The Latest Advancements In The Field Of Osteoporosis Treatment And Prevention

field of osteoporosis treatment

For years, osteoporosis was thought to be a condition in which the bones lose density and become fragile due to aging and a lack of both calcium and vitamin D.

More recently, it has been observed that the incidence of this disease was much higher in older women than in men. Further research has revealed the role of menopause, with the resulting decline in estrogen levels, as a major contributor to the development of osteoporosis. 

The latest advancements in diagnostic tools have helped to shed more light on how this disease occurs. 

The latest research is improving our understanding of osteoporosis, from prevention to diagnosis and treatment. The research has helped enhance treatment and better the outcomes of medical intervention aimed at the prevention of this disease. 

Advancements in diagnosis and injury prevention

Research studies have allowed for a more accurate diagnosis of osteoporosis. DEXA scan or the dual-energy X-ray absorptiometry is a test that can measure the density of the bones of the spine, hip, and wrist. These are the common sites for bone fractures. [1]

While the DEXA scan is fairly accurate in predicting the risk of osteoporosis, it has its own limitations. It has been observed that patients with a normal bone density measurement on the DEXA scan may still have a fracture. [2]

This occurs because the DEXA scan reveals how much bone could be present in the specific tissue scanned. However, it does not tell much about the strength or the internal structure of the bone. 

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When the risk of osteoporosis seems to be higher than average, doctors advise people to undergo additional tests and scans.

A computerized tomography (CT) scan of the hip or spine provides a three-dimensional image of bones that provides a look inside the bones. The density of each bone helps to assess the strength of that particular bone. This can help to predict which bone is the weakest and more prone to fractures. [3]

These advanced scans can help women to be aware of their risk of developing osteoporosis. The scans can also help them know which bones could be more prone to a fracture. This allows them to follow specific precautions aimed at reducing pressure on that part of the body. [4]

A new scanner is used to diagnose osteoporosis, called the high-resolution peripheral quantitative computerized tomography (HR-pQCT), is recommended in more serious cases. This diagnostic scanner exposes the bones to a slightly higher level of radiation. It can not be used to scan the spine or near any vital organ. However, this test is helpful to get images of the bones in the arms and legs. 

The higher resolution obtained by these peripheral scanners can more accurately predict the risks from osteoporosis.      

Treatment with bone anabolic agents

Several medications are being used to promote healthy bone remodeling processes. These medications help by supporting the process of bone formation and reducing bone loss. People who have osteoporosis and a higher risk of fractures are advised to use antiresorptive drugs like bisphosphonates and selective estrogen receptor modifiers (SERMs). These drugs work by inhibiting bone resorption thereby maintaining bone mineral density. 

There are recent developments of anabolic bone-building agents (drugs that increase bone mineral density).  These agents help women avoid the risk of fractures. 

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Anabolic bone building drugs are believed to work by enhancing the anabolic activities of the bones in order to minimize bone loss. The use of these medications is expected to curb the rising incidence of osteoporosis in women.

Research studies have revealed that the outcomes of the treatment of postmenopausal women with osteoporosis could be improved by using bone anabolic agents. These drugs ensure a  decline in the risk of fractures in the vertebra more effectively than bisphosphonates. 

Treatment with hormonal medications 

Advanced treatments for osteoporosis also involve hormonal therapies. In the recent past, most women with osteoporosis were advised to undergo hormone replacement therapy to replenish the levels of estrogen. The treatment was specifically recommended for women who had a very low bone mineral density and also suffered from severe symptoms of menopause. [5]

The latest studies aimed at assessing the effectiveness of hormonal medications for osteoporosis treatment have revealed encouraging results. It has been shown that the use of parathyroid hormones may help to reduce bone loss and support bone remodeling processes. 

The use of parathyroid hormone may also reduce the fracture risk by restoring the osteoporotic or weak, spongy trabecular bone to a near-normal, plate-like and thick cortical bone. [6

Osteoporosis treatment in women with RA

The latest advancement in the field of osteoporosis treatment has revealed that women with existing bone and joint problems need to regularly assess their risk of bone density loss and injury.

Women with rheumatoid arthritis (RA) tend to develop the loss of bone mass faster in the affected bones. Tests to assess the bone mineral density need to be performed more frequently in women who suffer from rheumatoid arthritis. 

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The results need to be correlated with the progress of the radiographic images of the RA-affected joints. Regular bone mineral density tests of the joints affected by RA can help in the early diagnosis of osteoporosis and allow women to seek appropriate treatment before a fracture occurs. [7]

It has been observed that patients with RA have a higher risk of fractures when they are treated with methotrexate and corticosteroids. These factors must be taken into consideration while treating women with both RA and osteoporosis to minimize the risk of complications. [8]

Conclusion

There has been a vast change in the way osteoporosis is diagnosed and treated. The latest research studies have helped us get a clearer understanding of how this condition develops and the best ways to treat it. The latest advancements have also helped to reveal the link between the risk of osteoporosis and RA. This has allowed doctors to offer comprehensive treatment to women diagnosed with osteoporosis and thus, improved the outcomes of the therapies.

References:  

  1. https://pubmed.ncbi.nlm.nih.gov/1914437/
  2. https://www.ncbi.nlm.nih.gov/books/NBK519042/
  3. https://www.webmd.com/osteoporosis/features/osteoporosis-on-the-cutting-edge-of-bone-health#2
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1069030/
  5. https://pubmed.ncbi.nlm.nih.gov/21985975/
  6. https://www.webmd.com/osteoporosis/features/osteoporosis-on-the-cutting-edge-of-bone-health#4
  7. https://www.medscape.org/viewarticle/445103
  8. https://pubmed.ncbi.nlm.nih.gov/30489459/

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