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Osteoporosis: HELP
Articles by Dr. John Bilezikian
Based on 89 articles published since 2008
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Between 2008 and 2019, J. Bilezikian wrote the following 89 articles about Osteoporosis.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4
1 Guideline An appendix to the 2012 IOF-ECTS guidelines for the management of glucocorticoid-induced osteoporosis. 2012

Lekamwasam, S / Adachi, J D / Agnusdei, D / Bilezikian, J / Boonen, S / Borgström, F / Cooper, C / Perez, A Diez / Eastell, R / Hofbauer, L C / Kanis, J A / Langdahl, B L / Lesnyak, O / Lorenc, R / McCloskey, E / Messina, O D / Napoli, N / Obermayer-Pietsch, B / Ralston, S H / Sambrook, P N / Silverman, S / Sosa, M / Stepan, J / Suppan, G / Wahl, D A / Compston, J E / Anonymous3270744. ·Centre for Metabolic Bone Diseases, Department of Medicine, Faculty of Medicine, Galle, Sri Lanka. ·Arch Osteoporos · Pubmed #23225278.

ABSTRACT: The use of glucocorticoids in the treatment of medical disorders can lead to rapid bone loss and increased risk of fragility fracture. Updated clinical guidelines are needed that accommodate recent advances in fracture risk assessment and new pharmacological interventions to reduce fracture risk. This document serves as an appendix to the 2012 IOF-ECTS guidelines for the management of glucocorticoid-induced osteoporosis.

2 Guideline Treatment failure in osteoporosis. 2012

Diez-Perez, A / Adachi, J D / Agnusdei, D / Bilezikian, J P / Compston, J E / Cummings, S R / Eastell, R / Eriksen, E F / Gonzalez-Macias, J / Liberman, U A / Wahl, D A / Seeman, E / Kanis, J A / Cooper, C / Anonymous5370732. ·Department of Internal Medicine and Infectious Diseases, Hospital del Mar-IMIM, Autonomous University of Barcelona, RETICEF, Instituto Carlos III, P. Maritim 25-29, 08003 Barcelona, Spain. adiez@parcdesalutmar.cat ·Osteoporos Int · Pubmed #22836278.

ABSTRACT: INTRODUCTION: This study aims to provide guidelines concerning the definition of failure of therapies used to reduce the risk of fracture. METHODS: A working group of the Committee of Scientific Advisors of the International Osteoporosis Foundation was convened to define outcome variables that may assist clinicians in decision making. RESULTS: In the face of limited evidence, failure of treatment may be inferred when two or more incident fractures have occurred during treatment, when serial measurements of bone remodelling markers are not suppressed by anti-resorptive therapy and where bone mineral density continues to decrease. CONCLUSION: The provision of pragmatic criteria to define failure to respond to treatment provides an unmet clinical need and may stimulate research into an important issue.

3 Guideline Osteoporosis in men: an Endocrine Society clinical practice guideline. 2012

Watts, Nelson B / Adler, Robert A / Bilezikian, John P / Drake, Matthew T / Eastell, Richard / Orwoll, Eric S / Finkelstein, Joel S / Anonymous3600728. ·Mercy Health Osteoporosis & Bone Health Services, Cincinnati Ohio 45236, USA. ·J Clin Endocrinol Metab · Pubmed #22675062.

ABSTRACT: OBJECTIVE: The aim was to formulate practice guidelines for management of osteoporosis in men. EVIDENCE: We used the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system to describe the strength of recommendations and evidence quality. CONSENSUS PROCESS: Consensus was guided by systematic evidence reviews, one in-person meeting, and multiple conference calls and e-mails. Task Force drafts were reviewed successively by The Endocrine Society's Clinical Guidelines Subcommittee and Clinical Affairs Core Committee; representatives of ASBMR, ECTS, ESE, ISCD; and members at large. At each stage, the Task Force received written comments and incorporated needed changes. The reviewed document was approved by The Endocrine Society Council before submission for peer review. CONCLUSIONS: Osteoporosis in men causes significant morbidity and mortality. We recommend testing higher risk men [aged ≥70 and men aged 50-69 who have risk factors (e.g. low body weight, prior fracture as an adult, smoking, etc.)] using central dual-energy x-ray absorptiometry. Laboratory testing should be done to detect contributing causes. Adequate calcium and vitamin D and weight-bearing exercise should be encouraged; smoking and excessive alcohol should be avoided. Pharmacological treatment is recommended for men aged 50 or older who have had spine or hip fractures, those with T-scores of -2.5 or below, and men at high risk of fracture based on low bone mineral density and/or clinical risk factors. Treatment should be monitored with serial dual-energy x-ray absorptiometry testing.

