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J Endocrinol Invest. 2016 Jul;39(7):807-34. doi: 10.1007/s40618-016-0434-8. Epub 2016 Mar 11.

Italian association of clinical endocrinologists (AME) position statement: drug therapy of osteoporosis.

Author information

1
Endocrinology and Metabolic Disease Unit, Azienda Ospedaliero-Universitaria Santa Maria della Misericordia, P.le S.M. della Misericordia, 15, 33100, Udine, Italy.
2
Endocrinology Service, Galeazzi Institute IRCCS, Milan, Italy. roberto.serena@libero.it.
3
Unit of Endocrinology and Diabetology, Department of Internal Medicine, M. Bufalini Hospital, Cesena, Italy.
4
Division of Endocrinology, Diabetes and Bone Diseases, Agamenon Magalhães Hospital, University of Pernambuco Medical School, Recife, Brazil.
5
Istituto Auxologico Italiano, Milan, Italy.
6
Unit of Endocrinology, Department of Medicine, University of Padova, Padua, Italy.
7
Endocrinology and Diabetology, Papa Giovanni XXIII Hospital, Bergamo, Italy.
8
Endocrinology, S. Maria Goretti Hospital, Latina, Italy.
9
Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
10
Post Acute and Long Term Care Department, I.N.R.C.A., Ancona, Italy.
11
San Pier Damiano Hospital, Villa Maria Group Care and Research, Faenza, Ravenna, Italy.
12
Endocrinology and Metabolic Diseases, S. Croce e Carle Hospital, Cuneo, Italy.
13
Endocrinology Unit, Regina Apostolorum Hospital, Albano Laziale, Rome, Italy.
14
Integrated Department of Medicine, Endocrinology and Metabolism, Geriatrics, University of Modena and Reggio Emilia, Modena, Italy.
15
Endocrine Unit 2, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Pisa, Italy.
16
Department of Endocrinology and Diabetes, University Campus Bio-Medico, Rome, Italy.
17
Endocrinology, Casa Sollievo della Sofferenza IRCCS, San Giovanni Rotondo, Italy.
18
Department of Clinical and Experimental Medicine, University Hospital of Pisa, Pisa, Italy.
19
Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
20
Endocrinology Unit, Arcispedale S. Maria Nuova IRCCS, Reggio Emilia, Italy.

Abstract

Treatment of osteoporosis is aimed to prevent fragility fractures and to stabilize or increase bone mineral density. Several drugs with different efficacy and safety profiles are available. The long-term therapeutic strategy should be planned, and the initial treatment should be selected according to the individual site-specific fracture risk and the need to give the maximal protection when the fracture risk is highest (i.e. in the late life). The present consensus focused on the strategies for the treatment of postmenopausal osteoporosis taking into consideration all the drugs available for this purpose. A short revision of the literature about treatment of secondary osteoporosis due both to androgen deprivation therapy for prostate cancer and to aromatase inhibitors for breast cancer was also performed. Also premenopausal females and males with osteoporosis are frequently seen in endocrine settings. Finally particular attention was paid to the tailoring of treatment as well as to its duration.

KEYWORDS:

Adherence; Androgen deprivation; Aromatase inhibitors; Bisphosphonates; Denosumab; Drug-induced osteoporosis; Fracture; Length of therapy; Male osteoporosis; Non-responder; Osteoporosis; SERMs; Side effects; Strontium ranelate; Teriparatide; Treatment

PMID:
26969462
PMCID:
PMC4964748
DOI:
10.1007/s40618-016-0434-8
[Indexed for MEDLINE]
Free PMC Article

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