Differences

This shows you the differences between two versions of the page.

@@ Line 1: / Line 1: @@
+====== Bone density conservation agents    ======
+<relatedarticle> [[home:diseases:osteoporosis_osteopenia|Osteoporosis and osteopenia]] </article>
+A variety of medications including the bisphosphonates have been touted to conserve or increase bone mass. These drugs have a number of side effects and are known or suspected to interfere with proper immune function.
+===== Bisphosphonates =====
+Bone has constant turnover, and is kept in balance (homeostasis) by osteoblasts creating bone and osteoclasts digesting bone. Bisphosphonates inhibit the digesting of bone by osteoclasts.
+The bisphosphonate has a variety of side effects:(({{pmid>long:19371818}}))
+  * chronic musculoskeletal pain(({{pmid>long:17627083}}))
+  * atrial fibrillation – Numerous studies have shown that the frequency of atrial fibrillation increases with increasing age in both men and women. Data from the Framingham Heart Study showed a greater biennial incidence of AF with increasing age, with the odds ratio rising by a factor of 2.2 for every additional 10 years of age.(({{pmid>long:8114238}}))
+  * calcium deposition in the soft tissues(({{pmid>long: 14523647}}))
+  * osteonecrosis of the jaw, i.e. bone death
+  * reduced organ function, e.g. renal dysfunction or failure
+Those patients with elevated 1,25-D – which is [[home:pathogenesis:vitamind:metabolism#evidence_for_high_1_25-d_in_patients_with_chronic_disease|very common]] among those suffering from Th1 disease – seem particularly predisposed to the adverse effects of dysregulated calcium metabolism.
+All these meds have some effect on the immune or endocrine system and are, therefore, to be avoided.
+==== Types of bisphopshonates ====
+  * alendronate (Fosamax)
+  * etidronate (Didronel)
+  * ibandronate (Boniva)
+  * pamidronate (Aredia)
+  * risedronate (Actonel)
+  * tiludronate (Skelid)
+  * zoledronic acid (Zometa, Zomera, Aclasta and Reclast)
+===== Other types of bone density conservation agents =====
+  * **calcitonin (Miacalcin nasal spray)** – A synthetic hormone with unknown effects on the immune system
+  * **raloxifene  (Evista)** – An oral selective estrogen receptor modulator (SERM) that has estrogenic actions on bone and anti-estrogenic actions on the uterus and breast. It is used in the prevention ofosteoporosis in postmenopausal women. In a 2006 study published in //New England Journal of Medicine//, raloxifene produced significantly more strokes and blood clots than the placebo.(({{pmid>long: 16837676}}))
+  * **teriparatide (Forteo)** – A hormonal injection of parathyroid hormone, a hormone secreted by the parathyroid gland that regulates calcium in the body. Parathyroid hormone controls many other hormones, and may cause deposition of calcium into soft tissues.
+{{tag>non-MP_therapies}}
+<nodisp>
+===== Notes and comments =====
+FDA Alert - Oral Bisphosphonates: Ongoing Safety Review - https://bit.ly/9EfpXY
+===== References ===== </nodisp>