Article (Scientific journals)
Implications for fracture healing of current and new osteoporosis treatments: an ESCEO consensus paper
Goldhahn, J.; Feron, J.M.; Kanis, J.A. et al.
2012In Calcified Tissue International, 90, p. 343-353
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Keywords :
Fractures; Healing; Bone formation; Osteoporosis; Treatment
Abstract :
[en] Osteoporotic fracture healing is critical to clinical outcome in terms of functional recovery, morbidity, and quality of life. Osteoporosis treatments may affect bone repair, so insights into their impact on fracture healing are important. We reviewed the current evidence for an impact of osteoporosis treatments on bone repair. Treatment with bisphosphonate in experimental models is associated with increased callus size and mineralization, reduced callus remodeling, and improved mechanical strength. Local and systemic bisphosphonate treatment may improve implant fixation. No negative impact on fracture healing has been observed, even after major surgery or when administered immediately after fracture. Experimental data for denosumab and raloxifene suggest no negative implications for bone repair. The extensive experimental results for teriparatide indicate increased callus formation, improved biomechanical strength, and greater external callus volume and total bone mineral content and density. Case reports and a randomized trial have produced mixed results but are consistent with a positive impact of teriparatide on clinical fracture healing. Studies with strontium ranelate in models of fracture healing indicate that it is associated with improved bone microstructure, callus volume, and biomechanical properties. Finally, there is experimental evidence for a beneficial effect of some of the agents currently being developed for osteoporosis, notably sclerostin antibody and DKK1 antibody. There is currently no evidence that osteoporosis treatments are detrimental for bone repair and some promising experimental evidence for positive effects on healing, notably for agents with a bone-forming mode of action, which may translate into therapeutic applications.
Disciplines :
General & internal medicine
Author, co-author :
Goldhahn, J.
Feron, J.M.
Kanis, J.A.
Papapoulos, S.
Reginster, Jean-Yves  ;  Université de Liège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé
Rizzoli, R.
Dere, W.
Mitlak, B.
Tsouderos, Y.
Boonen, S
Language :
English
Title :
Implications for fracture healing of current and new osteoporosis treatments: an ESCEO consensus paper
Publication date :
2012
Journal title :
Calcified Tissue International
ISSN :
0171-967X
eISSN :
1432-0827
Publisher :
Springer Verlag, New York, United States - New York
Volume :
90
Pages :
343-353
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 20 December 2016

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