Sequential management of postmenopausal health and osteoporosis: An update
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- dc.contributor.author Calaf Alsina, Joaquim
- dc.contributor.author Cano, Antonio
- dc.contributor.author Guañabens Gay, Núria
- dc.contributor.author Palacios, Santiago
- dc.contributor.author Cancelo Hidalgo, María Jesús
- dc.contributor.author Castelo-Branco Flores, Camil
- dc.contributor.author Larraínzar Garijo, Ricardo
- dc.contributor.author Neyrp, José Luis
- dc.contributor.author Nogués Solan, Francesc Xavier
- dc.contributor.author Díez Pérez, Adolfo
- dc.date.accessioned 2024-05-28T06:22:59Z
- dc.date.available 2024-05-28T06:22:59Z
- dc.date.issued 2023
- dc.description.abstract Increased life expectancy means that women are now in a hypoestrogenic state for approximately one-third of their lives. Overall health and specifically bone health during this period evolves in accordance with aging and successive exposure to various risk factors. In this review, we provide a summary of the approaches to the sequential management of osteoporosis within an integrative model of care to offer physicians a useful tool to facilitate therapeutic decision-making. Current evidence suggests that pharmacologic agents should be selected based on the risk of fractures, which does not always correlate with age. Due to their effect on bone turnover and on other hormone-regulated phenomena, such as hot flushes or breast cancer risk, we position hormone therapy and selective estrogen receptor modulators as an early postmenopause intervention for the management of postmenopausal osteoporosis. When the use of these agents is not possible, compelling evidence supports antiresorptive agents as first-line treatment of postmenopausal osteoporosis in many clinical scenarios, with digestive conditions, kidney function, readiness for compliance, or patient preferences playing a role in choosing between bisphosphonates or denosumab during this period. For patients at high risk of osteoporotic fracture, the "anabolic first" approach reduces that risk. The effect on bone health with these bone-forming agents or with denosumab should be consolidated with the subsequent use of antiresorptive agents. Regardless of the strategy, follow-up and treatment should be maintained indefinitely to help prevent fractures.
- dc.format.mimetype application/pdf
- dc.identifier.citation Calaf-Alsina J, Cano A, Guañabens N, Palacios S, Cancelo MJ, Castelo-Branco C, et al. Sequential management of postmenopausal health and osteoporosis: An update. Maturitas. 2023 Nov;177:107846. DOI: 10.1016/j.maturitas.2023.107846
- dc.identifier.doi http://dx.doi.org/10.1016/j.maturitas.2023.107846
- dc.identifier.issn 0378-5122
- dc.identifier.uri http://hdl.handle.net/10230/60258
- dc.language.iso eng
- dc.publisher Elsevier
- dc.relation.ispartof Maturitas. 2023 Nov;177:107846
- dc.rights © 2023 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
- dc.rights.accessRights info:eu-repo/semantics/openAccess
- dc.rights.uri http://creativecommons.org/licenses/by/4.0/
- dc.subject.keyword Integrative care
- dc.subject.keyword Osteoporosis
- dc.subject.keyword Postmenopausal health
- dc.subject.keyword Sequential management
- dc.title Sequential management of postmenopausal health and osteoporosis: An update
- dc.type info:eu-repo/semantics/article
- dc.type.version info:eu-repo/semantics/publishedVersion