4 Guideline Report of the International Society for Clinical Densitometry 2007 Adult Position Development Conference and Official Positions. 2008

Lewiecki, E Michael / Baim, Sanford / Binkley, Neil / Bilezikian, John P / Kendler, David L / Hans, Didier B / Silverman, Stuart / Anonymous1120602. ·New Mexico Clinical Research and Osteoporosis Center, Albuquerque, NM 87106, USA. lewiecki@aol.com ·South Med J · Pubmed #18580720.

ABSTRACT: The International Society for Clinical Densitometry (ISCD) periodically holds Position Development Conferences (PDCs) for the purpose of establishing standards and guidelines for the assessment of skeletal health -- the nomenclature, indications, acquisition, analysis, quality control, interpretation, and reporting of bone density tests. Topics are selected for consideration according to criteria that include clinical relevancy, uncertainty in the application of medical evidence to clinical practice, and the likelihood of the expert panel achieving agreement. The most recent Adult PDC was held July 20 to 22, 2007, in Lansdowne, Virginia. Topics included technical and clinical issues relevant to dual-energy x-ray absorptiometry (DXA), vertebral fracture assessment, and bone densitometry technologies other than central DXA. This report describes the methodology and presents the results of this PDC. The first ISCD Pediatric PDC was held June 20 to 21, 2007 in Montreal, Quebec, Canada, and is reported separately.

5 Editorial Bone Loss in the Intensive Care Unit. 2016

Bilezikian, John P. ·1 College of Physicians and Surgeons Columbia University Medical Center New York, New York. ·Am J Respir Crit Care Med · Pubmed #27035777.

ABSTRACT: -- No abstract --

6 Editorial Comparative effectiveness of combination osteoanabolic and antiresorptive therapy for osteoporosis: an update. 2013

Cusano, Natalie E / Bilezikian, John P. ·Metabolic Bone Diseases Unit, Division of Endocrinology, Department of Medicine, College of Physicians & Surgeons, Columbia University, 630 West 168th Street, New York, NY 10032, USA. ·J Comp Eff Res · Pubmed #24236786.

ABSTRACT: -- No abstract --

7 Editorial Combination antiresorptive and osteoanabolic therapy for osteoporosis: we are not there yet. 2011

Cusano, Natalie E / Bilezikian, John P. · ·Curr Med Res Opin · Pubmed #21740288.

ABSTRACT: Osteoanabolic therapy is theoretically and practically an appealing therapeutic option for men and postmenopausal women with osteoporosis because bone formation is directly stimulated, an action that is not shared by any antiresorptive agent. Parathyroid hormone (PTH), in the form of the full-length molecule (PTH[1-84]) and its fully active but truncated amino-terminal fragment teriparatide (PTH[1-34]), belong to this osteoanabolic class. Both formulations of PTH increase bone mineral density, increase biochemical markers of bone turnover, and reduce fracture incidence. They improve skeletal microstructure. While antiresorptive agents are considered by most to be first line for the treatment of osteoporosis, there are situations when anabolic therapy could be reasonably considered as first line. In most situations, however, treatment with PTH follows a course of antiresorptive therapy. Simultaneous combination therapy with PTH and an antiresorptive drug does not appear to provide any advantages over monotherapy. After the recommended 2-year period of PTH treatment, an antiresorptive should be used to maintain densitometric gains. The drugs are well tolerated. Early safety concerns about osteosarcoma in rats have not been borne out after almost 9 years experience with human subjects.

8 Review Primary hyperparathyroidism. 2018

Silva, Barbara C / Cusano, Natalie E / Bilezikian, John P. ·Division of Endocrinology, Felicio Rocho and Santa Casa Hospital, Belo Horizonte, Brazil; Department of Medicine, Centro Universitario de Belo Horizonte (UNIBH), Brazil. · Division of Endocrinology, Lenox Hill Hospital, New York, NY, USA. · Division of Endocrinology, College of Physicians and Surgeons, Columbia University, New York, NY, USA. Electronic address: jpb2@columbia.edu. ·Best Pract Res Clin Endocrinol Metab · Pubmed #30449543.

