Extraskeletal benefits and risks of calcium, vitamin D and anti-osteoporosis medications
Copyright policy )Extraskeletal benefits and risks of calcium, vitamin D and anti-osteoporosis medications
Drugs used for the prevention and the treatment of osteoporosis exert various favourable and unfavourable extra-skeletal effects whose importance is increasingly recognized notably for treatment selection.The therapeutic armamentarium for the prevention and the treatment of osteoporosis is increasingly large, and possible extra-skeletal effects of available drugs could influence the choice of a particular compound.The present document is the result of a national consensus, based on a systematic and critical review of the literature.Observational research has suggested an inverse relationship between calcium intake and cardiovascular diseases, notably through an effect on blood pressure, but recent data suggest a possible deleterious effect of calcium supplements on cardiovascular risk. Many diverse studies have implicated vitamin D in the pathogenesis of clinically important non-skeletal functions or diseases, especially muscle function, cardiovascular disease, autoimmune diseases and common cancers. The possible effects of oral or intravenous bisphosphonates are well-known. They have been associated with an increased risk of oesophageal cancer or atrial fibrillation, but large-scale studies have not found any association with bisphosphonate use. Selective oestrogen receptor modulators have demonstrated favourable or unfavourable extra-skeletal effects that vary between compounds. Strontium ranelate has a limited number of non-skeletal effects. A reported increase in the risk of venous thromboembolism is not found in observational studies, and very rare cases of cutaneous hypersensitivity reactions have been reported. Denosumab has been introduced recently, and its extra-skeletal effects still have to be assessed.Several non-skeletal effects of bone drugs are well demonstrated and influence treatment choices.
- University of Liege (ULG) Belgium
- KU Leuven Belgium
- Ghent University Belgium
- Saint-Luc University Hospital Belgium
- Centre Hospitalier Universitaire de Liège Belgium
Male, Medicine (General), Endocrinology, Diabetes and Metabolism, Selective Estrogen Receptor Modulators -- pharmacology -- therapeutic use, Neoplasms, Monoclonal, Diphosphonates/pharmacology/therapeutic use, Vitamin D, Human health sciences, Humanized, Bone Density Conservation Agents, Diphosphonates, Vitamin D/pharmacology/therapeutic use, Antibodies, Monoclonal, Strontium ranelate, Sciences bio-médicales et agricoles, Muscle, Skeletal -- drug effects, Middle Aged, Cardiovascular Diseases/chemically induced, Stroke -- chemically induced, Vitamin D -- pharmacology -- therapeutic use, Stroke, Osteoporosis -- drug therapy, Bone Density Conservation Agents -- pharmacology -- therapeutic use, Cardiovascular Diseases, Dietary Supplements -- adverse effects, Muscle, Monoclonal -- pharmacology, Female, Muscle, Skeletal/drug effects, Denosumab, Cardiovascular Diseases -- chemically induced, Médecine générale & interne, Osteoporosis/drug therapy, Selective Estrogen Receptor Modulators, Consensus, Antibodies, Monoclonal -- pharmacology, Calcium/pharmacology/therapeutic use, Selective Estrogen Receptor Modulators/pharmacology/therapeutic use, Neoplasms -- chemically induced, Thiophenes/pharmacology, Thiophenes -- pharmacology, Antibodies, Monoclonal, Humanized, Sciences de la santé humaine, Antibodies, R5-920, Stroke/chemically induced, Diphosphonates -- pharmacology -- therapeutic use, Organometallic Compounds, Bisphosphonate, Humans, Muscle, Skeletal, Aged, Calcium -- pharmacology -- therapeutic use, Consensus Statement, SERM, Antibodies, Monoclonal/pharmacology, Organometallic Compounds/pharmacology, Neoplasms/chemically induced, Dietary Supplements, Bone Density Conservation Agents/pharmacology/therapeutic use, Osteoporosis, Calcium, Skeletal -- drug effects, Dietary Supplements/adverse effects, General & internal medicine, Organometallic Compounds -- pharmacology
Male, Medicine (General), Endocrinology, Diabetes and Metabolism, Selective Estrogen Receptor Modulators -- pharmacology -- therapeutic use, Neoplasms, Monoclonal, Diphosphonates/pharmacology/therapeutic use, Vitamin D, Human health sciences, Humanized, Bone Density Conservation Agents, Diphosphonates, Vitamin D/pharmacology/therapeutic use, Antibodies, Monoclonal, Strontium ranelate, Sciences bio-médicales et agricoles, Muscle, Skeletal -- drug effects, Middle Aged, Cardiovascular Diseases/chemically induced, Stroke -- chemically induced, Vitamin D -- pharmacology -- therapeutic use, Stroke, Osteoporosis -- drug therapy, Bone Density Conservation Agents -- pharmacology -- therapeutic use, Cardiovascular Diseases, Dietary Supplements -- adverse effects, Muscle, Monoclonal -- pharmacology, Female, Muscle, Skeletal/drug effects, Denosumab, Cardiovascular Diseases -- chemically induced, Médecine générale & interne, Osteoporosis/drug therapy, Selective Estrogen Receptor Modulators, Consensus, Antibodies, Monoclonal -- pharmacology, Calcium/pharmacology/therapeutic use, Selective Estrogen Receptor Modulators/pharmacology/therapeutic use, Neoplasms -- chemically induced, Thiophenes/pharmacology, Thiophenes -- pharmacology, Antibodies, Monoclonal, Humanized, Sciences de la santé humaine, Antibodies, R5-920, Stroke/chemically induced, Diphosphonates -- pharmacology -- therapeutic use, Organometallic Compounds, Bisphosphonate, Humans, Muscle, Skeletal, Aged, Calcium -- pharmacology -- therapeutic use, Consensus Statement, SERM, Antibodies, Monoclonal/pharmacology, Organometallic Compounds/pharmacology, Neoplasms/chemically induced, Dietary Supplements, Bone Density Conservation Agents/pharmacology/therapeutic use, Osteoporosis, Calcium, Skeletal -- drug effects, Dietary Supplements/adverse effects, General & internal medicine, Organometallic Compounds -- pharmacology
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