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properties, but both have been shown to effectively reduce vertebral and non-
vertebral fractures. Newer agents that have different mechanisms of action have
either been approved recently (e.g., denosumab, an anti-catabolic) or may be
available soon (e.g., anti-sclerostin antibody, an anabolic). However, both the bis-
phosphonates and parathyroid hormone have been very effective in reducing risk of
fracture and improving the health of both postmenopausal women and older men.
References
1. Russell, R.G., Watts, N.B., Ebetino, F.H., Rogers, M.J.: Mechanisms of action of
bisphosphonates: similarities and differences and their potential influence on clinical
efficacy. Osteoporos. Int. 19, 733-759 (2008)
2. Delmas, P.D., Seeman, E.: Changes in bone mineral density explain little of the reduction in
vertebral or nonvertebral fracture risk with anti-resorptive therapy. Bone 34, 599-604 (2004)
3. Neer, R.M., Arnaud, C.D., Zanchetta, J.R., Prince, R., Gaich, G.A., Reginster, J.Y.,
Hodsman, A.B., Eriksen, E.F., Ish-Shalom, S., Genant, H.K., Wang, O., Mitlak, B.H.: Effect
of parathyroid hormone(1-34) on fractures and bone mineral density in postmenopausal
women with osteoporosis. N. Engl. J. Med. 344, 1434-1441 (2001)
4. Whyte, M.P., Mumm, S., Deal, C.: Adult hypophosphatasia treated with teriparatide. J. Clin.
Endocrinol. Metab. 92, 1203-1208 (2007)
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Donley, D.W., Dalsky, G.P., Martin, J.S., Eriksen, E.F.: Differential effects of teriparatide
and
alendronate
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6. Lindsay, R., Cosman, F., Zhou, H., Bostrom, M.P., Shen, V.W., Cruz, J.D., Nieves, J.W.,
Dempster, D.W.: A novel tetracycline labeling schedule for longitudinal evaluation of the
short-term effects of anabolic therapy with a single iliac crest bone biopsy: early actions of
teriparatide. J. Bone Miner. Res. 21, 366-373 (2006)
7. Lindsay, R., Zhou, H., Cosman, F., Nieves, J., Dempster, D.W., Hodsman, A.B.: Effects of a
one-month treatment with PTH(1-34) on bone formation on cancellous, endocortical, and
periosteal surfaces of the human ilium. J. Bone Miner. Res. 22, 495-502 (2007)
8. Dempster, D.W., Cosman, F., Kurland, E.S., Zhou, H., Nieves, J., Woelfert, L., Shane, E.,
Plavetic, K., Muller, R., Bilezikian, J., Lindsay, R.: Effects of daily treatment with
parathyroid hormone on bone microarchitecture and turnover in patients with osteoporosis:
a paired biopsy study. J. Bone Miner. Res. 16, 1846-1853 (2001)
9. Stroup, J.S., Rivers, S.M., Abu-Baker, A.M., Kane, M.P.: Two-year changes in bone
mineral density and T scores in patients treated at a pharmacist-run teriparatide clinic.
Pharmacotherapy 27, 779-788 (2007)
10. Rodan, G.A., Fleisch, H.A.: Bisphosphonates: mechanisms of action. J. Clin. Invest. 97,
2692-2696 (1996)
11. Galluzzo, S., Santini, D., Vincenzi, B., Caccamo, N., Meraviglia, F., Salerno, A., Dieli, F.,
Tonini, G.: Immunomodulating role of bisphosphonates on human gamma delta T cells: an
intriguing and promising aspect of their antitumour activity. Expert. Opin. Ther. Targets 11,
941-954 (2007)
12. Roelofs, A.J., Coxon, F.P., Ebetino, F.H., Lundy, M.W., Henneman, Z.J., Nancollas, G.H.,
Sun, S., Blazewska, K.M., Lynn, F.B.J., Kashemirov, B.A., Khalid, A.B., McKenna, C.E.,
Rogers, M.J.: Fluorescent risedronate analogs reveal bisphosphonate uptake by bone
marrow monocytes and localization around osteocytes in vivo. J. Bone Miner. Res. 12,12
(2009)
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