ABSTRACT: Primary hyperparathyroidism (PHPT), the most common cause of hypercalcemia, is most often identified in postmenopausal women with hypercalcemia and parathyroid hormone (PTH) levels that are either frankly elevated or inappropriately normal. The clinical presentation of PHPT includes three phenotypes: target organ involvement of the renal and skeletal systems; mild asymptomatic hypercalcemia; and more recently, high PTH levels in the context of persistently normal albumin-corrected and ionized serum calcium values. The factors that determine which of these three clinical presentations is more likely to predominate in a given country include the extent to which biochemical screening is employed, the prevalence of vitamin D deficiency, and whether a medical center or practitioner tends to routinely measure PTH levels in the evaluation of low bone density or frank osteoporosis. When biochemical screening is common, asymptomatic primary hyperparathyroidism is the most likely form of the disease. In countries where vitamin D deficiency is prevalent and biochemical screening is not a feature of the health care system, symptomatic disease with skeletal abnormalities is likely to predominate. Finally, when PTH levels are part of the evaluation for low bone mass, the normocalcemic variant is seen. Guidelines for surgical removal of hyperfunctioning parathyroid tissue apply to all three clinical forms of the disease. If guidelines for surgery are not met, parathyroidectomy can also be an appropriate option if there are no medical contraindications to surgery. In settings where either the serum calcium or bone mineral density is of concern, and surgery is not an option, pharmacological approaches are available and effective. Referencing in this article the most current published articles, we review the different presentations of PHPT, with particular emphasis on recent advances in our understanding of target organ involvement and management.

9 Review New and developing pharmacotherapy for osteoporosis in men. 2018

Gennari, Luigi / Bilezikian, John P. ·a Department Medicine, Surgery and Neurosciences , University of Siena , Siena , Italy. · b Medicine and Pharmacology, International Education and Research, Division of Endocrinology, Emeritus, Metabolic Bone Diseases Unit, Department of Medicine, College of Physicians and Surgeons , Columbia University , New York , NY , USA. ·Expert Opin Pharmacother · Pubmed #29350069.

ABSTRACT: INTRODUCTION: Osteoporosis represents a major health and societal burden in men, as well as in women. However, only a minority of men are screened and treated for osteoporosis and fracture prevention, even after first fracture. AREAS COVERED: This article provides a comprehensive summary of the currently available drugs for osteoporosis in men as well as insights into new and developing pharmacotherapy. EXPERT OPINION: To date, therapeutic approaches to osteoporosis in men remain not as well defined as in women, since antifracture efficacy data are lacking for most approved pharmaceuticals. Based on the currently available evidence, bisphosphonates are generally recommended as first line pharmacotherapy in men. Conceptually, osteoanabolic agents, such as teriparatide could be more appropriate for men with primary osteoporosis and low bone turnover. However, osteoanabolic agents display a limited anabolic window during which their stimulatory effects on bone formation prevail over the increase in bone resorption and their use, for theoretical safety reasons, is limited to a cumulative duration of two years. Due to the recent advances in bone biology, future drugs for osteoporosis in men might include more selective antiresorptive compounds which do not markedly inhibit bone formation as well as newer osteoanabolic agents that appear to more selectively stimulate bone formation.

10 Review Optimal dosing and delivery of parathyroid hormone and its analogues for osteoporosis and hypoparathyroidism - translating the pharmacology. 2018

Tay, Donovan / Cremers, Serge / Bilezikian, John P. ·Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, 10032, USA. · Department of Medicine, Sengkang Health, Singapore. · Osteoporosis and Bone Metabolism Unit, Department of Endocrinology, Singapore General Hospital, Singapore. · Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY, 10032, USA. · Irving Institute for Clinical and Translational Research, Columbia University Medical Center, New York, NY, 10032, USA. ·Br J Clin Pharmacol · Pubmed #29049872.

