Combined and Sequential Approaches to Osteoporosis Therapy

Dr. Benjamin Leder of Massachusetts General Hospital joins us to discuss the comparative effects of drug discontinuation among the currently approved osteoporosis medications and define the differential effects of the various drug sequences in osteoporosis therapy.

Presenter:
Benjamin Leder, MD, Massachusetts General Hospital, Endocrine Unit

Moderator:
Vinni Makin, MD, Director, EMI Live

#clevelandclinic #EMILive #grandrounds #endocrinology

[kpkbkpkb]

Why aren't CTX and P1NP routinely monitored in patients on Teraparatide or Reclast, or Romososumab? Insurance doesn't pay for CTX and says it's "experimental" but these seems to be markers that would help give a signal of how the medication is working 3-4 months into therapy rather than trusting and waiting for density tests annually only to find out "gee, no response." QUESTION: Do the patients with homozygous or heterozygous Sclerostiosis have higher incidence of cardiovascular events like stroke or heart attack?

[thjonesmd]

You mentioned RRR but we really want to know the ARR with these various treatments. Please comment

[oliaziz]

Does teraparatide stimulate formation and bone resorption? What is the ratio? Does it differ in each patient? Could it, overall, cause more resorption and therefore make matters worse? How about the Romosozumab is the ratio of formation and resorption dependably beneficial? There is no discussion on follow up therapy from teraparatide with romosozumab and then zoledronic acid?