Osteoporosis: Curković B

Curković B, Grazio S, Babić-Naglić D, Anić B, Vlak T, Hanih M, Anonymous00020. · Hrvatsko reumatolosko drustvo HLZ-a, Subićeva 9, 10000 Zagreb. · Reumatizam. · Pubmed #19024267 No free full text.

Abstract: Osteoporosis is a disease characterized by loss of bone mass and the structural deterioration of bone tissue leading to increased bone fragility and fractures. Preventive measures for osteoporosis and osteoporotic fractures include adequate calcium and vitamine D intake, adequate physical activity and reduction of the risk factors can be influenced. Currently, measurement of bone mineral density using dual energy x-ray absorptiometry (DXA) is still the gold standard for the diagnosis of osteoporosis. Non-pharmacological therapy is the integral part of the management ofosteoporosis. Nitrogen-containing bisphosphonates in weekly or more prolonged (monthly) dosing intervals are now the firstline osteoporosis therapy. Oral bisphosphonates show, generally, similar efficacy on vertebral fractures risk reduction. There, might be some differences among bisphosphonates, regarding risk reduction of non-vertebral, hip and glucocortiocoid related fratures. On behalf of Croatian Society of Rheumatology of Croatian Medical Association we propose recommendations for the prevention, diagnosis and management ofpostmenopausal osteoporosis.

Curković B. · Klinika za reumatske bolesti i rehabilitaciju Klinickog bolnickog centra Zagreb, Zagreb, Hrvatska. · Arh Hig Rada Toksikol. · Pubmed #17424781 No free full text.

Abstract: Glucocorticoids are the most common cause of drug-induced osteoporosis. Given the widespread use of oral glucocorticoids in the treatment of autoimmune, pulmonary, gastrointestinal disorders and organ transplantation, attention to glucocorticoid-induced osteoporosis has substantially increased. Bone loss occurs rapidly in the first few months of glucocorticoid therapy. Trabecular bone is affected more than cortical bone. Glucocorticoid treatment is associated with a substantially increased risk of fractures, particularly hip and vertebral fractures. The skeletal effects of glucocorticoids are both dose- and duration-dependent. The patophysiology of glucocorticoid-induced osteoporosis is a complex process, several mechanisms are proposed but not yet fully highlighted. Despite several evidence-based guidelines for the prevention and treatment of glucocorticoid-induced osteoporosis and the availability of effective therapeutic options, the proportion of individuals with appropriate evaluation and treatment remains relatively low.

Curković B. · Klinika za reumatske bolesti i rehabilitaciju Medicinskoga fakulteta Sveucilista u Zagrebu Klinicki bolnicki centar Zagreb, Kispatićeva 12, 10000 Zagreb. · Reumatizam. · Pubmed #15098377 No free full text.

Abstract: Bisphosphonates (risedronate and alendronate) inhibit bone resorption, increase bone mass and reduce the risk of vertebral and nonvertebral fractures in postmenopausal women as has been shown in a number of clinical trials. The concept of bone quality has recently been actualized with evidence that antiresorptive drugs reduce the occurrence of fractures to a greater extent than would be predicted by the amount of the increase in bone density. Concern about possible negative effect on fracture resistance with prolonged treatment with bisphosphonates has no evidence from clinical studies. Both preclinical and clinical studies, histologically and biomechanically performed, have revealed normal quality of bone formed during treatment with bisphosphonates.

Curković B. · Klinika za reumatske bolesti i rehabilitaciju, KBC Zagreb, Kispatićeva 12, 10000 Zagreb. · Reumatizam. · Pubmed #12476755 No free full text.

Abstract: Most often, physiatrists and rheumatologists are the first group of physicians to see patients presenting with a clinical picture of postmenopausal or corticosteroid induced osteoporosis. In this article, measures of treatment and prevention that are appropriate for use by this group of specialists will be assessed.