ABSTRACT: In primary hyperparathyroidism (PHPT), bone loss results from the resorptive effects of excess parathyroid hormone (PTH). Under physiological conditions, PTH has actions that are more targeted to homeostasis and to bone accrual. The predominant action of PTH, either catabolic, anabolic or homeostatic, can be understood in molecular and pharmacokinetic terms. When administered intermittently, PTH increases bone mass, but when present continuously and in excess (e.g. PHPT), bone loss ensues. This dual effect of PTH depends not only on the dosing regimen, continuous or intermittent, but also on how the PTH molecule interacts with various states of its receptor (PTH/PTHrP receptor) influencing downstream signalling pathways differentially. Altering the amino-terminal end of PTH or PTHrP could emphasize the state of the receptor that is linked to an osteoanabolic outcome. This concept led to the development of a PTHrP analogue that interacts preferentially with the transiently linked state of the receptor, emphasizing an osteoanabolic effect. However, designing PTH or PTHrP analogues with prolonged state of binding to the receptor would be expected to be linked to a homeostatic action associated with the tonic secretory state of the parathyroid glands that is advantageous in treating hypoparathyroidism. Ideally, further development of a drug delivery system that mimics the physiological tonic, circadian, and pulsatile profile of PTH would be optimal. This review discusses basic, translational and clinical studies that may well lead to newer approaches to the treatment of osteoporosis as well as to different PTH molecules that could become more advantageous in treating hypoparathyroidism.

11 Review Novel Therapies for Postmenopausal Osteoporosis. 2017

Bandeira, Leonardo / Bilezikian, John P. ·Department of Medicine, College of Physicians and Surgeons, Columbia University, 630 West 168th Street, PH8W-864, New York, NY 10032, USA. · Department of Medicine, College of Physicians and Surgeons, Columbia University, 630 West 168th Street, PH8W-864, New York, NY 10032, USA. Electronic address: jpb2@columbia.edu. ·Endocrinol Metab Clin North Am · Pubmed #28131134.

ABSTRACT: Recently discovered mechanisms have assisted in developing new therapies for osteoporosis. New classes of drugs have been developed for the treatment of postmenopausal osteoporosis. Although there have been numerous advances over the past 2 decades, the search for newer therapies continues.

12 Review Romosozumab for the treatment of osteoporosis. 2017

Bandeira, Leonardo / Lewiecki, E Michael / Bilezikian, John P. ·a Department of Medicine , College of Physicians and Surgeons, Columbia University Medical Center , New York , NY , USA. · b New Mexico Clinical Research & Osteoporosis Center , Albuquerque , NM , USA. ·Expert Opin Biol Ther · Pubmed #28064540.

ABSTRACT: INTRODUCTION: Sclerostin, a glycoprotein produced primarily by osteocytes, blocks the canonical Wnt signaling bone formation pathway. Romosozumab is a humanized monoclonal antibody to sclerostin that binds to sclerostin, permitting the engagement of Wnt ligands with their co-receptors, resulting in an increase in bone formation and bone mineral density (BMD). Clinical studies with romosozumab have shown dramatic improvements in BMD at the spine and hip. Romosozumab is associated with improvement in bone strength through mechanisms that include increases in bone formation and, different from classical osteoanabolic agents, suppression of bone resorption. Areas covered: Herein, the authors highlight the available data on romosozumab for the treatment of osteoporosis. This includes the latest data on the efficacy, pharmacokinetics and pharmacodynamics as well as safety and tolerability data. Expert opinion: Monthly subcutaneous dosing of romosozumab reduces the risk of vertebral and clinical fractures in women with postmenopausal osteoporosis, with a favorable balance of benefits and risks. Romosozumab is a promising emerging anabolic agent with a novel mechanism of action that may expand the options for treating osteoporotic patients at high risk of fracture.

13 Review Pharmacodynamics and pharmacokinetics of oral salmon calcitonin in the treatment of osteoporosis. 2016

Bandeira, Leonardo / Lewiecki, E Michael / Bilezikian, John P. ·a Department of Medicine , College of Physicians and Surgeons, Columbia University , New York , NY , USA. · b New Mexico Clinical Research & Osteoporosis Center , Albuquerque , NM , USA. ·Expert Opin Drug Metab Toxicol · Pubmed #27070719.

