Prevalence of low bone formation in untreated patients with osteoporosis

Hartmut H. Malluche, Daniel L. Davenport, Florence Lima, Marie Claude Monier-Faugere

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8 Scopus citations

Abstract

Background Osteoporosis treatment usually starts with an antiresorber and switches to an anabolic agent if it fails. It is known that suppressing bone resorption also results in reduced bone formation. In addition, patients with prior treatment with antiresorbers may have reduced response to subsequent anabolic treatment. This study determined the prevalence of low bone formation in untreated osteoporosis patients to identify patients who may not be optimally treated under the current paradigm. Methods This is a cross-sectional study of bone samples stored in the Kentucky Bone Registry. Included samples were from adult patients presenting for workup of osteoporosis. Exclusion criteria were other diseases or treatments affecting bone. Patients underwent iliac crest bone biopsies after tetracycline labeling for identification of bone formation. Results 107 patients met study criteria, 92 White and 5 Black women and 10 White men. Forty percent of patients (43/107) had low bone formation/bone surface (BFR/BS < 0.56 mm3/cm2/ yr). Clinical and serum parameters did not differ between formation groups, except for type II diabetes, which was found exclusively in the low formation group. Conclusions Starting treatment of osteoporotic patients with an antiresorber in all patients appears not optimal for a significant portion.

Original languageEnglish
Article numbere0271555
JournalPLoS ONE
Volume17
Issue number7 July
DOIs
StatePublished - Jul 2022

Bibliographical note

Publisher Copyright:
© 2022 Malluche et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

ASJC Scopus subject areas

  • General

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