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Bone Abstracts (2013) 1 CU1.4 | DOI: 10.1530/boneabs.1.CU1.4

ECTS2013 Clinical Update Clinical Update 1 (6 abstracts)

Medical management of osteoporosis in men

Steven Boonen

Leuven University, Leuven, Belgium.

Awareness of osteoporosis in men is improving, although it remains under-diagnosed and under-treated. Empirical data in men display similarities with data acquired in women, despite pathophysiological differences, which may not be clinically relevant. Men should receive treatment at a similar 10 years fracture probability as in women. Bisphosphonates inhibit osteoclastic bone resorption and are the most widely used drugs in male osteoporosis. The treatment response to oral bisphosphonates in male osteoporosis is similar to that observed in postmenopausal osteoporosis, in terms of bone density and bone remodelling. To date, conclusive anti-fracture evidence with alendronate and risedronate is unavailable in men, but fracture reductions are very consistent. With i.v. zoledronic acid, recent fracture endpoint data in osteoporotic men indicate that zoledronic acid anti-fracture efficacy in men mirrored that observed in women. Denosumab, a monoclonal antibody that binds and neutralises the activity of human receptor activator of nuclear factor-κB ligand (RANKL), a key osteoclast cytokine, has been shown to increase bone density and reduce fractures in men with prostate cancer on hormone ablation therapy. The efficacy and safety of denosumab in men with low bone mass at risk of fracture were recently confirmed to be similar to the effects in postmenopausal women with osteoporosis. In line with these findings with antiresorptives, teriparatide and strontium ranelate studies concluded that the changes in biochemical markers and bone density in men were essentially the same as in women. It would seem therefore that the approaches developed to treat and identify women at high risk (e.g. the FRAX approach) is equally useful in m.

Volume 1

European Calcified Tissue Society Congress 2013

Lisbon, Portugal
18 May 2013 - 22 May 2013

European Calcified Tissue Society 

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