ABSTRACT: INTRODUCTION: Salmon calcitonin (sCT) has been used for the treatment of postmenopausal osteoporosis for over 30 years. It is available in injectable and intranasal formulations. Two oral formulations have recently been developed. AREAS COVERED: The basis for oral sCT's bioavailability rests with a carrier molecule (8-(N-2-hydroxy-5-chloro-benzoyl)-amino-caprylic acid) or an acid-resistant enteric coating (Eudragit® polymer containing citric acid). With these formulations, sCT is resistant to gastric acid, and thus becomes available for absorption at the higher pH of the small intestine. Even though the changes in bone mineral density and bone turnover markers are greater with oral compared to nasal sCT, it shows only minor effects on these surrogate markers. EXPERT OPINION: Oral sCT is attractive in concept as it is would be more convenient to patients than other routes of administration. While there may be other advantages to the oral formulation such as improving bone mineral density to a greater extent than nasal CT, anti-fracture efficacy has not been shown in a recent major clinical trial. Together with the possibility of an association between the drug and cancer and the availability of antiresorptive drug classes that are clearly more efficacious than sCT, successful development of oral sCT as a treatment for postmenopausal osteoporosis is uncertain.

14 Review How Long to Treat with Denosumab. 2015

Costa, Aline G / Bilezikian, John P. · ·Curr Osteoporos Rep · Pubmed #26474564.

ABSTRACT: Chronic diseases typically require long-term treatment. Osteoporosis is a chronic disease in which fracture risk is high, and treatment is required to prevent fragility fractures. Denosumab is a fully human monoclonal antibody that inhibits RANK ligand, a powerful bone-resorbing cytokine. It is approved for individuals with osteoporosis who are at high risk for fracture. Clinical trial results confirm that denosumab is effective over the long term and has an excellent safety profile. In patients at high risk for osteoporotic fracture, therefore, long-term treatment with denosumab appears to present an attractive benefit profile.

15 Review The potential use of antisclerostin therapy in chronic kidney disease-mineral and bone disorder. 2015

Costa, Aline G / Bilezikian, John P / Lewiecki, E Michael. ·aMetabolic Bone Diseases Unit, Division of Endocrinology, Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, USA bDivision of Endocrinology, Department of Medicine, São Paulo Federal University, São Paulo, Brazil cNew Mexico Clinical Research Osteoporosis Center, Albuquerque, New Mexico, USA. ·Curr Opin Nephrol Hypertens · Pubmed #26050118.

ABSTRACT: PURPOSE OF REVIEW: Sclerostin is a regulator of the osteoanabolic canonical Wnt signaling pathway, and thus helps to govern rates of bone formation. The Wnt pathway is also recognized as playing an important role in the pathophysiology of the chronic kidney disease-mineral and bone disorder (CKD-MBD). It also may serve as an interface between bone and the vascular system. Pharmacological inhibition of sclerostin has shown promise as an osteoanabolic approach to the treatment of osteoporosis. Inhibition of sclerostin is a potentially useful but unproven strategy in the management of CKD-MBD. RECENT FINDINGS: Clinical trials with humanized monoclonal sclerostin antibodies (Scl-Ab) have shown a rapid initial increase in bone formation and a marked increase in bone mineral density. Although clinical data, to this point, in CKD are not available, animal models of low bone turnover CKD show that Scl-Ab improves trabecular bone volume and mineralization without affecting biochemical indices. SUMMARY: Targeted clinical trials are needed to evaluate the potential effectiveness of Scl-Ab in CKD. Based upon the available data, there is potential not only for this new therapeutic class to improve skeletal health but perhaps also to have substantial cardiovascular benefits in CKD.

16 Review Osteoporosis diagnosis in men: the T-score controversy revisited. 2014

Binkley, Neil / Adler, Robert / Bilezikian, John P. ·University of Wisconsin Osteoporosis Clinical Research Program, 2870 University Avenue, Suite 100, Madison, WI, 53705, USA, nbinkley@wisc.edu. ·Curr Osteoporos Rep · Pubmed #25255867.

