Quality of bone: what effects of treatment can be monitored and what does it require?Articles

J. Štěpán

Clin Osteol 2003; 8(3): 75-81

For monitoring skeletal effects of the antiresorption treatments it is advantageous to employ techniques aimed to a quantitative assessment of specific aspects of quality of bone that respond most significantly to the treatment and best reflect the mechanisms of action of the drug. Some treatment mo­ des, such as aminobisphosphonates, are best assessed using the bone mineral density measurement (BMD), while evaluation of bone resorption using biochemical markers is most suitable to judge efficacy of treatment with estradiol, raloxifene, and calcitonin. Monitoring enables to identify patients not responding to the treatment or not compliant. The information...

Monitoring the skeletal effects of estrogens and tibolonArticles

J. Vokrouhlická

Clin Osteol 2003; 8(3): 82-85

Long-term use of hormone replacement therapy (HRT) is associated with a significant reduction of vertebral and non-vertebral fracture risk in post­ menopausal women. HRT reduces bone turnover into premenopausal range and in a dose-response relationship gradually increases bone mass. For a 90% sensitivity to predict a positive bone mineral density (BMD) response cut-off values of bone markers, expressed as a percentage decrease from baseline, are: -45 % for urinary telopeptides, -35 % for serum CTX, -20 % for urinary deoxypyridinoline, -20 % for serum osteocalcin or bone ALP. Ta­ king into account the least significant change (LSC) of the DEXA machine...

Monitoring of bone changes in women treating with raloxifeneArticles

D. Michalská

Clin Osteol 2003; 8(3): 86-88

Raloxifene is a representative of II. generation of Selective Estrogen Receptor Modulators (SERM). Raloxifene reduces the risk of clinical vertebral frac­ tures by 68 % at 1 year and the risk of nonvertebral fractures by 47 % at 36 months in patients with high fracture risk. In a big group of patients the per­ centage changes in BMD accounted for about 4 % of the total vertebral fracture risk reduction and fracture risk decrease for any percentage changes in BMD. The fracture risk is lowest in the patients with the biggest decrease of bone marker at six months of raloxifene treatment, at twelve months of raloxifene treatment only moderate decrease...

Monitoring of salmon calcitonin treatmentReview articles

V. Zikán

Clin Osteol 2003; 8(3): 89-91

A treatment with salmon calcitonin (sCT) reduces the risk of vertebral compression fractures. However, the efficacy of nasal sCT as an antiresorptive drug in reducing fracture risk is limited by its bioavailability and by the development of resistance to sCT treatment with continued use (escape phe­ nomenon). When monitoring the individual patients, the changes in BMD or biochemical markers of bone remodeling in response to sCT therapy are only modest and similar in magnitude to the measurement precision error. The main objective of serial BMD measurements is to identify patients with significant loss of BMD despite the treatment. The calcitonin load...

6th Congress of Czech and Slovak Osteologists (České Budějovice, October 19-21, 2003)Abstracts

Clin Osteol 2003; 8(3): 92-109

CONGRESS ANNOUNCEMENTSInformations

Clin Osteol 2003; 8(3): 110