Endocrine Abstracts

Osteoporosis is characterised by compromised bone strength leading to an increased risk of fracture. Many lifestyle factors are known to affect bone strength and moreover, may further affect fracture risk through modification of the risk of falling. Bone mineral density (BMD) is a major determinant of bone strength and reflects peak bone mass and subsequent rates of bone loss, both of which are influenced by lifestyle factors. Peak bone mass is a strongly heritable trait but m...

The diagnosis of osteoporosis in the context of the growing skeleton requires both the presence of low bone mass for body size and a history of low trauma fractures. The presentation of osteoporosis may predate adolescence, or less commonly arise during that period. Primary osteoporosis is typically due to osteogenesis imperfecta or idiopathic juvenile osteoporosis. Secondary osteoporosis arises as a result of a variety of conditions, most of which fall under thematic headings...

Antiresorptive agents form an important part of the treatment strategy in almost every patient with osteoporosis. They are used both as the primary treatment option and as a means of maintaining gains in bone mass after bone anabolic therapy. Marketed drugs in this category comprise bisphosphonates, SERMs, calcitonin, and denosumab. By virtue of their effect on bone remodeling, potent antiresorptives have the potential to cause hypocalcaemia in susceptible patients (especially...

The explosion in our understanding of bone biology has resulted in a number of key targets in bone that should allow the development of new treatments. There are other important regulators of bone resorption that are being targeted and these include src kinase and the chloride channel on osteoclasts. The key enzyme in bone resorption is cathepsin K and small molecule inhibitors have been developed and these are currently in phase II and III clinical trials. These are an intere...