Anabolic Skeletal Agents for Osteoporosis

描述(由申请人提供)： 骨质疏松症是一个巨大且持续增长的公共健康问题。它导致了巨大的社会负担，如骨痛、骨骼骨折、死亡率和生活质量下降。它影响男性和女性，随着人口老龄化，发病率正在增加。在美国，仅女性每年因骨质疏松症而付出的代价就在300亿美元左右。骨质疏松症可以是原发性的(绝经后和老年性骨质疏松症)，也可以是继发性的(例如，风湿病和使用糖皮质激素治疗的肺气肿的患者)。到目前为止，治疗的主要方向是营养(钙和维生素D)，并通过使用一系列所谓的抗吸收药物，如雌激素、选择性雌激素受体调节剂、双膦酸类和降钙素，通过阻断破骨细胞性骨吸收来防止进一步的骨丢失。在《妇女健康倡议》中期结果公布后，最近雌激素的使用显著减少，这使得美国数百万女性在骨质疏松问题上得不到保护。 在过去的一年里，FDA批准了甲状旁腺激素，这是一种新型骨骼合成代谢药物中的第一种有效药物。这一事件，加上对成骨细胞骨形成的理解的快速和广泛的进展，以及大量新的潜在的信号分子和合成骨代谢药物的转录靶点的发现，使骨质疏松治疗领域发生了革命性的变化。 美国骨骼和矿物研究学会是世界上最大和最重要的学会，致力于研究和推进与骨骼相关的疾病的基础和临床研究。我们过去在会议发展方面与NIH进行了有效的合作。上述考虑清楚地表明，现在是高级思想领袖、职业生涯中期研究人员和年轻研究人员与美国国立卫生研究院工作人员在一个小型会议环境中会面的时候，审查该领域的现状，集体思考该领域应该发展的方向(S)，并试图确定未来临床和基础研究应重点关注的领域。 因此，这项提议的目的是在NIH利斯特·希尔中心召开一次会议，重点讨论骨骼合成代谢药物的进展和骨质疏松症的治疗。

DESCRIPTION (provided by applicant): Osteoporosis is an enormous and continually growing public health problem. It leads to a large societal burden of bone pain, skeletal fracture, mortality and reduction in the quality of life. It affects men and women, and is increasing in incidence as the population ages. The annual cost of osteoporosis in the US is in the range of $30 billion in women alone. Osteoporosis can be primary (post-menopausal and senile osteoporosis) or can be secondary (for example in patients with rheumatic disease and emphysema on glucocorticoid therapy). To date, the mainstays of therapy have been directed at nutrition (calcium and vitamin D) and at preventing further bone loss through the blockade of osteoclastic bone resorption using a family of so called "anti-resorptive" drugs such as estrogen, selective estrogen receptor modulators, bisphosphonates and calcitonin. The recent and marked reduction in the use of estrogens following the release of the interim results of the Women's Health Initiative has left millions of women in the US "unprotected" against osteoporosis. In the past year, the FDA has approved parathyroid hormone, the first effective drug in a new class of skeletal anabolic agents. This event, together with rapid and extensive advances in the understanding of osteoblastic bone formation, with the explosion in identification of a myriad of new potential signaling molecules and transcriptional targets for anabolic skeletal agents, has revolutionized the field of osteoporosis therapy. The American Society for Bone and Mineral Research is the world's largest and premier society for the study and advancement of basic and clinical research in disorders relating to the skeleton. We have worked effectively in the past with the NIH in conference development. The considerations described above make it very clear that this is the time for senior thought leaders, mid-career investigators, and young investigators to meet in a small meeting setting, with NIH Institute staff, to review the current status of the field, to think collectively about the direction(s) in which the field should move, and to try to prioritize areas in which future clinical and basic research should be focused. Thus, the Aim of this proposal is to develop a meeting at the NIH Lister Hill center focused on advances in Skeletal Anabolic Agents and the Treatment of Osteoporosis.