ABSTRACT: Osteoporosis becomes common with aging in both sexes, but is often ignored in men. The 2013 International Society for Clinical Densitometry consensus conference endorsed a Caucasian female referent database for T-score calculation in men. This recommendation has generated controversy and concern. Accumulating data indicate that at the same DXA-measured body mineral density (BMD) (g/cm(2)), men and women are at approximately the same fracture risk. With this point in mind, using the same database to derive the T-score in men and women is reasonable. As a result, a greater proportion of men who sustain a fragility fracture will have T-scores that are higher than they would if a male database were used; in fact, many men will fracture at T-scores that are "normal." This highlights the importance of diagnosing osteoporosis not just by T-score, but also by the presence of fragility fracture and/or by estimations of fracture risk as generated by tools such as the FRAX calculator. The practical consequences of this change in densitometric definition of osteoporosis in men should be monitored, including the proportion of men at risk identified and treated as well as defining the response to treatment in those assessed by this more comprehensive approach.

17 Review Bone markers and osteoporosis therapy. 2014

Bandeira, Francisco / Costa, Aline G / Soares Filho, Manoel Aderson / Pimentel, Larissa / Lima, Lourena / Bilezikian, John P. ·Division of Endocrinology, Diabetes and Bone Diseases, Agamenon Magalhães Hospital, Brazilian Ministry of Health, University of Pernambuco Medical School, Recife, PE, Brazil. · Division of Endocrinology, Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, United States. ·Arq Bras Endocrinol Metabol · Pubmed #25166041.

ABSTRACT: Several factors are involved in determining bone quality including bone density, bone turnover, the extent of trabecular bone connectivity, cortical porosity and geometry. Metabolically active and in a continuous process of remodeling, approximately 20% of bone tissue is renewed annually. Bone turn over markers (BTM) are frequently used in clinical trials and to provide valid information about the effectiveness of osteoporosis treatment, reflecting the state of bone metabolism and its response to treatment, although they are not useful alone to estimate bone loss. In this review the behavior of BTM from different clinical trials or different osteoporotic drugs will be addressed.

18 Review Trabecular bone score: perspectives of an imaging technology coming of age. 2014

Silva, Barbara C / Bilezikian, John P. ·Medical School, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil. · Division of Endocrinology, Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, United States. ·Arq Bras Endocrinol Metabol · Pubmed #25166040.

ABSTRACT: The trabecular bone score (TBS) is a new method to describe skeletal microarchitecture from the dual energy X-ray absorptiometry (DXA) image of the lumbar spine. While TBS is not a direct physical measurement of trabecular microarchitecture, it correlates with micro-computed tomography (µCT) measures of bone volume fraction, connectivity density, trabecular number, and trabecular separation, and with vertebral mechanical behavior in ex vivo studies. In human subjects, TBS has been shown to be associated with trabecular microarchitecture and bone strength by high resolution peripheral quantitative computed tomography (HRpQCT). Cross-sectional and prospective studies, involving a large number of subjects, have both shown that TBS is associated with vertebral, femoral neck, and other types of osteoporotic fractures in postmenopausal women. Data in men, while much less extensive, show similar findings. TBS is also associated with fragility fractures in subjects with secondary causes of osteoporosis, and preliminary data suggest that TBS might improve fracture prediction when incorporated in the fracture risk assessment system known as FRAX. In this article, we review recent advances that have helped to establish this new imaging technology.

19 Review Utility of the trabecular bone score (TBS) in secondary osteoporosis. 2014

Ulivieri, Fabio M / Silva, Barbara C / Sardanelli, Francesco / Hans, Didier / Bilezikian, John P / Caudarella, Renata. ·Bone Metabolic Unit, Division of Nuclear Medicine, Fondazione Irccs Ca' Ospedale Maggiore Policlinico, Milan, Italy. ·Endocrine · Pubmed #24853880.

ABSTRACT: Altered bone micro-architecture is an important factor in accounting for fragility fractures. Until recently, it has not been possible to gain information about skeletal microstructure in a way that is clinically feasible. Bone biopsy is essentially a research tool. High-resolution peripheral Quantitative Computed Tomography, while non-invasive, is available only sparsely throughout the world. The trabecular bone score (TBS) is an imaging technology adapted directly from the Dual Energy X-Ray Absorptiometry (DXA) image of the lumbar spine. Thus, it is potentially readily and widely available. In recent years, a large number of studies have demonstrated that TBS is significantly associated with direct measurements of bone micro-architecture, predicts current and future fragility fractures in primary osteoporosis, and may be a useful adjunct to BMD for fracture detection and prediction. In this review, we summarize its potential utility in secondary causes of osteoporosis. In some situations, like glucocorticoid-induced osteoporosis and in diabetes mellitus, the TBS appears to out-perform DXA. It also has apparent value in numerous other disorders associated with diminished bone health, including primary hyperparathyroidism, androgen-deficiency, hormone-receptor positive breast cancer treatment, chronic kidney disease, hemochromatosis, and autoimmune disorders like rheumatoid arthritis. Further research is both needed and warranted to more clearly establish the role of TBS in these and other disorders that adversely affect bone.

