1932

Abstract

A hallmark of menopause, which follows the decline in the ovarian production of estrogen, is the aggressive and persistent loss of bone mineral and structural elements leading to loss of bone strength and increased fracture risk. This review focuses on newer methods of diagnosing osteoporosis and assessing fracture risk, as well as on novel management strategies for prevention and treatment. Fracture-risk prediction has been significantly enhanced by the development of methods such as the trabecular bone score, which helps assess bone microarchitecture and adds value to standard bone densitometry, and the Fracture Risk Assessment Tool (FRAX) algorithm techniques. The treatment of osteoporosis, which has the goals of fracture prevention and risk reduction, is moving beyond traditional monotherapies with antiresorptives and anabolic agents into new combination regimens.

Loading

Article metrics loading...

/content/journals/10.1146/annurev-med-070313-022841
2015-01-14
2024-04-23
Loading full text...

Full text loading...

/deliver/fulltext/med/66/1/annurev-med-070313-022841.html?itemId=/content/journals/10.1146/annurev-med-070313-022841&mimeType=html&fmt=ahah

Literature Cited

  1. Lewiecki EM, Gordon CM, Baim S. 1.  et al. 2008. International Society for Clinical Densitometry 2007 Adult and Pediatric Official Positions. Bone 43:1115–21 [Google Scholar]
  2. 2. Eur. Found. Osteoporos. Bone Dis 2001. Osteoporosis prevention, diagnosis, and therapy. Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy. NIH Consensus. JAMA 285:78S [Google Scholar]
  3. Stone KL, Seeley DG, Lui LY. 3.  et al. 2003. BMD at multiple sites and risk of fracture of multiple types: long-term results from the Study of Osteoporotic Fractures. J. Bone Miner. Res. 18:1947–54 [Google Scholar]
  4. Johnell O, Kanis JA, Oden A. 4.  et al. 2005. Predictive value of BMD for hip and other fractures. J. Bone Miner. Res. 20:1185–94 [Google Scholar]
  5. Compston J.5.  2009. Monitoring bone mineral density during antiresorptive treatment for osteoporosis. BMJ 338:b1276 [Google Scholar]
  6. Schousboe JT, Vokes T, Broy SB. 6.  et al. 2008. Vertebral fracture assessment: the 2007 ISCD official positions. J. Clin. Densitom. 11:92–108 [Google Scholar]
  7. Blake GM, Chinn DJ, Steel SA. 7.  et al. 2005. A list of device-specific thresholds for the clinical interpretation of peripheral x-ray absorptiometry examinations. Osteoporos. Int. 16:2149–56 [Google Scholar]
  8. Kanis JA, Johnell O, Oden A. 8.  et al. 2008. FRAX and the assessment of fracture probability in men and women from the UK. Osteoporos. Int. 19:385–97 [Google Scholar]
  9. Kanis JA, Oden A, Johnell O. 9.  et al. 2007. The use of clinical risk factors enhances the performance of BMD in the prediction of hip and osteoporotic fractures in men and women. Osteoporos. Int. 18:1033–46 [Google Scholar]
  10. Leslie WD, Lix LM, Johansson H. 10.  et al. 2010. Independent clinical validation of a Canadian FRAX tool: fracture prediction and model calibration. J. Bone Miner. Res. 25:2350–58 [Google Scholar]
  11. Hippisley-Cox J, Coupland C. 11.  2009. Predicting risk of osteoporotic fracture in men and women in England and Wales: prospective derivation and validation of QFractureScores. BMJ 339:b4229 [Google Scholar]
  12. Kanis JA, Johnell O, De Laet C. 12.  et al. 2002. International variations in hip fracture probabilities: implications for risk assessment. J. Bone Miner. Res. 17:1237–44 [Google Scholar]
  13. Leslie WD, Lix LM, Johansson H. 13.  et al. 2012. Does osteoporosis therapy invalidate FRAX for fracture prediction?. J. Bone Miner. Res. 27:1243–51 [Google Scholar]
  14. Leslie WD, Lix LM, Johansson H. 14.  et al. 2011. Spine-hip discordance and fracture risk assessment: a physician-friendly FRAX enhancement. Osteoporos. Int. 22:839–47 [Google Scholar]
