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Identifying candidates who will benefit the most from these treatments is crucial. For example, this group might include individuals with severe osteoporosis, multiple vertebral fractures, a recent fragility fracture or those unresponsive to antiresorptive treatments. Definitions of patients with a very high fracture risk vary across nations, are often based on fracture history, bone mineral density (BMD), and\/or fracture risk calculated by FRAX\u00ae or other algorithms. However, for very high-risk patients, anabolic agents such as teriparatide, abaloparatide, or romosozumab are commonly recommended as first-line therapies due to their ability to stimulate new bone formation and improve bone microarchitecture, offering significant benefits in rapid fracture reduction over antiresorptive therapies. The cost-effectiveness of these agents is a critical consideration for decision-makers. Despite their higher costs, their effectiveness in significantly reducing fracture risk and improving quality of life can justify the investment, especially when long-term savings from reduced fracture rates and associated healthcare costs are considered. Additionally, after completing a course of anabolic therapy, transitioning to antiresorptive agents like bisphosphonates or denosumab is crucial to maintain the gains in bone density and minimize subsequent fracture risks. This sequential treatment approach ensures sustained protection and optimal resource utilization. In summary, the effective use of bone forming agents in osteoporosis requires a comprehensive strategy that includes accurate patient identification, consideration of cost-effectiveness, and implementation of appropriate sequential treatments, ultimately maximizing patient outcomes and healthcare efficiency.<\/jats:p>","DOI":"10.1007\/s40520-024-02826-3","type":"journal-article","created":{"date-parts":[[2024,8,9]],"date-time":"2024-08-09T10:02:47Z","timestamp":1723197767000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["Recommendations for the optimal use of bone forming agents in osteoporosis"],"prefix":"10.1007","volume":"36","author":[{"given":"Nicola","family":"Veronese","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karine","family":"Briot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuria","family":"Gua\u00f1abens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben Hur","family":"Albergaria","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Majed","family":"Alokail","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nasser","family":"Al-Daghri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angie Botto-van","family":"Bemden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Bruy\u00e8re","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nansa","family":"Burlet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cyrus","family":"Cooper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth M.","family":"Curtis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter R.","family":"Ebeling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Halbout","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Hesse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Micka\u00ebl","family":"Hiligsmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno Muzzi","family":"Camargos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas C.","family":"Harvey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adolfo Diez","family":"Perez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R\u00e9gis Pierre","family":"Radermecker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Yves","family":"Reginster","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ren\u00e9","family":"Rizzoli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heide","family":"Siggelkow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard","family":"Cortet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Luisa","family":"Brandi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,8,9]]},"reference":[{"key":"2826_CR1","doi-asserted-by":"publisher","first-page":"390","DOI":"10.1007\/BF01623782","volume":"7","author":"JA Kanis","year":"1997","unstructured":"Kanis JA, Delmas P, Burckhardt P et al (1997) Guidelines for diagnosis and management of osteoporosis. 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Aging Clin Exp Res 36:1\u201311","journal-title":"Aging Clin Exp Res"}],"container-title":["Aging Clinical and Experimental Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40520-024-02826-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s40520-024-02826-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40520-024-02826-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,9]],"date-time":"2024-08-09T11:43:30Z","timestamp":1723203810000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s40520-024-02826-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,9]]},"references-count":48,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["2826"],"URL":"https:\/\/doi.org\/10.1007\/s40520-024-02826-3","relation":{},"ISSN":["1720-8319"],"issn-type":[{"value":"1720-8319","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,9]]},"assertion":[{"value":"24 June 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 July 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 August 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"NV has received personal honoraria from IBSA, Mylan, Nestl\u00e8, Viatris; NG has received honoraria for advisory board and lectures from Amgen, UCB, Gedeon-Richter and Theramex. BHA has received research grants from Eli Lilly, Merck & Co, Sanofi-Aventis, Novartis, Organon, Amgen, Radius; Honorarium for speaking from Eli Lilly, Amgen, Theramex, Momenta, Sanofi-Aventis; consulting fees from Theramex, Eli Lilly, Mantecorp, Amgen, UCB. OB has received consulting or lecture fees from Amgen, Aptissen, Biophytis, IBSA, Mylan, Novartis, Nutricia, Orifarm, Sanofi, UCB and Viatris. EH has received honoraria for advisory board meetings and lectures from Amgen, UCB, Eli Lilly, Kyowa Kirin, Ipsen, UCB, AgNovos, Binding Site and Theramex. EH is co-founder of Sirana Pharma. MH has received research grants (paid to institution) from Radius Health, and Angelini Pharma, lecture fees from IBSA (paid to institution) and Mylan Pharmaceuticals, and was grant advisor for Pfizer (paid to institution). EC has received lecture fees and conference support from Eli Lilly, Pfizer, Thornton & Ross and UCB. OB has received consulting or lecture fees from Amgen, Aptissen, Biophytis, IBSA, Mylan, Novartis, Nutricia, Orifarm, Sanofi, UCB and Viatris. JYR declares that he has received consulting fees or been on paid advisory boards for IBSA-Genevrier, Mylan, Radius Health, Pierre Fabre, Faes Pharma, Rejuvenate Biomed, Samumed, Teva, Theramex, Pfizer, Mithra Pharmaceuticals, received lecture fees when speaking at the invitation of the sponsor for IBSA-Genevrier, Mylan, Cniel, Dairy Research Council (DRC), Nutricia, Danone, Agnovos and received grant support from IBSA-Genevrier, Mylan, Cniel, Radius Health, TRB. RR declares that he has received fees as a speaker or consultant for Abiogen, Effryx, Nestl\u00e9, ObsEva and Theramex. HS reports advisory boards from Theramex (teriparatide generics, abaloparatide), UCB (romosozumab) and speaker engagements from stadapharm GmbH (teriparatide generics), Theramex (teriparatide generics, abaloparatide), UCB (romosozumab). BC has reported occasional interventions as an expert or speaker for Alexion, Amgen, Aptissen, Besins, Expanscience, Lilly, Kyowa-Kirin,Sublimed, Theramex, UCB, Viatris. ADP has received speaker and consultant fees from Theramex. PRE has received research funding from Amgen, Sanofi and Alexion, and speaker fees from Amgen, Alexion and Kyowa Kirin. CC has received lecture fees and honoraria from Amgen, Danone, Eli Lilly, GSK, Kyowa Kirin, Medtronic, Merck, Nestl\u00e9, Novartis, Pfizer, Roche, Servier, Shire, Takeda and UCB outside of the submitted work.The other authors did not any competing interests for this work.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}],"article-number":"167"}}