Algorithm for the se 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...

Descripción completa

Detalles Bibliográficos
Autores: Lorentzon, Mattias, Díez Pérez, Adolfo, Cavalier, Etienne
Tipo de recurso: artículo
Estado:Versión aceptada para publicación
Fecha de publicación:2019
País:España
Institución:Universitat Pompeu Fabra
Repositorio:Repositorio Digital de la UPF
OAI Identifier:oai:repositori.upf.edu:10230/42733
Acceso en línea:http://hdl.handle.net/10230/42733
http://dx.doi.org/10.1007/s12325-019-01063-9
Access Level:acceso abierto
Palabra clave:Algorithm
Bone
Bone biomarker
CTX
Osteoporosis
P1NP
Rheumatology
id ES_c2ae09dfd1922266fc4458ae9bc6f5db
oai_identifier_str oai:repositori.upf.edu:10230/42733
network_acronym_str ES
network_name_str España
repository_id_str
spelling Algorithm for the se of biochemical markers of bone turnover in the diagnosis, assessment and follow-up of treatment for osteoporosisLorentzon, MattiasDíez Pérez, AdolfoCavalier, EtienneAlgorithmBoneBone 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.Springer20192019info:eu-repo/semantics/articleinfo:eu-repo/semantics/acceptedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/42733http://dx.doi.org/10.1007/s12325-019-01063-9reponame:Repositorio Digital de la UPFinstname:Universitat Pompeu FabraInglés© Springer The final publication is available at Springer via http://dx.doi.org/10.1007/s12325-019-01063-9info:eu-repo/semantics/openAccessoai:repositori.upf.edu:10230/427332026-06-12T07:21:37Z
dc.title.none.fl_str_mv Algorithm for the se of biochemical markers of bone turnover in the diagnosis, assessment and follow-up of treatment for osteoporosis
title Algorithm for the se of biochemical markers of bone turnover in the diagnosis, assessment and follow-up of treatment for osteoporosis
spellingShingle Algorithm for the se of biochemical markers of bone turnover in the diagnosis, assessment and follow-up of treatment for osteoporosis
Lorentzon, Mattias
Algorithm
Bone
Bone biomarker
CTX
Osteoporosis
P1NP
Rheumatology
title_short Algorithm for the se of biochemical markers of bone turnover in the diagnosis, assessment and follow-up of treatment for osteoporosis
title_full Algorithm for the se of biochemical markers of bone turnover in the diagnosis, assessment and follow-up of treatment for osteoporosis
title_fullStr Algorithm for the se of biochemical markers of bone turnover in the diagnosis, assessment and follow-up of treatment for osteoporosis
title_full_unstemmed Algorithm for the se of biochemical markers of bone turnover in the diagnosis, assessment and follow-up of treatment for osteoporosis
title_sort Algorithm for the se 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
Díez Pérez, Adolfo
Cavalier, Etienne
author Lorentzon, Mattias
author_facet Lorentzon, Mattias
Díez Pérez, Adolfo
Cavalier, Etienne
author_role author
author2 Díez Pérez, Adolfo
Cavalier, Etienne
author2_role author
author
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 2019
2019
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/acceptedVersion
format article
status_str acceptedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/42733
http://dx.doi.org/10.1007/s12325-019-01063-9
url http://hdl.handle.net/10230/42733
http://dx.doi.org/10.1007/s12325-019-01063-9
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Springer
publisher.none.fl_str_mv Springer
dc.source.none.fl_str_mv reponame:Repositorio Digital de la UPF
instname:Universitat Pompeu Fabra
instname_str Universitat Pompeu Fabra
reponame_str Repositorio Digital de la UPF
collection Repositorio Digital de la UPF
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869418708326154240
score 15,811543

Similares en LA Referencia