About this Research Topic
Osteoporosis (OP) is one of the most common metabolic bone diseases and osteoporotic derived fragility fractures represent a costly socioeconomic burden worldwide, due to its high incidence and the severe consequences to elderly people. Treatments aim at reducing the fracture risk by trying to recover the mechanical integrity of bone to pre-disease state. This is done by reversing the effect of the metabolic disorders caused by the disease on bone remodeling.
Drug treatments include anti-catabolic and anabolic therapies; the latter being preferred over the former as anti-catabolic treatments tend to achieve an excessively mineralized tissue that may become very brittle and also lead to low-energy fractures in the long term. For this reason, anti-catabolic treatments are usually interrupted after a certain time. However, it has been reported that discontinuation of these treatments produces a rebound of bone loss and associated fractures, whose causes still remain unclear. These facts together pose a dilemma that is still unresolved and is being addressed from different points of view: a combination of drug therapies, patient-specific treatments, or addition of exercise to the therapy, among others. Not many studies have been published to date addressing the effect of exercise on osteoporosis though it has a clear effect on bone strength and maintenance.
Osteoporotic derived fractures are usually low-trauma as a consequence of the prolonged deterioration of bone strength by fatigue. This fact makes this type of fracture occur inadvertently and emphasizes the importance of an early evaluation of the fracture risk. Much effort from the scientific community has been focused on the development of techniques to assess this fracture risk, from the old and quite simplistic FRAX, nowadays outdated, to more recent and powerful computational techniques, based on image analysis and bone histomorphometry. Such cutting-edge techniques are under a continuous process of development and improvement and may be favored by the collaboration of researchers of different fields.
This Research Topic is intended to cover new studies that focus on reducing the fracture risk in osteoporotic patients either by proposing new therapies or improving existing therapies, or by developing new techniques to detect this fracture risk in advance.
Addressed topics:
- Development of computational tools to evaluate fracture risk in bone.
- Evaluation of fracture risk in patients with OP.
- Bone remodeling models applied to the simulation of OP.
- Pharmacokinetics and pharmacodynamics of drugs against OP.
- Analysis of different treatment strategies: dosing, a combination of drugs.
- Influence of the mechanical environment in patients with OP, with and without drug treatments.
Drug treatments include anti-catabolic and anabolic therapies; the latter being preferred over the former as anti-catabolic treatments tend to achieve an excessively mineralized tissue that may become very brittle and also lead to low-energy fractures in the long term. For this reason, anti-catabolic treatments are usually interrupted after a certain time. However, it has been reported that discontinuation of these treatments produces a rebound of bone loss and associated fractures, whose causes still remain unclear. These facts together pose a dilemma that is still unresolved and is being addressed from different points of view: a combination of drug therapies, patient-specific treatments, or addition of exercise to the therapy, among others. Not many studies have been published to date addressing the effect of exercise on osteoporosis though it has a clear effect on bone strength and maintenance.
Osteoporotic derived fractures are usually low-trauma as a consequence of the prolonged deterioration of bone strength by fatigue. This fact makes this type of fracture occur inadvertently and emphasizes the importance of an early evaluation of the fracture risk. Much effort from the scientific community has been focused on the development of techniques to assess this fracture risk, from the old and quite simplistic FRAX, nowadays outdated, to more recent and powerful computational techniques, based on image analysis and bone histomorphometry. Such cutting-edge techniques are under a continuous process of development and improvement and may be favored by the collaboration of researchers of different fields.
This Research Topic is intended to cover new studies that focus on reducing the fracture risk in osteoporotic patients either by proposing new therapies or improving existing therapies, or by developing new techniques to detect this fracture risk in advance.
Addressed topics:
- Development of computational tools to evaluate fracture risk in bone.
- Evaluation of fracture risk in patients with OP.
- Bone remodeling models applied to the simulation of OP.
- Pharmacokinetics and pharmacodynamics of drugs against OP.
- Analysis of different treatment strategies: dosing, a combination of drugs.
- Influence of the mechanical environment in patients with OP, with and without drug treatments.
Keywords: Osteoporosis, Bone Integrity, Fracture Risk, Pharmacological Treatment, Fracture Mechanics, Bone Remodeling Models
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