The title of this talk really should be “Another extraordinary Year in Bone” - because progress in diagnosis and management of both common and rare bone diseases in the last year has been rapid and exciting. It’s going to be hard in half an hour to cover everything but I will aim to present as least some of the new data – all from the last 12 months! – addressing the following:
- a) New anabolic agents in osteoporosis (romosozumab, abaloparatide)
- b) Head-to-head trials in osteoporosis therapeutics
- c) what is the longterm safety of denosumab?
- d) what happens after denosumab discontinuation?
- e) Options after stopping denosumab? (could oral agents be better than IV?)
- f) Does zoledronate need annual dosing?
- g) How should we best identify and treat osteoporosis in the community?
- h) Does HRpQCT add anything useful to BMD?
- i) Bone protection for women going onto aromatase inhibitors? (our own ESA/ANZBMS publication here!)
- j) Does exercise do anything useful in osteoporosis?
- k) What’s the best option for glucocorticoid-induced osteoporosis?
There’s been great progress in rare skeletal diseases:
- a) The pivotal trial of Burosumab (an FGF23-neutralising antibodies) in children with X-linked hypophosphataemic rickets
- b) Phase 2 results of palovarotene for fibrodysplasia ossificans progressive data (Phase 3 studies in progress…..)
- c) Palovarotene for multiple hereditary exostoses
- d) Romosozumab in skeletal dysplasias (osteogenesis imperfecta and hypophosphatasia)
- e) Fresolimumab in adults with osteogenesis imperfecta
- f) The first RCT of zoledronate in bone marrow oedema syndrome
The ongoing saga of calcium and vitamin D has continued, including genetic dissection of calcium in vascular disease. And of course my own personal interest: how many genes contribute to osteoporosis?
Don’t know what some of these agents are, or even some of these diagnoses? Come along and listen. Without doubt bone disease is one area in medicine undergoing significant change!