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Printable Handouts
Navigable Slide Index
- Introduction
- Disclosures
- Topics
- Osteoporotic Fx incidence is high
- Incidence of chronic disease: men
- USA: 2 million OP fractures/year
- Fracture facts
- Secondary OP: short list
- Secondary osteoporosis
- Treatment of osteoporosis
- Bisphosphonates: FDA-approved indications
- OP Rx: EMA approved
- Bisphosphonates
- Oral Alendronate
- Oral Risedronate
- Oral Ibandronate
- Intravenous Zoledronic acid (ZA)
- Bisphosphonates: vertebral fracture reduction
- Bisphosphonates: hip fracture reduction
- Bisphosphonates: non-hip, non-vert Fx reduction
- Dilemmas facing the clinician
- Nonadherence
- Compliance and fractures
- Side effects: mild or avoidable
- Esophageal cancer & oral bisphosphonates
- Osteonecrosis of the jaw (ONJ)
- American Dental Association recommendations
- Atypical subtrochanteric fractures
- Atypical femoral fracture
- Long term bisphosphonate studies
- Design of FIT and FLEX trials
- Effects of ALN for 7 years
- Total hip BMD: mean % change from FIT baseline
- Design of HORIZON extension
- BMD – Zoledronic acid
- Vertebral fracture reductions: FLEX, HORIZON
- Summary of FLEX and Horizon extension studies
- % change total hip BMD: 6 vs. 9 years of ZA
- Long term studies
- Bisphosphonate drug holiday
- How long do bisphosphonate effects last?
- Duration of NTx suppression in men
- Effect of ZA on BMD
- Legacy effects
- DCCT/EDIC
- DCCT/EDIC: cardiovascular events
- Legacy effect of ALN at year 9
- Duration of bisphosphonate Rx
- Bisphosphonates: decrease in mortality
- Osteoporosis Rx: other agents
- SERMs: Raloxifene
- Raloxifene side effects
- Raloxifene for PMO
- Denosumab for osteoporosis
- Denosumab 8 year phase 2 data
- Denosumab side effects
- SubQ Denosumab
- Teriparatide
- Teriparatide side effects
- SubQ Teriparatide
- HRT and osteoporosis
- 5 years of strontium ranelate: BMD changes
- New non-vertebral fractures, strontium ranelate
- Strontium Ranelate – long term
- Rx duration: other agents
- Duration of Rx: conclusions
Topics Covered
- The commonness of fractures due to osteoporosis
- Positive and negative effects of treatment (bisphosphonates & others)
- Review of long term studies
- Individualizing treatment
Talk Citation
Adler, R.A. (2015, January 19). Osteoporosis: how long to treat? [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved December 3, 2024, from https://doi.org/10.69645/HBLM5753.Export Citation (RIS)
Publication History
Financial Disclosures
- For talk published in 2024: Dr. Robert A. Adler has no financial matters to disclose. For archived talk published in 2015: Dr. Robert A. Adler, Consultant: Research consultant for Amgen. Grant/research Support (Principal Investigator): Merck, Novartis, Genentech.
Other Talks in the Series: Bone in Health and Disease
Transcript
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0:00
Hello, my name is
Robert Adler, and I'm
from the Veterans Hospital
in Richmond, Virginia.
I teach at Virginia Commonwealth
University where I'm
in the Department of Medicine
as well as Epidemiology
and Community Health.
My topic today is how long
to treat osteoporosis.
And I thank Professor Juliet
Compston for the opportunity
to discuss this most
challenging subject.
0:30
Here are my disclosures
on the next slide.
0:34
And on the next slide, the
topics that I will cover today.
First of all, I'm going to
talk about why this is such
an important subject because
fractures are really quite common.
And then I'll go over the
treatments that we have emphasizing
bisphosphonates because
they've been the mainstay
of our osteoporosis treatment.
I will review the few
long-term studies we have,
and then talk about the
importance of individualizing
assessment and treatment
in your patients.
1:06
In the next slide, I show just how
common osteoporotic fractures are.
This is data from
the States, but it's
applicable to many other countries.
And then in a given year, a
woman has a much greater chance
of having an osteoporotic
fracture than developing
a new onset heart
disease or breast cancer.
1:30
And even in men, as shown in the
next slide, osteoporotic fracture
is more common than many other
disorders that are of more
general concern, such as
prostate cancer or stroke.