Treatment of Male Osteoporosis: A Review

Chaim Vanek, MD, Eric S. Orwoll, MD

Abstract


 

Pope John Paul II fell in the bathroom and broke his hip in May 1994. Since that time, it has become evident that osteoporosis in men is a significant public health issue.Aging men can benefit from osteoporosis diagnoses and treatment in a manner similar to post-menopausal women. We will review current therapeutic options for male osteoporosis (calcium, vitamin D, bisphosphonates, RANK ligand inhibitors, anabolic agents). Bone loss due to androgen deprivation therapy for prostate cancer is a unique scenario for men that requires special attention for oncologists and primary care physicians.


Keywords


osteoporosis; male; review; prostate cancer; glucocorticoid

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References


Looker AC, Orwoll ES, Johnston CC, et al. Prevalence of Low Femoral Bone Density in Older U.S. Adults from NHANES III. Journal of Bone and Mineral Research. 1997;12(11):1761-1768. doi:10.1359/jbmr.1997.12.11.1761.

Ross AC, Manson JE, Abrams SA, et al. The 2011 Report on Dietary Reference Intakes for Calcium and Vitamin D from the Institute of Medicine: What Clinicians Need to Know. The Journal of Clinical Endocrinology & Metabolism. 2011;96(1):53-58. doi:10.1210/jc.2010-2704.

Holick MF, Binkley NC, Bischoff-Ferrari HA, et al. Evaluation, Treatment, and Prevention of Vitamin D Deficiency: an Endocrine Society Clinical Practice Guideline. The Journal of Clinical Endocrinology & Metabolism. 2011;96(7):1911-1930. doi:10.1210/jc.2011-0385.

Holick MF. Vitamin D Deficiency. New England Journal of Medicine. 2007;357(3):266-281. doi:10.1056/nejmra070553.

Fisher JE, Rogers MJ, Halasy JM, et al. Alendronate mechanism of action: geranylgeraniol, an intermediate in the mevalonate pathway, prevents inhibition of osteoclast formation, bone resorption, and kinase activation in vitro. Proceedings of the National Academy of Sciences. 1999;96(1):133-138. doi:10.1073/pnas.96.1.133.

Orwoll E, Ettinger M, Weiss S, et al. Alendronate for the Treatment of Osteoporosis in Men. New England Journal of Medicine. 2000;343(9):604-610. doi:10.1056/nejm200008313430902.

Sawka AM, Papaioannou A, Adachi JD, Gafni A, Hanley DA, Thabane L. Does Alendronate reduce the risk of fracture in men? A meta-analysis incorporating prior knowledge of anti-fracture efficacy in women. BMC Musculoskeletal Disorders. 2005;6(1). doi:10.1186/1471-2474-6-39.

Schousboe JT, Taylor BC, Fink HA, et al. Cost-effectiveness of Bone Densitometry Followed by Treatment of Osteoporosis in Older Men. Jama. 2007;298(6):629. doi:10.1001/jama.298.6.629.

Boonen S, Reginster J-Y, Kaufman J-M, et al. Fracture Risk and Zoledronic Acid Therapy in Men with Osteoporosis. New England Journal of Medicine. 2012;367(18):1714-1723. doi:10.1056/nejmoa1204061.

Boyle WJ, Simonet WS, Lacey DL. Osteoclast differentiation and activation. Nature. 2003;423(6937):337-342. doi:10.1038/nature01658.

Bone HG, Wagman RB, Brandi ML, et al. 10 years of denosumab treatment in postmenopausal women with osteoporosis: results from the phase 3 randomised FREEDOM trial and open-label extension. The Lancet Diabetes & Endocrinology. 2017;5(7):513-523. doi:10.1016/s2213-8587(17)30138-9.

Langdahl BL, Teglbjærg CS, Ho P-R, et al. A 24-Month Study Evaluating the Efficacy and Safety of Denosumab for the Treatment of Men With Low Bone Mineral Density: Results From the ADAMO Trial. The Journal of Clinical Endocrinology & Metabolism. 2015;100(4):1335-1342. doi:10.1210/jc.2014-4079.

Silverman S, Agodoa I, Kruse M, Parthan A, Orwoll E. Denosumab for Elderly Men with Osteoporosis: A Cost-Effectiveness Analysis from the US Payer Perspective. Journal of Osteoporosis. 2015;2015:1-9. doi:10.1155/2015/627631.

