Pathophysiology of Avascular Necrosis.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: Conflict of interest Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, and so forth) that might pose a conflict of interest in connection with the submitted article. Disclosure The views expressed in this publication are those of the author(s) and do not reflect the official policy or position of William Beaumont Army Medical Center, Department of the Army, Defense Health Agency, or the US Government. 14. Osteoporos Int. 2018 May;29(5):1009-1022. doi: 10.1007/s00198-018-4507-8. Epub 2018 Apr 7. Anabolic agents: what is beyond osteoporosis? Liu Y(1), Levack AE(1), Marty E(1), Or O(1)(2), Samuels BP(1), Redko M(1), Lane JM(3). Author information: (1)Department of Orthopedic Surgery, Hospital for Special Surgery, Weill Cornell Medical College, 535 East 70th Street, New York, NY, 10021, USA. (2)Department of Orthopedic Surgery, Hadassah Medical Center, 91120, Jerusalem, Israel. (3)Department of Orthopedic Surgery, Hospital for Special Surgery, Weill Cornell Medical College, 535 East 70th Street, New York, NY, 10021, USA. lanej@hss.edu. Osteoporosis is a common skeletal disorder characterized by low bone mass, which leads to reduced bone strength and an increased risk of fractures. Anabolic agents have been shown to improve bone mass and decrease fracture risk in osteoporosis patients by directly stimulating osteoblasts to produce new bone. Currently, two anabolic agents are available in the USA: recombinantly produced teriparatide (TPTD), which is the fully active (1-34) amino active sequence of human parathyroid hormone (PTH), and abaloparatide (APTD), a synthetic analog of parathyroid hormone-related peptide (PTHrP). At present, both agents are approved only for treatment of patients with osteoporosis at high risk of fracture. Nonetheless, their anabolic properties have led to off-label application in additional settings which include spine fusion, osteonecrosis of the jaw, arthroplasty, and fracture healing. In this article, we summarize available scientific literature regarding the efficacy, effectiveness, and safety of TPTD in these off-label settings. DOI: 10.1007/s00198-018-4507-8 PMCID: PMC5949085