New Horizons in Osteoporosis Management PDF
Preview New Horizons in Osteoporosis Management
New Horizons in Osteoporosis Management Yasser El Miedany Editor 123 New Horizons in Osteoporosis Management Yasser El Miedany Editor New Horizons in Osteoporosis Management Editor Yasser El Miedany Canterbury Christ Church University Canterbury, Kent, UK ISBN 978-3-030-87949-5 ISBN 978-3-030-87950-1 (eBook) https://doi.org/10.1007/978-3-030-87950-1 © Springer Nature Switzerland AG 2022 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, expressed or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. This Springer imprint is published by the registered company Springer Nature Switzerland AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland Preface Advances in the understanding of bone health and osteoporosis management in the last three decades have exceeded that of most other chronic diseases of aging. Clinicians treating osteoporosis have witnessed significant change in the disease management, from being a debilitating chronic illness with few treatment options and small chance of real improvement to a disease amena- ble to therapy, particularly with the introduction of new management modali- ties such as biologic therapy, with a consequent improvement in the bone mineral content and reduction in the fracture rates. Osteoporosis can be considered of as an equation. Simply, the equation states that osteoporosis is the net outcome of deducting the ongoing losses related to age and menopause from the peak bone mass achieved by the age of 30. Osteoporosis is a complex disorder, which occurs as the consequence of the interactions between genetic and acquired factors. However, not all patients respond properly or equally to the same therapeutic modality, and some of them even suffer fragility fractures despite taking anti-osteoporotic pharmacotherapies. Furthermore, though no genetic markers for either low peak bone mass or high later losses are yet being measured routinely in clini- cal settings, genome-wide association studies have pointed to several genes as determinants of the osteoporosis risk. This paved the way for applying pharmacogenetic approaches to osteoporosis research. The rationale for this book is the note that musculoskeletal health knowl- edge has focussed mainly on basic sciences, results of pharmaceutical drug research outcomes or specific medication-related side effects. Consequently, it has been felt there is a gap that need filling between basic skeletal health science and new developments in the field of bone health both in terms of concepts and management. So, this book has been set aiming at discussing the new horizons in bone health and osteoporosis management. The book starts with an introductory part including six chapters on the fundamentals of bone health, the skeletal structure and nature of osteoporosis, as well as the purposes of bone remodelling. This expands to discuss muscle health, and bone health in men and women as well as transgenders. The next part is on diagnosis, which includes six chapters and represents a clinician’s guide to risk assessment tools, current imaging techniques, the challenges and limita- tions of osteoporosis diagnosis, best practice recommendations for DXA scans and reports, pitfalls in DXA scanning, and, lastly, best approach to mind the gap in osteopenia diagnosis and management. The next part deals with recent advances in prevention of osteoporosis. This includes four v vi Preface chapters discussing the new concept of imminent fracture risk, fracture liai- son service, and the unmet needs and challenges in osteoporosis as well as an osteoporosis update for primary care physicians. The fourth part includes new treatment concepts. The part contains four chapters discussing bone modulation therapy, the concept of Treat to Target in osteoporosis manage- ment, geroscience and management of osteoporosis in older adults as well as treatment strategies concerning fracture healing. In concordance, the fifth part is composed of four chapters discussing approaches towards optimized practice. This includes discussion of gaps in the patients’ care and treatment, pharmacogenetics and pharmacogenomics of osteoporosis, optimizing the anabolic window, as well as optimizing sequential and combined osteoporo- sis therapy. The next set of chapters comes under a separate part discussing disparities of bone health. This includes four chapters handling osteoporosis in men, paediatric osteoporosis, atypical femur fractures as well as preg- nancy, lactation and bone Health. The last set of chapters deals with bone health as a comorbidity. This includes four chapters discussing bone health and cancer therapy, chronic kidney disease, glucocorticoids as well as osteonecrosis of the jaw. The final chapter brings together novel thoughts on recent advances in osteoporosis and bone care. The main theme of this book is to deliver a very practical and reader- friendly guide. On the one hand, it delivers the science-based evidence and advanced knowledge of bone health and osteoporosis management; on the other hand, it provides the most recent in this field and examples of recent tools which the readers/researchers can use for their standard practice/clinical trials. With its 32 key chapters, this book is expected to fill an important void in the current literature. It represents what can be considered the best current thinking on bone health. Therefore, New Horizons in Osteoporosis Management can serve as both an excellent introductory book and a very good reference as well as a resource for implementation in standard clinical practice and future reading. Special thanks to my colleagues and family for their support throughout the whole project which helped to make this book complete. Personally, I feel privileged to have compiled this work and am enthusias- tic about all that it offers our readers. I hope you too will find this edition a uniquely valuable educational resource. London, UK Yasser El Miedany 1 August 2020 Contents Part I Bone Health: Towards Better Bones 1 Bone Health: Basic and Applied Bone Biology . . . . . . . . . . . . . . . 