An expert working group of the International Osteoporosis Foundation (IOF) and the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) has released a new position paper which reviews the evidence of bone turnover markers (BTMs) in fracture risk prediction and monitoring of osteoporosis therapy. More importantly, it identifies research priorities and recommends that specific markers be used as reference analytes for BTMs in clinical and observational studies.
BTMs have been extensively studied in relation to fracture risk assessment and have been found, in some cases, to predict fracture risk independently of bone mineral density (BMD). However, the use of different markers and a number of measurement methods, even for the same marker, has resulted in incomparable and inconsistent data and therefore currently limits the incorporation of BTMs in fracture risk prediction tools, such as FRAX.
In clinical practice, BTMs are used to monitor osteoporosis treatment. BTMs generally show large and rapid responses to the treatments used for osteoporosis, which make them an appealing tool to inform physicians and patients on treatment efficacy. Some evidence suggests that changes in BTMs following treatment with antiresorptive agents may explain a greater percentage of the fracture risk reduction than does the change in BMD. However, further population studies, with correct sample handling and statistical methods, are needed to confirm these findings.
In its position paper* the Joint IOF-IFCC Bone Marker Standards Working Group identified several research priorities to address the gaps in the literature. It recommends that specific markers of bone formation (s-PINP) and of bone resorption (s-CTX) be used as reference analytes for bone turnover markers in clinical and observational studies. Professor Cyrus Cooper, Co-chair of the Joint IOF-IFCC Bone Marker Standards Working Group and Chair of the IOF Committee of Scie
|Contact: L. Misteli|
International Osteoporosis Foundation