  15. Wainwright SA, Marshall LM, Ensrud KE. 15.  et al. 2005. Hip fracture in women without osteoporosis. J. Clin. Endocrinol. Metab. 90:2787–93 [Google Scholar]
  16. Boutroy S, Bouxsein ML, Munoz F, Delmas PD. 16.  2005. In vivo assessment of trabecular bone microarchitecture by high-resolution peripheral quantitative computed tomography. J. Clin. Endocrinol. Metab. 90:6508–15 [Google Scholar]
  17. Genant HK, Engelke K, Prevrhal S. 17.  2008. Advanced CT bone imaging in osteoporosis. Rheumatology 47:Suppl. 4v9–16 [Google Scholar]
  18. Krug R, Carballido-Gamio J, Banerjee S. 18.  et al. 2008. In vivo ultra-high-field magnetic resonance imaging of trabecular bone microarchitecture at 7 T. J. Magn. Reson. Imaging 27:854–59 [Google Scholar]
  19. Poole KE, Treece GM, Mayhew PM. 19.  et al. 2012. Cortical thickness mapping to identify focal osteoporosis in patients with hip fracture. PLOS ONE 7:e38466 [Google Scholar]
  20. Center JR, Nguyen TV, Pocock NA. 20.  et al. 1998. Femoral neck axis length, height loss and risk of hip fracture in males and females. Osteoporos. Int. 8:75–81 [Google Scholar]
  21. Naylor KE, McCloskey EV, Eastell R, Yang L. 21.  2013. Use of DXA-based finite element analysis of the proximal femur in a longitudinal study of hip fracture. J. Bone Miner. Res. 28:1014–21 [Google Scholar]
  22. Pothuaud L, Benhamou CL, Porion P. 22.  et al. 2000. Fractal dimension of trabecular bone projection texture is related to three-dimensional microarchitecture. J. Bone Miner. Res. 15:691–99 [Google Scholar]
  23. Hans D, Barthe N, Boutroy S. 23.  et al. 2011. Correlations between trabecular bone score, measured using anteroposterior dual-energy X-ray absorptiometry acquisition, and 3-dimensional parameters of bone microarchitecture: an experimental study on human cadaver vertebrae. J. Clin. Densitom. 14:302–12 [Google Scholar]
  24. Silva BC, Walker MD, Abraham A. 24.  et al. 2013. Trabecular bone score is associated with volumetric bone density and microarchitecture as assessed by central QCT and HRpQCT in Chinese American and white women. J. Clin. Densitom. 16:554–61 [Google Scholar]
  25. Silva BC, Leslie WD, Resch H. 25.  et al. 2014. Trabecular bone score: a noninvasive analytical method based upon the DXA image. J. Bone Miner. Res. 29:518–30 [Google Scholar]
  26. Hans D, Goertzen AL, Krieg MA, Leslie WD. 26.  2011. Bone microarchitecture assessed by TBS predicts osteoporotic fractures independent of bone density: the Manitoba study. J. Bone Miner. Res. 26:2762–69 [Google Scholar]
  27. Briot K, Paternotte S, Kolta S. 27.  et al. 2013. Added value of trabecular bone score to bone mineral density for prediction of osteoporotic fractures in postmenopausal women: the OPUS study. Bone 57:232–36 [Google Scholar]
  28. Cormier C, Lamy O, Poriau S. 28.  2012. TBS in Routine Medical Practice: Proposals of Use Plan-les-Ouates, Switz.: Medimaps Group. http://www.medimapsgroup.com/upload/MEDIMAPS-UK-WEB.pdf
  29. Pothuaud L, Barthe N, Krieg MA. 29.  et al. 2009. Evaluation of the potential use of trabecular bone score to complement bone mineral density in the diagnosis of osteoporosis: a preliminary spine BMD-matched, case-control study. J. Clin. Densitom. 12:170–76 [Google Scholar]
  30. Winzenrieth R, Dufour R, Pothuaud L, Hans D. 30.  2010. A retrospective case-control study assessing the role of trabecular bone score in postmenopausal Caucasian women with osteopenia: analyzing the odds of vertebral fracture. Calcif. Tissue Int. 86:104–9 [Google Scholar]
  31. Rabier B, Heraud A, Grand-Lenoir C. 31.  et al. 2010. A multicentre, retrospective case-control study assessing the role of trabecular bone score (TBS) in menopausal Caucasian women with low areal bone mineral density (BMDa): analysing the odds of vertebral fracture. Bone 46:176–81 [Google Scholar]