3 Yasser El Miedany 2 Muscle Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 Yasser El Miedany 3 Osteosarcopenia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95 Yasser El Miedany 4 Bone Health in Women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143 Yasser El Miedany 5 Bone Health in Men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171 Yasser El Miedany 6 Bone Health in the Transgenders. . . . . . . . . . . . . . . . . . . . . . . . . . 199 Yasser El Miedany Part II D iagnosis: Clinician’s Guide 7 Osteoporosis Risk Assessment Tools . . . . . . . . . . . . . . . . . . . . . . . 213 Yasser El Miedany 8 Current Imaging Techniques . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 243 Yasser El Miedany 9 The Challenges and Limitations of Osteoporosis Diagnosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 277 Yasser El Miedany 10 Best Practice Recommendations for DXA Scans and Reports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 297 Yasser El Miedany 11 Pitfalls in DXA Scanning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 327 Abdellah El Maghraoui 12 Osteopenia: Mind the Gap . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 345 Yasser El Miedany vii viii Contents Part III P revention: Recent Advances 13 Imminent Fracture Risk . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 369 Yasser El Miedany 14 Fracture Liaison Service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 387 Yasser El Miedany 15 Unmet Needs and Challenges in Osteoporosis . . . . . . . . . . . . . . . 407 Yasser El Miedany 16 Osteoporosis Update for Primary Care Physicians . . . . . . . . . . . 433 Yasser El Miedany Part IV N ew Treatment Concepts 17 Bone Modulation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 457 Yasser El Miedany 18 Treat-to-Target in Osteoporosis . . . . . . . . . . . . . . . . . . . . . . . . . . . 473 Yasser El Miedany and Sami Bahlas 19 Geroscience and Management of Osteoporosis in Older Adults . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 491 Yasser El Miedany 20 Bone Healing and Osteoporosis . . . . . . . . . . . . . . . . . . . . . . . . . . . 525 Yasser El Miedany Part V Towards Optimized Practice 21 Osteoporosis Management: Gaps in Patients’ Care and Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . 549 Yasser El Miedany 22 Precision Medicine: Pharmacogenetics and Pharmacogenomics of Osteoporosis . . . . . . . . . . . . . . . . . . . . . . . 575 Yasser El Miedany 23 Romosozumab: Optimizing the Anabolic Window . . . . . . . . . . . 593 Yasser El Miedany 24 New Frontiers in Osteoporosis Management: Optimizing Sequential and Combination Therapy . . . . . . . . . . . 617 Yasser El Miedany Part VI D isparities in Bone Health 25 Osteoporosis in Men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 647 Yasser El Miedany 26 Pediatric Osteoporosis and Optimizing Bone Health in Children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 675 Yasser El Miedany Contents ix 27 Atypical Femur Fractures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 715 Yasser El Miedany 28 Pregnancy, Lactation, and Bone Health . . . . . . . . . . . . . . . . . . . . 735 Yasser El Miedany Part VII Bone Health as a Comorbidity 29 Bone Health and Cancer Therapy . . . . . . . . . . . . . . . . . . . . . . . . . 765 Yasser El Miedany 30 Bone Health in Chronic Kidney Disease . . . . . . . . . . . . . . . . . . . . 801 Chien-Lin Lu, Chia-Chao Wu, Yi-Chou Hou, Cai- Mei Zheng, and Kuo-Cheng Lu 31 Glucocorticoids and Musculoskeletal Health . . . . . . . . . . . . . . . . 827 Yasser El Miedany 32 Osteonecrosis of the Jaw . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 857 Yasser El Miedany Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 903 Contributors Sami Bahlas Rheumatology, Internal Medicine Department, King Abdulaziz University, Jeddah, Saudi Arabia Abdellah El Maghraoui Rheumatology Office, Rabat, Morocco Mohamed V University, Rabat, Morocco Yasser El Miedany Canterbury Christ Church University, Canterbury, Kent, UK Yi-Chou Hou Division of Nephrology, Department of Medicine, Cardinal- Tien Hospital, School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan Chien-Lin Lu Division of Nephrology, Department of Medicine, Fu Jen Catholic University Hospital, School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan Kuo-Cheng Lu Division of Nephrology, Department of Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan Chia-Chao Wu Division of Nephrology, Department of Medicine, Tri- Service General Hospital, National Defense Medical Center, Taipei, Taiwan Cai-Mei Zheng Division of Nephrology, Department of Internal Medicine, Taipei Medical University Shuang Ho Hospital, New Taipei City, Taiwan xi
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