md-medicaldata

Authors

 

Jovanović Ljiljana¹, Vasić Lazić Marija¹, Šijan Gobeljić Mirjana<sup>2

1</sup>Institut za medicinsku biohemiju, Vojnomedicinska akademija, Crnotravska 17, Beograd
²Visoka medicinska škola strukovnih studija ˝Milutin Milanković˝, Crnotravska 27, Beograd

 

UDK: 616.71-007.234-074

The paper was received / Rad primljen: 13.09.2018.

Accepted / Rad prihvaćen: 03.10.2018.

 

Correspondence to:

Mr Ph Ljiljana Jovanović
Institut za medicinsku biohemiju Vojnomedicinska akademija
Beograd, Crnotravska 17
tel: 064/3551460
e-mail: biohemicar@ymail.com

 

 

Abstract

 

Bone turnover markers (BTMs) are increasingly being evaluated for their role in detection of bone loss, assesment of fracture risk, selecting the most appropriate therapy, assessment and following of therapeutic response. During the last decade several new remedies with special mechanisms of action, as denosumab, cathepsin K inhibitors and anti-sclerostin therapy, have been tested in the treatment of osteoporosis. The clinical chal¬lenge will be to select medications with different effects on bone resorption and formation, alone or in combination, in order to treat osteoporosis patients most effectively. Therefore, the aim of our analysis of recently published clinical trials was quantifying differences between teriparatide and new remedies (denosumab, romosozumab, blosozumab, odanacatib) effects on bone mineral density and the most widely used BTMs such as procollagen type I N propeptide (PINP) and β croos-linked C-telopeptides (βCTX). Founded differences may contribute not only to better understanding of relationship between various mechanisms of action of these drugs and their influence on the level of BTMs, but also to their more appropriate choice in the treatment of osteoporosis.

 

 

Keywords:

osteoporosis, bone turnover markers, P1NP, βCTX, teriparatide, denosumab, romosozumab, blosozumab, odanacatib

 

 

Sažetak

 

Biomarkeri koštanog prometa se sve vise proučavaju zbog svoje uloge u proceni gubitka koštane mase i rizika od frakture kostiju, zatim učestvuju prilikom izbora odgovarajuće terapije i tokom praćenja terapeutskog odgovora. U poslednjoj deceniji, nekoliko novih lekova sa specifičnim mehanizmom delovanja kao što su denosumab, katepsin K inhibitori i anti-sklerostn terapija, testirani su u tretmanu osteoporoze. Klinički izazov predstavlja odabir pojedinačnih lekova ili njihovih kombinacija za efikasan tretman pacijenata obolelih od osteoporoze zbog njihovog različitog delovanja na procese formiranja i razgradnje kostiju. Cilj našeg proučavanja nedavno objavljenih kliničkih studija bilo je određivanje razlika između teriparatida i novijih lekova (denosumaba, romosozumaba, blosozumaba, odanacatiba), kao i njihovog uticaja na gustinu kostiju i markere koštanog prometa, kao što su N-terminalni propeptid kolagena tipa I (eng. procollagen type I N propeptide -PINP) i C-terminalni telopeptid kolagena tipa I (β croos-linked C-telopeptides- βCTX). Pronađene razlike mogu doprineti, kako boljem razumevanju odnosa između različitih mehanizama dejstva proučavanih lekova i njihovog uticaja na koncetraciju markera koštanog prometa, tako i na primenu odgovarajućeg tretmana u lečenju osteoporoze.

 

 

Ključne reči:

osteoporoza, marker koštanog prometa, P1NP, βCTX, teriparatid, denosumab, romosozumab, blosozumab, odanacatib

 

 

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