  32. Krueger D, Fidler E, Libber J. 32.  et al. 2014. Spine trabecular bone score subsequent to bone mineral density improves fracture discrimination in women. J. Clin. Densitom. 17:60–65 [Google Scholar]
  33. Leib E, Winzenrieth R, Aubry-Rozier B, Hans D. 33.  2014. Vertebral microarchitecture and fragility fracture in men: a TBS study. Bone 62:51–55 [Google Scholar]
  34. Boutroy S, Hans D, Sornay-Rendu E. 34.  et al. 2013. Trabecular bone score improves fracture risk prediction in non-osteoporotic women: the OFELY study. Osteoporos. Int. 24:77–85 [Google Scholar]
  35. Krieg MA, Aubry-Rozier B, Hans D, Leslie WD. 35.  2013. Effects of anti-resorptive agents on trabecular bone score (TBS) in older women. Osteoporos. Int. 24:1073–78 [Google Scholar]
  36. Senn C, Gunther B, Popp AW. 36.  et al. 2014. Comparative effects of teriparatide and ibandronate on spine bone mineral density (BMD) and microarchitecture (TBS) in postmenopausal women with osteoporosis: a 2-year open-label study. Osteoporos. Int. 25:1945–51 [Google Scholar]
  37. Kolta S, Briot K, Fechtenbaum J. 37.  et al. 2014. TBS result is not affected by lumbar spine osteoarthritis. Osteoporos. Int. 25:1759–64 [Google Scholar]
  38. Leslie WD, Krieg MA, Hans D. 38.  2013. Clinical factors associated with trabecular bone score. J. Clin. Densitom. 16:374–79 [Google Scholar]
  39. Lamy O, Krieg MA, Stoll D. 39.  et al. 2013. What is the performance in vertebral fracture discrimination by bone mineral density (BMD), microarchitecture estimation (TBS), and FRAX in stand-alone, combined or adjusted approaches: the OsteoLaus Study. Bone Abstr. 1:PP339 [Google Scholar]
  40. Tang BM, Eslick GD, Nowson C. 40.  et al. 2007. Use of calcium or calcium in combination with vitamin D supplementation to prevent fractures and bone loss in people aged 50 years and older: a meta-analysis. Lancet 370:657–66 [Google Scholar]
  41. Bolland MJ, Avenell A, Baron JA. 41.  et al. 2010. Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis. BMJ 341:c3691 [Google Scholar]
  42. Wang L, Manson JE, Song Y, Sesso HD. 42.  2010. Systematic review: Vitamin D and calcium supplementation in prevention of cardiovascular events. Ann. Intern. Med. 152:315–23 [Google Scholar]
  43. Lewis JR, Calver J, Zhu K. 43.  et al. 2011. Calcium supplementation and the risks of atherosclerotic vascular disease in older women: results of a 5-year RCT and a 4.5-year follow-up. J. Bone Miner. Res. 26:35–41 [Google Scholar]
  44. Bockman RS, Zapalowski C, Kiel DP, Adler RA. 44.  2012. Commentary on calcium supplements and cardiovascular events. J. Clin. Densitom. 15:130–34 [Google Scholar]
  45. Langsetmo L, Berger C, Kreiger N. 45.  et al. 2013. Calcium and vitamin D intake and mortality: results from the Canadian Multicentre Osteoporosis Study (CaMos). J. Clin. Endocrinol. Metab. 98:3010–18 [Google Scholar]
  46. Anderson GL, Limacher M, Assaf AR. 46.  et al. 2004. Effects of conjugated equine estrogen in postmenopausal women with hysterectomy: the Women's Health Initiative randomized controlled trial. JAMA 291:1701–12 [Google Scholar]
  47. Ross AC, Manson JE, Abrams SA. 47.  et al. 2011. The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. J. Clin. Endocrinol. Metab. 96:53–58 [Google Scholar]
  48. Bischoff-Ferrari HA, Willett WC, Wong JB. 48.  et al. 2005. Fracture prevention with vitamin D supplementation: a meta-analysis of randomized controlled trials. JAMA 293:2257–64 [Google Scholar]
  49. Chapuy MC, Arlot ME, Duboeuf F. 49.  et al. 1992. Vitamin D3 and calcium to prevent hip fractures in the elderly women. N. Engl. J. Med. 327:1637–42 [Google Scholar]
  50. Rossouw JE, Anderson GL, Prentice RL. 50.  et al. 2002. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women's Health Initiative randomized controlled trial. JAMA 288:321–33 [Google Scholar]
  51. Cauley JA, Robbins J, Chen Z. 51.  et al. 2003. Effects of estrogen plus progestin on risk of fracture and bone mineral density: the Women's Health Initiative randomized trial. JAMA 290:1729–38 [Google Scholar]
  52. Greendale GA, Espeland M, Slone S. 52.  et al. 2002. Bone mass response to discontinuation of long-term hormone replacement therapy: results from the Postmenopausal Estrogen/Progestin Interventions (PEPI) Safety Follow-up Study. Arch. Intern. Med. 162:665–72 [Google Scholar]
  53. Ettinger B, Black DM, Mitlak BH. 53.  et al. [Multiple Outcomes of Raloxifene Evaluation (MORE) Investigators.] 1999. Reduction of vertebral fracture risk in postmenopausal women with osteoporosis treated with raloxifene: results from a 3-year randomized clinical trial. JAMA 282:637–45 [Google Scholar]
  54. Russell RG, Watts NB, Ebetino FH, Rogers MJ. 54.  2008. Mechanisms of action of bisphosphonates: similarities and differences and their potential influence on clinical efficacy. Osteoporos. Int. 19:733–59 [Google Scholar]
  55. Black DM, Cummings SR, Karpf DB. 55.  et al. 1996. Randomised trial of effect of alendronate on risk of fracture in women with existing vertebral fractures. Fracture Intervention Trial Research Group.. Lancet 348:1535–41 [Google Scholar]
  56. Cummings SR, Black DM, Thompson DE. 56.  et al. 1998. Effect of alendronate on risk of fracture in women with low bone density but without vertebral fractures: results from the Fracture Intervention Trial. JAMA 280:2077–82 [Google Scholar]
  57. Harris ST, Watts NB, Genant HK. 57.  et al. [Vertebral Efficacy With Risedronate Therapy (VERT) Study Group.] 1999. Effects of risedronate treatment on vertebral and nonvertebral fractures in women with postmenopausal osteoporosis: a randomized controlled trial. JAMA 282:1344–52 [Google Scholar]
  58. Black DM, Schwartz AV, Ensrud KE. 58.  et al. 2006. Effects of continuing or stopping alendronate after 5 years of treatment: the Fracture Intervention Trial Long-term Extension (FLEX): a randomized trial. JAMA 296:2927–38 [Google Scholar]
  59. Black DM, Reid IR, Boonen S. 59.  et al. 2012. The effect of 3 versus 6 years of zoledronic acid treatment of osteoporosis: a randomized extension to the HORIZON-Pivotal Fracture Trial (PFT). J. Bone Miner. Res. 27:243–54 [Google Scholar]
  60. Felsenberg D, Miller P, Armbrecht G. 60.  et al. 2005. Oral ibandronate significantly reduces the risk of vertebral fractures of greater severity after 1, 2, and 3 years in postmenopausal women with osteoporosis. Bone 37:651–54 [Google Scholar]
  61. Black DM, Thompson DE, Bauer DC. 61.  et al. 2000. Fracture risk reduction with alendronate in women with osteoporosis: the Fracture Intervention Trial. FIT Research Group.. J. Clin. Endocrinol. Metab. 85:4118–24 [Google Scholar]
  62. Liberman UA, Weiss SR, Broll J. 62.  et al. 1995. Effect of oral alendronate on bone mineral density and the incidence of fractures in postmenopausal osteoporosis. The Alendronate Phase III Osteoporosis Treatment Study Group.. N. Engl. J. Med. 333:1437–43 [Google Scholar]
  63. Cranney A, Wells GA, Yetisir E. 63.  et al. 2009. Ibandronate for the prevention of nonvertebral fractures: a pooled analysis of individual patient data. Osteoporos. Int. 20:291–97 [Google Scholar]
  64. Black DM, Delmas PD, Eastell R. 64.  et al. 2007. Once-yearly zoledronic acid for treatment of postmenopausal osteoporosis. N. Engl. J. Med. 356:1809–22 [Google Scholar]
  65. Lyles KW, Colon-Emeric CS, Magaziner JS. 65.  et al. 2007. Zoledronic acid and clinical fractures and mortality after hip fracture. N. Engl. J. Med. 357:1799–809 [Google Scholar]
  66. Khosla S, Burr D, Cauley J. 66.  et al. 2007. Bisphosphonate-associated osteonecrosis of the jaw: report of a task force of the American Society for Bone and Mineral Research. J. Bone Miner. Res. 22:1479–91 [Google Scholar]
  67. Shane E, Burr D, Abrahamsen B. 67.  et al. 2014. Atypical subtrochanteric and diaphyseal femoral fractures: second report of a task force of the American Society for Bone and Mineral Research. J. Bone Miner. Res. 29:1–23 [Google Scholar]
  68. Kim SY, Schneeweiss S, Katz JN. 68.  et al. 2011. Oral bisphosphonates and risk of subtrochanteric or diaphyseal femur fractures in a population-based cohort. J. Bone Miner. Res. 26:993–1001 [Google Scholar]
  69. Vestergaard P, Schwartz F, Rejnmark L, Mosekilde L. 69.  2011. Risk of femoral shaft and subtrochanteric fractures among users of bisphosphonates and raloxifene. Osteoporos. Int. 22:993–1001 [Google Scholar]
  70. Black DM, Kelly MP, Genant HK. 70.  et al. 2010. Bisphosphonates and fractures of the subtrochanteric or diaphyseal femur. N. Engl. J. Med. 362:1761–71 [Google Scholar]
  71. Abrahamsen B, Eiken P, Eastell R. 71.  2010. Cumulative alendronate dose and the long-term absolute risk of subtrochanteric and diaphyseal femur fractures: a register-based national cohort analysis. J. Clin. Endocrinol. Metab. 95:5258–65 [Google Scholar]
  72. Giusti A, Hamdy NA, Papapoulos SE. 72.  2010. Atypical fractures of the femur and bisphosphonate therapy: a systematic review of case/case series studies. Bone 47:169–80 [Google Scholar]
  73. Lenart BA, Neviaser AS, Lyman S. 73.  et al. 2009. Association of low-energy femoral fractures with prolonged bisphosphonate use: a case control study. Osteoporos. Int. 20:1353–62 [Google Scholar]
  74. Wang Z, Bhattacharyya T. 74.  2011. Trends in incidence of subtrochanteric fragility fractures and bisphosphonate use among the US elderly, 1996–2007. J. Bone Miner. Res. 26:553–60 [Google Scholar]
  75. Black DM, Bauer DC, Schwartz AV. 75.  et al. 2012. Continuing bisphosphonate treatment for osteoporosis—for whom and for how long?. N. Engl. J. Med. 366:2051–53 [Google Scholar]
  76. Sambrook PN, Cameron ID, Chen JS. 76.  et al. 2011. Oral bisphosphonates are associated with reduced mortality in frail older people: a prospective five-year study. Osteoporos. Int. 22:2551–56 [Google Scholar]
  77. Beaupre LA, Morrish DW, Hanley DA. 77.  et al. 2011. Oral bisphosphonates are associated with reduced mortality after hip fracture. Osteoporos. Int. 22:983–91 [Google Scholar]
  78. Cummings SR, San Martin J, McClung MR. 78.  et al. 2009. Denosumab for prevention of fractures in postmenopausal women with osteoporosis. N. Engl. J. Med. 361:756–65 [Google Scholar]
  79. Kong YY, Yoshida H, Sarosi I. 79.  et al. 1999. OPGL is a key regulator of osteoclastogenesis, lymphocyte development and lymph-node organogenesis. Nature 397:315–23 [Google Scholar]
  80. Wong BR, Josien R, Lee SY. 80.  et al. 1997. TRANCE (tumor necrosis factor [TNF]-related activation-induced cytokine), a new TNF family member predominantly expressed in T cells, is a dendritic cell-specific survival factor. J. Exp. Med. 186:2075–80 [Google Scholar]
  81. Watts NB, Roux C, Modlin JF. 81.  et al. 2012. Infections in postmenopausal women with osteoporosis treated with denosumab or placebo: coincidence or causal association?. Osteoporos. Int. 23:327–37 [Google Scholar]
  82. Papapoulos S, Chapurlat R, Libanati C. 82.  et al. 2012. Five years of denosumab exposure in women with postmenopausal osteoporosis: results from the first two years of the FREEDOM extension. J. Bone Miner. Res. 27:694–701 [Google Scholar]
  83. Bone HG, Bolognese MA, Yuen CK. 83.  et al. 2011. Effects of denosumab treatment and discontinuation on bone mineral density and bone turnover markers in postmenopausal women with low bone mass. J. Clin. Endocrinol. Metab. 96:972–80 [Google Scholar]
