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Biomarkers of Bisphosphonate Failure in Osteoporosis

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Biomarkers in Bone Disease

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Abstract

Bisphosphonates are the first-line agents for the management of osteoporosis. Through the suppression of bone turnover, they are able to significantly reduce fracture risk in patients with an adequate calcium and vitamin D supplementation. Bisphosphonate failure can be assumed when two or more fragility fractures occur in the course of treatment, but surrogate markers of the efficacy of bisphosphonate treatment are the variations of bone mineral density (BMD) and of bone turnover markers (BTM). Indeed, the demonstration of a significant decrease in BMD and the absence of a significant decrease in BTM while on therapy are considered as indicators of treatment failure. Moreover, other biochemical, clinical, and genetic parameters can be predictive of an inadequate response to bisphosphonate treatment.

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Abbreviations

AFF:

Atypical femoral fracture

ALP:

Alkaline phosphatase

BALP:

Bone-specific alkaline phosphatase

BMD:

Bone mineral density

BSP:

Bone sialoprotein

BTM:

Bone turnover marker

CTX:

Carboxy-terminal cross-linking telopeptide of type I collagen

DPD:

Deoxypyridinoline

FDFT1:

Squalene synthase

FPPS:

Farnesyl pyrophosphate synthase

GGPS:

Geranylgeranyl diphosphate synthase

IFCC:

International Federation of Clinical Chemistry and Laboratory Medicine

IOF:

International Osteoporosis Foundation

LRP5:

Low-density lipoprotein receptor-related protein

LSC:

Least significant change

MVK:

Mevalonate kinase

NTX:

Amino-terminal cross-linking telopeptide of type I collagen

OC:

Osteocalcin

ONJ:

Osteonecrosis of the jaw

PINP:

Amino-terminal propeptide of type I procollagen

VDR:

Vitamin D receptor

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Authors and Affiliations

  1. Unit of Endocrinology and Metabolic Diseases, Fondazione IRCCS Ca’ Granda – Ospedale Maggiore Policlinico, Padiglione Granelli Via F. Sforza 35, 20122, Milan, Italy

    Elisa Cairoli & Iacopo Chiodini

  2. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy

    Elisa Cairoli

Authors
  1. Elisa Cairoli
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  2. Iacopo Chiodini
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Corresponding authors

Correspondence to Elisa Cairoli or Iacopo Chiodini .

Editor information

Editors and Affiliations

  1. Department of Biomedical Sciences, Faculty of Science and Technology, University of Westminster, London, United Kingdom

    Vinood B. Patel

  2. Department of Nutrition and Dietetics, Division of Diabetes and Nutritional Sciences, Faculty of Life Sciences and Medicine, King’s College London, London, United Kingdom

    Victor R. Preedy

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Cairoli, E., Chiodini, I. (2017). Biomarkers of Bisphosphonate Failure in Osteoporosis. In: Patel, V., Preedy, V. (eds) Biomarkers in Bone Disease. Biomarkers in Disease: Methods, Discoveries and Applications. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-7693-7_45

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