Compston J. Safety of long-term denosumab therapy for osteoporosis. The Lancet Diabetes & Endocrinology. 2017;5(7):485-487. doi:10.1016/s2213-8587(17)30178-x.

Shane E, Burr D, Abrahamsen B, et al. Atypical Subtrochanteric and Diaphyseal Femoral Fractures: Second Report of a Task Force of the American Society for Bone and Mineral Research. Journal of Bone and Mineral Research. 2013;29(1):1-23. doi:10.1002/jbmr.1998.

Adler RA, Fuleihan GE-H, Bauer DC, et al. Managing Osteoporosis in Patients on Long-Term Bisphosphonate Treatment: Report of a Task Force of the American Society for Bone and Mineral Research. Journal of Bone and Mineral Research. 2016;31(1):16-35. doi:10.1002/jbmr.2708.

Bilezikian JP. Osteonecrosis of the Jaw — Do Bisphosphonates Pose a Risk? New England Journal of Medicine. 2006;355(22):2278-2281. doi:10.1056/nejmp068157.

Orwoll E, Scheele W, Paul S, et al. The Effect of Teriparatide [Human Parathyroid Hormone (1-34)] Therapy on Bone Density in Men With Osteoporosis. Journal of Bone and Mineral Research. 2003;18(1):9-17. doi:10.1359/jbmr.2003.18.1.9.

Andrews EB, Gilsenan AW, Midkiff K, et al. The US postmarketing surveillance study of adult osteosarcoma and teriparatide: Study design and findings from the first 7 years. Journal of Bone and Mineral Research. 2012;27(12):2429-2437. doi:10.1002/jbmr.1768.

Shahinian VB, Kuo Y-F, Freeman JL, Goodwin JS. Risk of Fracture after Androgen Deprivation for Prostate Cancer. New England Journal of Medicine. 2005;352(2):154-164. doi:10.1056/nejmoa041943.

Smith MR, Egerdie B, Toriz NH, et al. Denosumab in Men Receiving Androgen-Deprivation Therapy for Prostate Cancer. New England Journal of Medicine. 2009;361(8):745-755. doi:10.1056/nejmoa0809003.

Graff JN, Beer TM. Reducing Skeletal-Related Events in Metastatic Castration-Resistant Prostate Cancer. Oncology. 2015 Jun 1;29(6):416-423

Kanis JA, Johansson H, Oden A, et al. A Meta-Analysis of Prior Corticosteroid Use and Fracture Risk. Journal of Bone and Mineral Research. 2004;19(6):893-899. doi:10.1359/jbmr.040134.

Grossman JM, Gordon R, Ranganath VK, et al. American College of Rheumatology 2010 recommendations for the prevention and treatment of glucocorticoid-induced osteoporosis. Arthritis Care & Research. 2010;62(11):1515-1526. doi:10.1002/acr.20295.

Moayyeri A, Kaptoge S, Luben RN, et al. Estimation of absolute fracture risk among middle-aged and older men and women: the EPIC-Norfolk population cohort study. European Journal of Epidemiology. 2009;24(5):259-266. doi:10.1007/s10654-009-9337-8.

Snyder PJ, Kopperdahl DL, Stephens-Shields AJ, et al. Effect of Testosterone Treatment on Volumetric Bone Density and Strength in Older Men With Low Testosterone. JAMA Internal Medicine. 2017;177(4):471. doi:10.1001/jamainternmed.2016.9539.

Handelsman DJ. Testosterone and Male Aging. Jama. 2017;317(7):699. doi:10.1001/jama.2017.0129.

Watts NB, Adler RA, Bilezikian JP, et al. Osteoporosis in Men: An Endocrine Society Clinical Practice Guideline. The Journal of Clinical Endocrinology & Metabolism. 2012;97(6):1802-1822. doi:10.1210/jc.2011-3045.

Tarkan L. The 'Women's Disease' That Also Strikes Men. The New York Times. http://www.nytimes.com/2000/08/29/health/the-women-s-disease-that-also-strikes-men.html. Published August 29, 2000. Accessed December 30, 2017.




DOI: http://dx.doi.org/10.18103/imr.v4i3.667

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