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Printable Handouts
Navigable Slide Index
- Introduction
- Potential conflicts
- Objectives of the talk
- Twenty years of studying osteoporosis in men
- Osteoporosis in men: importance of hip fractures
- Annual and projected rates of hip fractures
- Mechanisms of bone loss in men
- Natural history of bone loss in men
- Cortical porosity & vertebral fractures in men
- Age-related changes in bone turnover
- Relative contributions of E vs. T to bone turnover
- Effects of sex steroids on bone resorption
- E vs. T effects on bone turnover in men
- Hypogonadism with estrogen removal study
- Cortical porosity and trabecular microarchitecture
- Conclusions (hypogonadal bone loss)
- High bone turnover predicts fracture risk
- Origins of the fractures in overweight/obese men
- BMD measurement in obese men
- Why do obese men fracture?
- Body composition change and BMD loss
- The endocrine society guidelines
- Evaluation and treatment plan for men at high risk
- Evaluation - BMD testing
- Evaluation - role of DXA
- Evaluation - identification of spinal fractures
- Evaluation - clinical risk factors
- Evaluation - further directed testing
- Lifestyle - calcium and vitamin D
- Weight-bearing exercise, alcohol and tobacco
- Studies of anti-fracture efficacy in men
- Men recommended for treatment (1)
- Men recommended for treatment (2)
- Selection of therapeutic agent
- Effects of alendronate on spinal BMD
- Risedronate treatment in men
- Zoledronic acid vs. alendronate treatment
- Zoledronic acid vs. placebo
- Treatment with zoledronic acid after hip fracture
- Effects of denosumab vs placebo on BMD
- Effects of denosumab on new vertebral fractures
- Incidence of vertebral fractures in men
- Effects of strontium ranelate vs placebo on BMD
- Hypogonadal men at high risk of fracture
- Testosterone levels and changes in spinal BMD
- Clinical implications of serum estrodiol levels
- Potential clinical approach
- Serum E2 and transdermal T replacement
- Clinical implications of E receptor modulators
- Raloxifene in men with prostate cancer on GnRH
- Serm, toremifine and vertebral fractures
- Monitoring therapy BMD
- Bone turnover markers (BTM)
- Zoledronic acid vs alendronate - BTMs
- Predicting anabolic responses
- Duration of bisphosphonate therapy
- Bisphosphonate: for whom and for how long?
- Continuing or stopping treatment
- Conclusions
- Thank you!
Topics Covered
- Epidemiology and mechanisms of bone loss in men
- Hip fractures in men
- Role of IGF-I and sex hormones in bone loss
- Bone fractures in obese/overweight men
- Review of the endocrine society guidelines on osteoporosis in men
- Assessing risk factors for osteoporosis in men
- Review of osteoporosis treatments
- Gaps in evidence base
Talk Citation
Ebeling, P.R. (2015, January 19). Osteoporosis in men [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved December 13, 2024, from https://doi.org/10.69645/JXNY4148.Export Citation (RIS)
Publication History
Financial Disclosures
- Prof. Peter R. Ebeling 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 Peter Ebeling,
and I'm the head of the Department
of Medicine in the School for
Clinical Sciences at the Monash
Health Translation Precinct
in Victoria, Australia.
My Henry Stewart talk today
is about osteoporosis in men.
0:17
My potential conflicts
are listed here.
I receive departmental research
funding from Merck, Novartis,
Amgen, and Eli-Lilly,
and I've received
honoraria from Amgen and Merck.
0:28
Today, I'd like to discuss with you
epidemiology and mechanisms of bone
loss in men and the
importance of estradiol.
I'd like to review
the Endocrine Society
guidelines on osteoporosis in men.
I'd like to assess risk factors
for osteoporosis in men,
and review osteoporosis treatments
and gaps in our evidence base.
0:51
We've spent 20 years
studying osteoporosis in men.
And these are data
from Cyrus Cooper
when we were working
together at the Mayo Clinic.
These data show that with aging,
vertebral and hip fractures
increasing in men, but
colles fractures do not.
The number of hip fractures and
vertebral fractures occurring
in men are about half that
occurring with aging in women.
So it is an important
health problem.
1:16
In fact, one third of hip
fractures occur in men.
The increase in men
with hip fractures
is due to both an
increase in longevity
and a later-born or
secular increase.
However, now we're seeing that
age-related hip fracture incidence
rates in many Western countries
are increasing in women,
but not so much in men.
And the mortality rates after a
hip fracture in men are about 50%
higher than those in women at
a rate of 37.5% in 12 months.