We noted you are experiencing viewing problems
-
Check with your IT department that JWPlatform, JWPlayer and Amazon AWS & CloudFront are not being blocked by your network. The relevant domains are *.jwplatform.com, *.jwpsrv.com, *.jwpcdn.com, jwpltx.com, jwpsrv.a.ssl.fastly.net, *.amazonaws.com and *.cloudfront.net. The relevant ports are 80 and 443.
-
Check the following talk links to see which ones work correctly:
Auto Mode
HTTP Progressive Download Send us your results from the above test links at access@hstalks.com and we will contact you with further advice on troubleshooting your viewing problems. -
No luck yet? More tips for troubleshooting viewing issues
-
Contact HST Support access@hstalks.com
-
Please review our troubleshooting guide for tips and advice on resolving your viewing problems.
-
For additional help, please don't hesitate to contact HST support access@hstalks.com
We hope you have enjoyed this limited-length demo
This is a limited length demo talk; you may
login or
review methods of
obtaining more access.
Printable Handouts
Navigable Slide Index
- Introduction
- Disclosures/acknowledgements
- Pharmacologic management of osteoporosis
- Choosing anabolic vs. antiresorptive therapy
- Combination therapy rarely used
- PaTH 1 year changes with PTH1-84 in DXA BMD
- Caveats in generalizability of PaTH trial
- Treatment naďve/experienced response to TPTD
- Inactive and normal osteoclasts
- Re-evaluating combination and sequential therapy
- IV zoledronic acid and daily TPTD study overview
- IV Zol and daily TPTD in serum β–CTx and PINP
- IV Zol and daily TPTD in lumbar spine BMD (1)
- IV Zol and daily TPTD in lumbar spine BMD (2)
- IV Zol and daily TPTD - summary
- DATA trial: monotherapy vs. combination
- Monotherapy vs. combination therapy (1)
- Monotherapy vs. combination therapy (2)
- Monotherapy vs. combination therapy (3)
- Combination therapy in treatment naďve women
- TPTD in the treatment experienced woman
- TPTD after prior bisphosphonate treatment
- TPTD after raloxifene or alendronate
- Total hip BMD percent changes from baseline
- Adjusted mean BMD changes from baseline
- Total hip BMD
- Switch to TPTD after Dmab treatment
- DATA trial 1 year extension
- Switch to TPTD after antiresorptive treatment
- TPTD in treatment experienced
- Switch vs. add: PINP
- Switch vs. add: CTX
- Switch vs. add: BMD at 6 months
- Switch vs. add: BMD at 18 months
- Spine volumetric BMD
- Estimated spine strength
- Hip volumetric BMD
- Estimated hip strength
- Alendronate stratum - hip volumetric BMD
- Alendronate stratum - estimated hip strength
- CONFORS trial
- Bone turnover
- BMD
- Summary: combination therapy studies
- Possible role of combination Rx
Topics Covered
- Current pharmacologic management of osteoporosis
- Choosing anabolic vs. antiresorptive therapy
- The PaTH trial
- Response to teriparatide (TPTD)
- Evaluating combination and sequential therapy
- Zoledronic acid and daily TPTD study
- DATA trial (TPTD or denosumab monotherapy vs. combination)
- TPTD in naïve vs. treatment experienced women
- TPTD monotherapy vs. combination therapy
- TPTD after prior treatment (bisphosphonate, raloxifene or alendronate)
- Total hip BMD percent changes
- Switch to TPTD in patients on prior denosumab or antiresorptive treatment
- TPTD in treatment experienced (switch vs. add)
- Hip & spine strength and volumetric BMD
- CONFORS trial
- Bone turnover
Talk Citation
Cosman, F. (2015, January 19). Combination and sequential therapy for the treatment of osteoporosis [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved December 7, 2024, from https://doi.org/10.69645/AUOR9356.Export Citation (RIS)
Publication History
Financial Disclosures
- Prof. Felicia Cosman has not informed HSTalks of any commercial/financial relationship that it is appropriate to disclose.
Other Talks in the Series: Bone in Health and Disease
Transcript
Please wait while the transcript is being prepared...
0:00
Hello, my
name is Felicia Cosman.
I'm an endocrinologist and medical
director of the Clinical Research
Center at Helen Hayes Hospital, and
professor of medicine at Columbia
University College of
Physicians and Surgeons.
Today, I'll be talking about
the role of combination
anabolic and antiresorptive
therapy for the treatment
of severe osteoporosis
Here are my disclosures.
0:28
The majority of pharmacologic
agents for osteoporosis
are antiresorptive medications,
which act primarily by inhibiting
osteoclast number, lifespan,
and/or activity, and thereby
reducing the rate
of bone resorption.
Antiresorptive medications
include all of these listed here.
But the most commonly used for the
treatment of osteoporosis, at least
in adults above age 65, are
the bisphosphonates, including
oral alendronate,
risedronate, and ibandronate,
the intravenous bisphosphonate
zoledronic acid,
and the RANK ligand
inhibitor denosumab.
There is only one class of anabolic
therapy with two agents that are
both parathyroid hormone analogues,
the intact PTH 1-84 molecule
and the amino terminal
PTH peptide teriparatide.
With anabolic agents,
the mechanism of action
is a direct stimulation of
osteoblast number, activation,
and/or function leading to a
rapid increase in bone formation
and a subsequent stimulation
of osteoclast activity
and overall bone remodeling with
a persistent net increment in bone
formation.