Dr. Miller’s

Journal  Articles

Vertebral fractures are common and can result in acute and chronic pain, decreases in quality of life, and diminished lifespan. The identification of vertebral fractures is important because they are robust predictors of future fractures. The majority of vertebral fractures do not come to clinical [...]

Unlike treatments for the vast majority of chronic dis- eases, US Food and Drug Administration–-approved osteoporosis treatments are currently limited to the use of a single drug at a fixed dose. Furthermore, although the therapeutic options for osteoporosis treatment have expanded greatly over the past [...]

The effects of anabolic medications (teriparatide [TPTD] and parathyroid hormone [PTH]) differ in patients who have received recent treatment with potent antiresorptives. This perspective reviews studies evaluating bone density (BMD) and histomorphometric effects of treatment sequences beginning with TPTD/PTH followed by potent antiresorptives and those [...]

Osteoporosis can lead to fragility fractures, which result in clinical burden and increased mortality. Even after a fracture, fewer than 25% of patients receive pharmacologic treatment for osteoporosis.3-5 After the discovery that sclerostin deficiency causes rare genetic conditions that are characterized by high bone mass [...]

Abstract Postmenopausal women with severe osteoporosis may require treatment with the bone anabolic drug teriparatide. While changes in bone mineral density (BMD) are one measure of response, BMD changes often require a minimum of one year to observe measureable changes. Biochemical markers of bone turnover [...]

The Special Committee recommends changing the nomenclature of bisphosphonate-related osteonecrosis of the jaw (BRONJ). The Special Committee favors the term medication-related osteonecrosis of the jaw (MRONJ). The change is justified to accommodate the growing number of osteonecrosis cases involving the maxilla and mandible associated with [...]

Osteoporosis is both an under-diagnosed and under-treated disease. The annual costs in the US of caring for osteoporotic-related fractures parallel or exceed the annual costs of caring for myocardial infarction, breast cancer and/or cerebrovascular accident. In a large Manitoba, Canada study, the ratio of the [...]

Idiopathic hypercalciuria increases the risk of urinary stones and osteoporosis. The aim of this review is to delineate our current understanding of idiopathic hypercalciuria in the context of bone health, specifically its definition, causes, epidemiology, laboratory evaluation, and potential treatments.... Download the Entire Article [...]

When a patient with chronic kidney disease suffers a fragility fracture (or fragility fractures), a key question is whether the patient has osteoporosis or, instead, renal osteodystrophy. Bone densitometry does not help in this distinction: biochemical tests, and sometimes also bone biopsy, are needed. However, [...]

Abaloparatide is a peptide that selectively binds to the RG conformation of the parathyroid hormone type 1 receptor. As a result of its mechanism of action, it was hypothesized that abaloparatide would have a more pronounced anabolic action on bone compared with teriparatide. The primary [...]

Unlike most chronic diseases, osteoporosis treatments are generally limited to a single drug at a fixed dose and frequency. Nonetheless, no approved therapy is able to restore skeletal integrity in most osteoporotic patients and the long-term use of osteoporosis drugs is controversial. Thus, many patients [...]

Denosumab, a fully human IgG2 anti-RANK ligand antibody, quickly and substantially inhibits bone remodeling. As expected by the pharmacology of Denosumab, this inhibition of remodeling is completely reversible upon stopping treatment. In clinical trials, discontinuing therapy after 2 years results in a rapid rebound in [...]

Ever since the publication of the United States fluoride clinical trial data showing that the studied dose of fluoride therapy in postmenopausal osteoporosis (PMO) induced a linear increase in spinal bone mineral density (BMD) but without a reduction in fracture risk,(1) registration for all subsequent [...]

Bisphosphonates are analogs of naturally occurring compounds, pyrophosphates (P–O–P). P–O–P are byproducts of adenosine triphosphate (ATP) metabolism but have little or no biological activity in healthy individuals because they undergo rapid enzymatic degradation by ubiquitous pyrophosphatases (e.g., acid phosphatase and alkaline phosphatase) (the exception is [...]

Bisphosphonates (BPs) are bone-avid compounds used as first-line medications for the prevention and treatment of osteoporosis. They are also used in other skeletal pathologies such as Paget’s and metastatic bone disease. They effectively reduce osteoclast viability and also activity in the resorptive phase of bone [...]

Bone turnover markers (BTMs) have become increasingly important in the management of postmenopausal osteoporosis (PMO). In bisphosphonate-treated women with PMO, BTMs can provide early indications of treatment efficacy, are predictors of BMD response and fracture risk reduction, and are potentially useful for monitoring patient compliance. [...]

Denosumab ( fully human monoclonal antibody to Rank-Ligand) was approved for the treatment of post-menopausal osteoporosis in June 2010, and is highly effective to reduce the risk of vertebral, non-vertebral, and hip fracture risk. The registration of denosumab was the culmination of the discovery and [...]