Advances in Bone Turnover Markers (PINP and CTX) in Optimizing Anti-resorptive and Anabolic Therapies Against Osteoporosis.

Osteoporosis has been a major health problem for many elderly people and postmenopausal women with poor prognosis. Bone turnover markers (BTMs) reflecting bone metabolisms are applied to evaluating clinical results and monitoring of compliance in anti-resorptive and anabolic therapy for osteoporosis. The numerical changes and clinical significance of BTMs in two therapies are summarized and the practical application and potential value of PINP and CTX as therapeutic target, threshold of follow-up therapy, and evaluation of fracture risk in different regimes such as bisphosphonates, denosumab, raloxifene, teriparatide, abaloparatide, and romosozumab are reviewed in this paper. The application of BTMs is expected to improve the efficacy of the treatments and reduce the rate of osteoporotic fracture in clinical practice.