  84. McCloskey EV, Johansson H, Oden A. 84.  et al. 2012. Denosumab reduces the risk of osteoporotic fractures in postmenopausal women, particularly in those with moderate to high fracture risk as assessed with FRAX. J. Bone Miner. Res. 27:1480–86 [Google Scholar]
  85. Neer RM, Arnaud CD, Zanchetta JR. 85.  et al. 2001. Effect of parathyroid hormone (1–34) on fractures and bone mineral density in postmenopausal women with osteoporosis. N. Engl. J. Med. 344:1434–41 [Google Scholar]
  86. Chen P, Miller PD, Delmas PD. 86.  et al. 2006. Change in lumbar spine BMD and vertebral fracture risk reduction in teriparatide-treated postmenopausal women with osteoporosis. J. Bone Miner. Res. 21:1785–90 [Google Scholar]
  87. Gallagher JC, Rosen CJ, Chen P. 87.  et al. 2006. Response rate of bone mineral density to teriparatide in postmenopausal women with osteoporosis. Bone 39:1268–75 [Google Scholar]
  88. Cosman F, Eriksen EF, Recknor C. 88.  et al. 2011. Effects of intravenous zoledronic acid plus subcutaneous teriparatide [rhPTH(1–34)] in postmenopausal osteoporosis. J. Bone Miner. Res. 26:503–11 [Google Scholar]
  89. Finkelstein JS, Wyland JJ, Lee H, Neer RM. 89.  2010. Effects of teriparatide, alendronate, or both in women with postmenopausal osteoporosis. J. Clin. Endocrinol. Metab. 95:1838–45 [Google Scholar]
  90. Schafer AL, Sellmeyer DE, Palermo L. 90.  et al. 2012. Six months of parathyroid hormone (1–84) administered concurrently versus sequentially with monthly ibandronate over two years: the PTH and ibandronate combination study (PICS) randomized trial. J. Clin. Endocrinol. Metab. 97:3522–29 [Google Scholar]
  91. Black DM, Bilezikian JP, Ensrud KE. 91.  et al. 2005. One year of alendronate after one year of parathyroid hormone (1–84) for osteoporosis. N. Engl. J. Med. 353:555–65 [Google Scholar]
  92. Tsai JN, Uihlein AV, Lee H. 92.  et al. 2013. Teriparatide and denosumab, alone or combined, in women with postmenopausal osteoporosis: the DATA study randomised trial. Lancet 382:50–56 [Google Scholar]
  93. Tsai JN, Uihlein AV, Lee H. 93.  et al. 2013. Teriparatide and denosumab, alone or combined, in women with postmenopausal osteoporosis: the DATA study randomised trial. Lancet6;382988650–56
  94. Tsai JC, Uihlein AV, Zhu Y. 94.  et al. 2014. Comparative effects of teriparatide, denosumab, and combination therapy on peripheral compartmental bone density and microarchitecture: the DATA-HRpQCT Study. J. Bone Miner. Res. In press
  95. Muschitz C, Kocijan R, Fahrleitner-Pammer A. 95.  et al. 2013. Antiresorptives overlapping ongoing teriparatide treatment result in additional increases in bone mineral density. J. Bone Miner. Res. 28:196–205 [Google Scholar]
  96. Bockman RS, Nielsen E, Huang W. 96.  2013. Early bone resorptive response to teriparatide predicts bone density outcome at 2 years. Presentation No. SA0375. Poster presented at Annu. Meet. Am. Soc. Bone Miner. Res., Baltimore, MD
  97. McClung MR, Grauer A, Boonen S. 97.  et al. 2014. Romosozumab in postmenopausal women with low bone mineral density. N. Engl. J. Med. 370:412–20 [Google Scholar]
  98. Austin M, Yang YC, Vittinghoff E. 98.  et al. 2012. Relationship between bone mineral density changes with denosumab treatment and risk reduction for vertebral and nonvertebral fractures. J. Bone Miner. Res. 27:687–93 [Google Scholar]
  99. Jacques RM, Boonen S, Cosman F. 99.  et al. 2012. Relationship of changes in total hip bone mineral density to vertebral and nonvertebral fracture risk in women with postmenopausal osteoporosis treated with once-yearly zoledronic acid 5 mg: the HORIZON-Pivotal Fracture Trial (PFT). J. Bone Miner. Res. 27:1627–34 [Google Scholar]
/content/journals/10.1146/annurev-med-070313-022841
Loading
/content/journals/10.1146/annurev-med-070313-022841
Loading

Data & Media loading...

  • Article Type: Review Article
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error