20 Review Executive summary of the 2013 International Society for Clinical Densitometry Position Development Conference on Body Composition. 2013

Shepherd, John A / Baim, Sanford / Bilezikian, John P / Schousboe, John T. ·Department of Radiology and Biomedical Imaging, University of California at San Francisco, San Francisco, CA, USA. Electronic address: john.shepherd@ucsf.edu. ·J Clin Densitom · Pubmed #24183639.

ABSTRACT: There have been many scientific advances in measurement of fat and lean body mass as determined by dual-energy X-ray absorptiometry (DXA). The International Society for Clinical Densitometry (ISCD) convened a Position Development Conference (PDC) on the use of DXA for body composition measurement. Previously, no guidelines to the use of DXA for body composition existed. The recommendations pertain to clinically relevant issues regarding DXA indications of use, acquisition, analysis, quality control, interpretation, and reporting were addressed. The topics and questions for consideration were developed by the ISCD Board of Directors and the Scientific Advisory Committee and were designed to address the needs of clinical practitioners. Three Task Forces were created and assigned these questions and asked to conduct comprehensive literature reviews. The Task Forces included participants from 6 countries and a variety of interests including academic institutions, private clinics, and industry. Reports with proposed Position Statements were then presented to an international panel of experts with backgrounds in DXA and bone densitometry and a variety of fields that use body composition measures. The PDC was held in Tampa, FL, contemporaneously with the Annual Meeting of the ISCD, March 21 through March 23, 2013. This report describes the methodology of the 2013 ISCD Body Composition PDC and summarizes the results. Three separate articles in this issue will detail the rationale, discussion, and additional research topics for each question the Task Forces addressed.

21 Review Executive summary of the 2013 International Society for Clinical Densitometry Position Development Conference on bone densitometry. 2013

Schousboe, John T / Shepherd, John A / Bilezikian, John P / Baim, Sanford. ·Park Nicollet Osteoporosis Center, Park Nicollet Health Services; Division of Health Policy and Management, University of Minnesota, Minneapolis, MN, USA. Electronic address: schouj@parkincollet.com. ·J Clin Densitom · Pubmed #24183638.

ABSTRACT: The International Society for Clinical Densitometry (ISCD) convenes a Position Development Conference (PDC) every 2-3 yr to make recommendations for guidelines and standards in the field of musculoskeletal measurement and assessment. The recommendations pertain to clinically relevant issues regarding the acquisition, quality control, interpretation, and reporting of various aspects of musculoskeletal health metrics. Topics for consideration are developed by the ISCD Board of Directors and the Scientific Advisory Committee. For the 2013 PDC, body composition analysis was a central topic area for the first time and considered timely because of the scientific advances in measurement of fat and lean body mass by dual-energy X-ray absorptiometry (DXA). Indications for DXA and vertebral fracture assessment and use of reference data to calculate bone mineral density T-scores were also updated. Task Forces for each of these areas were assigned questions of relevance to a clinical audience and asked to conduct comprehensive literature reviews. Reports with proposed Position Statements were then presented to an international panel of experts. The Expert Panel included representatives of the International Osteoporosis Foundation, the American Society for Bone and Mineral Research, the National Osteoporosis Foundation, Osteoporosis Canada, and the North American Menopause Society. The PDC was held in Tampa, FL, contemporaneously with the Annual Meeting of the ISCD, March 21 through March 23, 2013. This report describes the methodology of the 2013 ISCD PDC and summarizes the results of the 2013 ISCD PDC for vertebral fracture assessment/DXA and National Health and Nutrition Survey (NHANES) Reference Database Task Forces. A separate article in this issue will summarize the results of the Body Composition Analysis Task Forces.

22 Review Idiopathic osteoporosis in men. 2013

Gennari, Luigi / Bilezikian, John P. ·Department of Medicine, Surgery and Neurosciences, University of Siena, Viale Bracci, 53100, Siena, Italy, gennari@unisi.it. ·Curr Osteoporos Rep · Pubmed #24052235.

