Male osteoporosis and the use of teriparatide in the treatment: a review of the literature
Hüsniye Başer1, Reyhan Ersoy2, Bekir Çakır2
1S.B. Ankara Atatürk Eğitim ve Araştırma Hastanesi, Endokrinoloji ve Metabolizma Hastalıkları Kliniği, Bilkent, Ankara
2Yıldırım Beyazıt Üniversitesi Tıp Fakültesi, İç Hastalıkları AD, Bilkent, Ankara
Keywords: Male osteoporosis, parathyroid hormon, teriparatide
Osteoporosis is considered a challenge affecting women more than men, and the outcomes of the condition are not well-known. The prevalance of osteoporosis-linked fractures is less in men, but osteoporosis leads to higher rate of mortality and morbidity in men. In more than half of the patients with osteoporosis, the disorder arises from a secondary result. Among the most frequent reasons of secondary osteoporosis in men are over-consumption of alcohol, hypogonodism and over-use of glucocorticoids. In post-menauposal women, osteoporosis is described as bone mineral density lower than -2.5 standard deviation of peak bone density of young adult reference population. The same criterion is also used for men; however, peak bone density is higher in men, compared to women, and the fact that the same diagnostic reference values for women are used may cause healthcare providers to ignore the diagnosis of osteoporosis in men. The number of drugs to be used in the treatment of osteoporotic men is too limited. Osteoclastic activity is inhibited by antiresorptive treatment (biphosphonates, calcium, vitamin D); thus, bone turnover decreases, bone mineral density increases, and risk of vertebral and/or peripheric fractures diminishes. Antiresorptive treatment may cease the loss of bones, but is effective neither in the formation of new bones nor in the amelioration of microstructure. Anabolic treatment, however, is based on the stimulation of bone formation. Teriparatide (parathyroid hormon 1-34) is now an approved anabolic agent in the treatment of osteoporosis in men. In this article, osteoporosis in men and the effectiveness of parathyroid hormon treatment will be discussed in light of literature.