Osteoporosis secondary prevention: Difference between revisions
Jump to navigation
Jump to search
No edit summary |
No edit summary |
||
| Line 12: | Line 12: | ||
*The primary most important goal for treatment of [[osteoporosis]] is to reduce longtime [[fracture]] risk in patients. Increasing [[Bone mineral density|bone mineral density (BMD)]] in response to the treatment is far less important than improvement of clinical aspects of [[osteoporosis]], i.e., [[Osteoporosis|osteoporotic]] [[Bone fracture|fracture]]. Therefore, most of the [[drugs]]' efficacy is measured by the extent they improve the [[fracture]] risk, in turn of increasing [[Bone mineral density|BMD]].<ref name="pmid11893367">{{cite journal |vauthors=Cummings SR, Karpf DB, Harris F, Genant HK, Ensrud K, LaCroix AZ, Black DM |title=Improvement in spine bone density and reduction in risk of vertebral fractures during treatment with antiresorptive drugs |journal=Am. J. Med. |volume=112 |issue=4 |pages=281–9 |year=2002 |pmid=11893367 |doi= |url=}}</ref> | *The primary most important goal for treatment of [[osteoporosis]] is to reduce longtime [[fracture]] risk in patients. Increasing [[Bone mineral density|bone mineral density (BMD)]] in response to the treatment is far less important than improvement of clinical aspects of [[osteoporosis]], i.e., [[Osteoporosis|osteoporotic]] [[Bone fracture|fracture]]. Therefore, most of the [[drugs]]' efficacy is measured by the extent they improve the [[fracture]] risk, in turn of increasing [[Bone mineral density|BMD]].<ref name="pmid11893367">{{cite journal |vauthors=Cummings SR, Karpf DB, Harris F, Genant HK, Ensrud K, LaCroix AZ, Black DM |title=Improvement in spine bone density and reduction in risk of vertebral fractures during treatment with antiresorptive drugs |journal=Am. J. Med. |volume=112 |issue=4 |pages=281–9 |year=2002 |pmid=11893367 |doi= |url=}}</ref> | ||
*It has to explain to patients that treatment purpose is to reduce their [[fracture]] risk in the future. During the treatment, if a single [[fracture]] happened, it does not necessarily | *It has to explain to patients that treatment purpose is to reduce their [[fracture]] risk in the future. During the treatment, if a single [[fracture]] happened, it does not necessarily indicate treatment failure; despite the major complicates [[fractures]] that may need to start alternative treatments or patient referral to a [[specialist]].<ref name="pmid28761958">{{cite journal |vauthors=Ensrud KE, Crandall CJ |title=Osteoporosis |journal=Ann. Intern. Med. |volume=167 |issue=3 |pages=ITC17–ITC32 |year=2017 |pmid=28761958 |doi=10.7326/AITC201708010 |url=}}</ref> | ||
*[[Calcium]] and [[vitamin D]] supplementation have been found to be effective in reducing the long term [[Bone fracture|fracture]] risk, significantly. In order to suggest the people use [[vitamin D]] and [[calcium]] [[supplements]], first, the [[physician]] has to become sure that patient is not able to obtain the [[nutrients]] through the daily intake. The available supplemental ions of [[calcium]] include [[calcium carbonate]], [[calcium citrate|calcium citrate,]] and [[vitamin D3]] has various [[Dosage form|dosage forms]].<ref name="pmid24131178">{{cite journal |vauthors=Bauer DC |title=Clinical practice. Calcium supplements and fracture prevention |journal=N. Engl. J. Med. |volume=369 |issue=16 |pages=1537–43 |year=2013 |pmid=24131178 |pmc=4038300 |doi=10.1056/NEJMcp1210380 |url=}}</ref> | *[[Calcium]] and [[vitamin D]] supplementation have been found to be effective in reducing the long term [[Bone fracture|fracture]] risk, significantly. In order to suggest the people use [[vitamin D]] and [[calcium]] [[supplements]], first, the [[physician]] has to become sure that patient is not able to obtain the [[nutrients]] through the daily intake. The available supplemental ions of [[calcium]] include [[calcium carbonate]], [[calcium citrate|calcium citrate,]] and [[vitamin D3]] has various [[Dosage form|dosage forms]].<ref name="pmid24131178">{{cite journal |vauthors=Bauer DC |title=Clinical practice. Calcium supplements and fracture prevention |journal=N. Engl. J. Med. |volume=369 |issue=16 |pages=1537–43 |year=2013 |pmid=24131178 |pmc=4038300 |doi=10.1056/NEJMcp1210380 |url=}}</ref> | ||
Revision as of 17:38, 11 September 2017
|
Osteoporosis Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Medical Therapy |
|
Case Studies |
|
Osteoporosis secondary prevention On the Web |
|
American Roentgen Ray Society Images of Osteoporosis secondary prevention |
|
Risk calculators and risk factors for Osteoporosis secondary prevention |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]
Overview
Effective measures for the secondary prevention of osteoporosis include pharmacological therapy and also lifestyle modification as soon as osteoporosis is diagnosed.
Secondary prevention
Effective measures for the secondary prevention of osteoporosis include pharmacological therapy and also lifestyle modification.
Pharmacological therapy
- The primary most important goal for treatment of osteoporosis is to reduce longtime fracture risk in patients. Increasing bone mineral density (BMD) in response to the treatment is far less important than improvement of clinical aspects of osteoporosis, i.e., osteoporotic fracture. Therefore, most of the drugs' efficacy is measured by the extent they improve the fracture risk, in turn of increasing BMD.[1]
- It has to explain to patients that treatment purpose is to reduce their fracture risk in the future. During the treatment, if a single fracture happened, it does not necessarily indicate treatment failure; despite the major complicates fractures that may need to start alternative treatments or patient referral to a specialist.[2]
- Calcium and vitamin D supplementation have been found to be effective in reducing the long term fracture risk, significantly. In order to suggest the people use vitamin D and calcium supplements, first, the physician has to become sure that patient is not able to obtain the nutrients through the daily intake. The available supplemental ions of calcium include calcium carbonate, calcium citrate, and vitamin D3 has various dosage forms.[3]
Life style modifications
- Exercise: Exercise promotes the mineralization of bone and bone accumulation particularly during growth. High impact exercise, in particular, has been shown to prevent the development of osteoporosis, however, it can have a negative effect on bone mineralization in cases of poor nutrition, such as anorexia nervosa and celiac disease.
- Nutrition: A diet high in calcium and vitamin D prevents bone loss. Patients at risk for osteoporosis, such as persons with chronic steroid use are generally treated with vitamin D and calcium supplementation. In renal disease, more active forms of vitamin D, such as 1,25-dihydroxycholecalciferol or calcitriol are used; as the kidney can not adequately generate calcitriol from calcidiol (25-hydroxycholecalciferol), which is the storage form of vitamin D.
- Quitting smoking helps prevent osteoporosis, as well as other diseases.
- Not drinking alcohol, or drinking only in moderation (1–2 alcoholic beverages/day)
- Taking certain medications linked to osteoporosis (anticonvulsants or corticosteroids) only at the least possible dose and time needed.[4]
References
- ↑ Cummings SR, Karpf DB, Harris F, Genant HK, Ensrud K, LaCroix AZ, Black DM (2002). "Improvement in spine bone density and reduction in risk of vertebral fractures during treatment with antiresorptive drugs". Am. J. Med. 112 (4): 281–9. PMID 11893367.
- ↑ Ensrud KE, Crandall CJ (2017). "Osteoporosis". Ann. Intern. Med. 167 (3): ITC17–ITC32. doi:10.7326/AITC201708010. PMID 28761958.
- ↑ Bauer DC (2013). "Clinical practice. Calcium supplements and fracture prevention". N. Engl. J. Med. 369 (16): 1537–43. doi:10.1056/NEJMcp1210380. PMC 4038300. PMID 24131178.
- ↑ Buckley, Lenore; Guyatt, Gordon; Fink, Howard A.; Cannon, Michael; Grossman, Jennifer; Hansen, Karen E.; Humphrey, Mary Beth; Lane, Nancy E.; Magrey, Marina; Miller, Marc; Morrison, Lake; Rao, Madhumathi; Robinson, Angela Byun; Saha, Sumona; Wolver, Susan; Bannuru, Raveendhara R.; Vaysbrot, Elizaveta; Osani, Mikala; Turgunbaev, Marat; Miller, Amy S.; McAlindon, Timothy (2017). "2017 American College of Rheumatology Guideline for the Prevention and Treatment of Glucocorticoid-Induced Osteoporosis". Arthritis & Rheumatology. 69 (8): 1521–1537. doi:10.1002/art.40137. ISSN 2326-5191.