ABSTRACT: Over the last decade, the increasingly significant problem of osteoporosis in men has begun to receive much more attention than in the past. In particular, recent observations from large scale population studies in males led to an advance in the understanding of morphologic basis of growth, maintenance and loss of bone in men, as well as new insights about the pathophysiology and treatment of this disorder. While fracture risk consistently increases after age 65 in men (with up to 50 % of cases due to secondary etiologies), osteoporosis and fractures may also occur in young or middle aged males in the absence of an identifiable etiology. For this category (so called idiopathic osteoporosis), there are still major gaps in knowledge, particularly concerning the etiology and the clinical management. This article provides a summary of recent developments in the acquisition and maintenance of bone strength in men, as well as new insights about the pathogenesis, diagnosis, and treatment of idiopathic osteoporosis.

23 Review Osteoporosis: what's new and on the horizon. 2013

Silva, Barbara C / Costa, Aline G / Cusano, Natalie E / Bilezikian, John P. ·Department of Medicine, Metabolic Bone Diseases Unit, College of Physicians and Surgeons, Columbia University, New York, New York. ·Clin Obstet Gynecol · Pubmed #24036482.

ABSTRACT: In this review, we consider new concepts in the assessment of fracture risk and pharmacologic therapy for osteoporosis. We discuss trabecular bone score, a new imaging technology that adds information that cannot be obtained by only measuring bone mineral density by dual-energy x-ray absorptiometry. We also discuss innovations in antiresorptive, osteoanabolic, and combination therapy; and newer therapeutic classes, including cathepsin K inhibitors and antisclerostin antibodies. We do not cover agents that have not yet been studied in human clinical trials or that are no longer under active investigation.

24 Review Osteoporosis update from the 2012 Santa Fe Bone Symposium. 2013

Lewiecki, E Michael / Adler, Robert A / Bilezikian, John P / Bouxsein, Mary L / Marcus, Robert / McClung, Michael R / Miller, Paul D / Tanner, S Bobo / Randall, Susan. ·New Mexico Clinical Research & Osteoporosis Center, Albuquerque, NM, USA. Electronic address: mlewiecki@gmail.com. ·J Clin Densitom · Pubmed #23419827.

ABSTRACT: The core of the 2012 Santa Fe Bone Symposium consisted of plenary presentations on new developments in the fields of osteoporosis and metabolic bone disease, with a focus on current and future implications for patient care. These were complemented by oral abstracts, interactive discussions of challenging cases, a debate on benefits and risks of long-term bisphosphonate therapy, and a panel discussion of controversial issues in the management of osteoporosis. Other topics included a review of the most important scientific publications in the past year, new and emerging therapy for osteoporosis, the benefits and limitations of clinical practice guidelines in the care of individual patients, the effects of metallic elements on skeletal health, clinical applications of bone turnover markers, an engineering perspective of skeletal health and disease, and an update on the role of the International Society for Clinical Densitometry in education, certification, accreditation, and advocacy for high-quality bone density testing. The symposium was highlighted by an inaugural presentation of "2 Million 2 Many," a national campaign of the National Bone Health Alliance to increase awareness of osteoporosis.

25 Review Combination anabolic and antiresorptive therapy for osteoporosis. 2012

Cusano, Natalie E / Bilezikian, John P. ·Division of Endocrinology, Department of Medicine, College of Physicians and Surgeons, Columbia University, 630 West 168th Street, PH 8W-864, New York, NY 10032, USA. ·Endocrinol Metab Clin North Am · Pubmed #22877434.

ABSTRACT: Osteoanabolic agents directly stimulate bone formation to improve bone mass and skeletal microarchitecture. At present, parathyroid hormone (PTH), in the form of the full-length molecule (PTH(1-84)) and its fully active, but truncated amino-terminal fragment, PTH(1-34) (teriparatide), are the only medications that belong to the osteoanabolic class. It is appealing to consider simultaneous combination therapy with antiresorptive and osteoanabolic drugs as potentially more beneficial than monotherapy with either class, given that their mechanisms of action differ. This review focuses on the research that has been conducted on combination therapy with PTH and an antiresorptive drug.

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