Article (Scientific journals)
Algorithm for the Use of Biochemical Markers of Bone Turnover in the Diagnosis, Assessment and Follow-Up of Treatment for Osteoporosis
Lorentzon, Mattias; Branco, Jaime Cunha; Brandi, Maria Luisa et al.
2019In Advances in Therapy, 36 (10), p. 2811-2824
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Keywords :
Algorithm; Bone; Bone biomarker; CTX; Osteoporosis; P1NP; Rheumatology
Abstract :
[en] Introduction: Increased biochemical bone turnover markers (BTMs) measured in serum are associated with bone loss, increased fracture risk and poor treatment adherence, but their role in clinical practice is presently unclear. The aim of this consensus group report is to provide guidance to clinicians on how to use BTMs in patient evaluation in postmenopausal osteoporosis, in fracture risk prediction and in the monitoring of treatment efficacy and adherence to osteoporosis medication. Methods: A working group with clinical scientists and osteoporosis specialists was invited by the Scientific Advisory Board of European Society on Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). Results: Serum bone formation marker PINP and resorption marker βCTX-I are the preferred markers for evaluating bone turnover in the clinical setting due to their specificity to bone, performance in clinical studies, wide use and relatively low analytical variability. BTMs cannot be used to diagnose osteoporosis because of low sensitivity and specificity, but can be of value in patient evaluation where high values may indicate the need to investigate some causes of secondary osteoporosis. Assessing serum levels of βCTX-I and PINP can improve fracture prediction slightly, with a gradient of risk of about 1.2 per SD increase in the bone marker in addition to clinical risk factors and bone mineral density. For an individual patient, BTMs are not useful in projecting bone loss or treatment efficacy, but it is recommended that serum PINP and βCTX-I be used to monitor adherence to oral bisphosphonate treatment. Suppression of the BTMs greater than the least significant change or to levels in the lower half of the reference interval in young and healthy premenopausal women is closely related to treatment adherence. Conclusion: In conclusion, the currently available evidence indicates that the principal clinical utility of BTMs is for monitoring oral bisphosphonate therapy. © 2019, The Author(s).
Disciplines :
Public health, health care sciences & services
Laboratory medicine & medical technology
Rheumatology
Author, co-author :
Lorentzon, Mattias;  Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden, Region Västra Götaland, Geriatric Medicine Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden, Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
Branco, Jaime Cunha;  CEDOC, NOVA Medical School, Medical Sciencies Faculty, NOVA University of Lisbon, Lisbon, Portugal, Rheumatology Department, Egas Moniz Hospital, CHLO, Lisbon, Portugal
Brandi, Maria Luisa;  FirmoLab Fondazione F.I.R.M.O, University of Florence, Florence, Italy
Bruyère, Olivier  ;  Université de Liège - ULiège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé
Chapurlat, Roland D.;  INSERM, UMR 1033, Université de Lyon, Hôpital E Herriot, Lyon Cedex 03, 69437, France
Cooper, Cyrus;  MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom, NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton, Southampton, United Kingdom, NHS Foundation Trust, Southampton, United Kingdom, NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom
Cortet, Bernard;  Department of Rheumatology and EA 44090, CHU Lille and University of Lille, Lille, 59000, France
Diez-Perez, Adolfo Diez;  Hospital del Mar Institue of Medical Investigation, Autonomous University of Barcelona and Biomedical Research Network on Frailty and Healthy Aging (CIBERFES), Madrid, Spain
Ferrari, Serge Livio;  Service of Bone Diseases, Geneva University Hospital and Faculty of Medicine, Geneva 14, 1211, Switzerland
Gasparik, Andrea Ildiko;  Department of Public Health and Health Management, University of Medicine, Pharmacy, Science and Technology of Targu Mures, Targu Mures, Romania
Herrmann, Markus;  Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
Jorgensen, Niklas Rye;  Department of Clinical Biochemistry, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark, OPEN, Odense Patient Data Explorative Network, Odense University Hospital/Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
Kanis, John A.;  Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia, Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Sheffield, United Kingdom
Kaufman, Jean-Marc;  Department of Endocrinology, Ghent University Hospital, Ghent, 9000, Belgium
Laslop, Andrea;  Scientific Office, Federal Office for Safety in Health Care, Austrian Agency for Health and Food Safety, Vienna, Austria
Locquet, Médéa ;  Université de Liège - ULiège > Département des sciences de la santé publique > Epidémiologie clinique
Matijevic, Radmila;  University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia, Clinical Center of Vojvodina, Clinic for Orthopedic Surgery, Novi Sad, Serbia
McCloskey, Eugene V.;  Department of Oncology and Metabolism, Centre for Integrated Research in Musculoskeletal Ageing, University of Sheffield, Sheffield, United Kingdom
Minisola, Salvatore;  Department of Internal Medicine and Medical Disciplines, Rome University, Sapienza, Italy
Pikner, Richard;  Department of Clinical Biochemistry and Bone Metabolism, Klatovska Hospital, Klatovy, Czech Republic, Department of Clinical Biochemistry and Heamathology, Faculty of Medicine Pilsen, Charles University Prague, Pilsen, Czech Republic, Faculty of Health Care Studies, University of West Bohemia, Pilsen, Czech Republic
Reginster, Jean-Yves  ;  Université de Liège - ULiège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé
Rizzoli, René;  Service of Bone Diseases, Geneva University Hospital and Faculty of Medicine, Geneva 14, 1211, Switzerland
Szulc, Pawel;  INSERM, UMR 1033, Université de Lyon, Hôpital E Herriot, Lyon Cedex 03, 69437, France
Vlaskovska, Mila;  Department of Pharmacology, Medical Faculty, Medical University Sofia, 2, Zdrave Str, Sofia, 1431, Bulgaria
Cavalier, Etienne  ;  Université de Liège - ULiège > Département de pharmacie > Chimie médicale
More authors (15 more) Less
Language :
English
Title :
Algorithm for the Use of Biochemical Markers of Bone Turnover in the Diagnosis, Assessment and Follow-Up of Treatment for Osteoporosis
Publication date :
2019
Journal title :
Advances in Therapy
ISSN :
0741-238X
eISSN :
1865-8652
Publisher :
Springer Healthcare
Volume :
36
Issue :
10
Pages :
2811-2824
Peer reviewed :
Peer Reviewed verified by ORBi
Funders :
Amgen
Available on ORBi :
since 14 February 2020

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