- Bone Metabolism
- Operationalizing Treat-to-Target for Osteoporosis
-
E. Michael Lewiecki
-
Endocrinol Metab. 2021;36(2):270-278. Published online March 24, 2021
-
DOI: https://doi.org/10.3803/EnM.2021.970
-
-
5,534
View
-
297
Download
-
5
Web of Science
-
5
Crossref
-
Abstract
PDFPubReader ePub
- Treat-to-target (TTT) for osteoporosis is a concept for individualizing patient treatment decisions that focuses on achieving an acceptable level of fracture risk rather than response to treatment alone. While a response to treatment is essential in order to achieve an acceptable level of risk, it is not necessarily sufficient. Some patients have a good response to treatment yet remain at high level of fracture risk. Since there is no way to directly measure bone strength in patients treated for osteoporosis, a surrogate measurement must be used. Bone mineral density (BMD) is commonly used to select patients for treatment and has emerged as the most useful surrogate for assessing reduction of fracture risk after treatment is started. Recent large meta-regression studies have shown a robust correlation between larger increases in BMD with treatment and greater reductions in fracture risk. Application of TTT for osteoporosis involves assessing fracture risk before starting treatment and initiating treatment with an agent that is most likely to reduce fracture risk to an acceptable level, represented by a target BMD T-score, over a reasonable period of time. This review offers suggestions for implementing TTT for osteoporosis in clinical practice and managing patients who fail or succeed in reaching the target. More study is needed to fully validate the use of TTT for osteoporosis for initiating and modifying treatments to reduce fracture risk.
-
Citations
Citations to this article as recorded by
- Treatment sequencing using the dual amylin and calcitonin receptor agonist KBP-336 and semaglutide results in durable weight loss
Anna Thorsø Larsen, Morten A. Karsdal, Kim Henriksen European Journal of Pharmacology.2023; 954: 175837. CrossRef - Osteoporosis: Spotlight on current approaches to pharmacological treatment
Dilşad Sindel Turkish Journal of Physical Medicine and Rehabilitation.2023; 69(2): 140. CrossRef - Postmenopausal Osteoporosis
Caren G. Solomon, Marcella Donovan Walker, Elizabeth Shane New England Journal of Medicine.2023; 389(21): 1979. CrossRef - Prevalence and Risk Factors of T-Score Spine-Hip Discordance in Patients with Osteoporotic Vertebral Compression Fracture
Byung-Ho Yoon, Ho Won Kang, Su Min Kim, Young Do Koh Journal of Bone Metabolism.2022; 29(1): 43. CrossRef - Pharmacological treatment of osteoporosis: 2022 update
Yunkyung Jeon, In-Joo Kim Journal of the Korean Medical Association.2022; 65(4): 241. CrossRef
|