Bones Turnover Markers and Osteoporosis

Physical Therapist interviews Dr. Stuart L. Silverman on the role of bone markers in the osteoporosis treatment and management.

0:00 Introduction: Dr. Stuart Silverman
2:25 How to Best Communicate Fracture Risk to Patients (RICO (Risk Communication in Osteoporosis))
3:34 Dr Silverman Introduces Bone Markers
4:15 Conflict of Interest Declaration
4:44 Bone Remodelling Overview
5:43 Introduction to Bone Turnover Markers
6:17 Two Reference Bone Markers
8:52 Dr Silverman Presents a Bone Strength Triangle Model: Use of Bone Turnover Markers
10:34 When Does Dr. Silverman Use Bone Markers With His Patients?
13:25 How Bone Markers are Tested: CTX, P1NP and NTX
16:16 Osteoporosis in Cortical Bone
17:28 How to Prepare for Your Bone Marker Test
17:50 Sources of Variability of Bone Markers
19:41 Does Collagen Supplement Affect Bone Marker Results?
20:12 Automated Technology: Reference Range for P1NP and CTX Markers
21:23 Frequency of Orders: Bone Markers
22:30 How to Measure Least Significant Change
23:17 Bone Markers Can Predict the Rate of Bone Loss
23:57 Bone Markers and Fracture Risk
24:41 How Widely Used Are Bone Marker Tests in Therapeutic Decisions for Individuals?
26:38 Applications for Bone Turnover Markers
26:53 Some Uses of Bone Markers
30:08 What are High Bone Turnover and Low Bone Turnover Osteoporosis?
31:29 Bone Health Therapy for Younger Individuals (Below 40)
34:13 Prolia Transition and Bone Markers
37:15 Bone Markers and Drug Holidays from Bisphosphonates
37:39 Definition of Drug Holiday
39:28 Dr. Silverman Discusses Prolia Usage
40:11 Prolia for Younger Patients
40:53 Prolia, Bone Fragility and Dental Work
41:39 Guidelines for Prolia Use With Dental Surgery
42:30 Dr. Silverman Discusses His Strategy for Prolia Patients and Dental Surgery
44:32 Are There External Factors That Can Influence Bone Turnover Marker Results?
46:41 Where Can You Get a Bone Marker Test and What are the Approximate Costs?
47:41 How Often Does Dr. Silverman Use Trabecular Bone Scores (TBS)?
48:46 The TBS Does not Catch Cortical Bone Loss
49:22 Dr. Silverman's Approach: A More Comprehensive Focus on Measuring Bone Health
49:43 Outro

Stuart L. Silverman MD FACP FACR is the Clinical Professor of Medicine at Cedars-Sinai Medical Center and UCLA School of Medicine, and Medical Director of OMC Clinical Research Center

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Medical Disclaimer
All the information, content, and material presented in this video is for informational purposes only. It is not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider.