osteoporosis
title_fullStr Algorithm for the Use of Biochemical Markers of Bone Turnover in the Diagnosis, Assessment and Follow-Up of Treatment for Osteoporosis
title_full_unstemmed Algorithm for the Use of Biochemical Markers of Bone Turnover in the Diagnosis, Assessment and Follow-Up of Treatment for Osteoporosis
title_sort Algorithm for the Use of Biochemical Markers of Bone Turnover in the Diagnosis, Assessment and Follow-Up of Treatment for Osteoporosis
dc.creator.none.fl_str_mv Lorentzon, Mattias|||0000-0003-0749-1431
Branco, Jaime|||0000-0001-7024-4375
Brandi, Maria Luisa|||0000-0002-8741-0592
Bruyère, Olivier|||0000-0003-4269-9393
Chapurlat, Roland|||0000-0001-8214-6385
Cooper, Cyrus|||0000-0003-3510-0709
Cortet, Bernard|||0000-0001-8912-0452
Díez Pérez, Adolfo|||0000-0001-8162-0209
Ferrari, Serge|||0000-0002-1372-4417
Gasparik, A.
Herrmann, M.
Jorgensen, N. R.
Kanis, J.
Kaufman, Jean-Marc
Laslop, A.
Locquet, Medea
Matijevic, Radmila|||0000-0002-4993-9399
McCloskey, E.
Minisola, S.
Pikner, R.
Reginster, Jean-Yves|||0000-0001-6290-752X
Rizzoli, R.
Szulc, Pawel
Vlaskovska, M.
Cavalier, Etienne|||0000-0003-0947-2226
author Lorentzon, Mattias|||0000-0003-0749-1431
author_facet Lorentzon, Mattias|||0000-0003-0749-1431
Branco, Jaime|||0000-0001-7024-4375
Brandi, Maria Luisa|||0000-0002-8741-0592
Bruyère, Olivier|||0000-0003-4269-9393
Chapurlat, Roland|||0000-0001-8214-6385
Cooper, Cyrus|||0000-0003-3510-0709
Cortet, Bernard|||0000-0001-8912-0452
Díez Pérez, Adolfo|||0000-0001-8162-0209
Ferrari, Serge|||0000-0002-1372-4417
Gasparik, A.
Herrmann, M.
Jorgensen, N. R.
Kanis, J.
Kaufman, Jean-Marc
Laslop, A.
Locquet, Medea
Matijevic, Radmila|||0000-0002-4993-9399
McCloskey, E.
Minisola, S.
Pikner, R.
Reginster, Jean-Yves|||0000-0001-6290-752X
Rizzoli, R.
Szulc, Pawel
Vlaskovska, M.
Cavalier, Etienne|||0000-0003-0947-2226
author_role author
author2 Branco, Jaime|||0000-0001-7024-4375
Brandi, Maria Luisa|||0000-0002-8741-0592
Bruyère, Olivier|||0000-0003-4269-9393
Chapurlat, Roland|||0000-0001-8214-6385
Cooper, Cyrus|||0000-0003-3510-0709
Cortet, Bernard|||0000-0001-8912-0452
Díez Pérez, Adolfo|||0000-0001-8162-0209
Ferrari, Serge|||0000-0002-1372-4417
Gasparik, A.
Herrmann, M.
Jorgensen, N. R.
Kanis, J.
Kaufman, Jean-Marc
Laslop, A.
Locquet, Medea
Matijevic, Radmila|||0000-0002-4993-9399
McCloskey, E.
Minisola, S.
Pikner, R.
Reginster, Jean-Yves|||0000-0001-6290-752X
Rizzoli, R.
Szulc, Pawel
Vlaskovska, M.
Cavalier, Etienne|||0000-0003-0947-2226
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universitat Autònoma de Barcelona
dc.subject.none.fl_str_mv Algorithm
Bone
Bone biomarker
CTX
Osteoporosis
P1NP
Rheumatology
topic Algorithm
Bone
Bone biomarker
CTX
Osteoporosis
P1NP
Rheumatology
description Introduction: Increased biochemical bone turnover markers (BTMs) measured in serum are associated with bone loss, increased fracture risk and poor treatment adherence, but their role in clinical practice is presently unclear. The aim of this consensus group report is to provide guidance to clinicians on how to use BTMs in patient evaluation in postmenopausal osteoporosis, in fracture risk prediction and in the monitoring of treatment efficacy and adherence to osteoporosis medication. Methods: A working group with clinical scientists and osteoporosis specialists was invited by the Scientific Advisory Board of European Society on Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). Results: Serum bone formation marker PINP and resorption marker βCTX-I are the preferred markers for evaluating bone turnover in the clinical setting due to their specificity to bone, performance in clinical studies, wide use and relatively low analytical variability. BTMs cannot be used to diagnose osteoporosis because of low sensitivity and specificity, but can be of value in patient evaluation where high values may indicate the need to investigate some causes of secondary osteoporosis. Assessing serum levels of βCTX-I and PINP can improve fracture prediction slightly, with a gradient of risk of about 1.2 per SD increase in the bone marker in addition to clinical risk factors and bone mineral density. For an individual patient, BTMs are not useful in projecting bone loss or treatment efficacy, but it is recommended that serum PINP and βCTX-I be used to monitor adherence to oral bisphosphonate treatment. Suppression of the BTMs greater than the least significant change or to levels in the lower half of the reference interval in young and healthy premenopausal women is closely related to treatment adherence. Conclusion: In conclusion, the currently available evidence indicates that the principal clinical utility of BTMs is for monitoring oral bisphosphonate therapy.
publishDate 2019
dc.date.none.fl_str_mv 2
2019-01-01
2019
2019-01-01
dc.type.none.fl_str_mv Article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/223295
https://dx.doi.org/urn:doi:10.1007/s12325-019-01063-9
url https://ddd.uab.cat/record/223295
https://dx.doi.org/urn:doi:10.1007/s12325-019-01063-9
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by-nc/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
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https://creativecommons.org/licenses/by-nc/4.0/
eu_rights_str_mv openAccess
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dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
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