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Brigitte Uebelhart, Serge Ferrari
The risk for a second fracture within two years after a first one is high. Ten years denosumab treatment show favorable results with a risk of early vertebral fractures in patients with prevalent vertebral fractures when treatment is stopped. Teriparatide is more effective than risedronate to prevent vertebral and clinical fractures in high risk patients. Romosozumab acts as an anabolic agent in osteoporosis. Atypical femoral fractures associated with bisphosphonate treatment could be more frequent in patients with particular anatomical features...
January 10, 2018: Revue Médicale Suisse
Piet Geusens, Fernando Marin, David L Kendler, Luis A Russo, Cristiano A F Zerbini, Salvatore Minisola, Jean Jacques Body, Eric Lespessailles, Susan L Greenspan, Alicia Bagur, Jan J Stepan, Péter Lakatos, Enrique Casado, Rüdiger Moericke, Pedro López-Romero, Astrid Fahrleitner-Pammer
The 2-year, randomized, double-blind, active-controlled fracture endpoint VERO study included postmenopausal women with established osteoporosis, who had at least 2 moderate or 1 severe baseline vertebral fractures (VFx), and BMD T-score ≤-1.5. Patients were treated with either s.c. daily teriparatide 20 μg or oral weekly risedronate 35 mg. As previously reported, the risk of new VFx and clinical fractures (a composite of clinical VFx and non vertebral fragility fractures [NVFFx]) was statistically significantly reduced with teriparatide compared with risedronate...
January 12, 2018: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
Athanasios D Anastasilakis, Polyzois Makras, Maria Pikilidou, Symeon Tournis, Konstantinos Makris, Ilias Bisbinas, Olga Tsave, John G Yovos, Maria P Yavropoulou
Context: Expression of microRNAs (miRs) related to bone metabolism in the serum maybe affected by anti-osteoporotic treatment. Objective: To investigate the effect of two anti-osteoporotic agents with opposite effects on bone metabolism on microRNA expression profile in the serum. Design: Observational, open label, non-randomized clinical trial. Setting: The outpatient clinics for Metabolic Bone Diseases of 424 General Military Hospital, Thessaloniki, Greece...
December 22, 2017: Journal of Clinical Endocrinology and Metabolism
Jing Yuan Tan, Cherng Jye Seow
Osteogenesis imperfecta (OI) is a generalised connective tissue disorder associated with low bone mass, bone fragility and increased susceptibility to fractures. First-line treatment to improve bone mineral density (BMD) is usually with bisphosphonates but long-term usage has been associated with uncommon complications such as atypical femoral fractures (AFF). Treatment with teriparatide in this situation has been reported with positive outcomes. However, choice of treatment after 2 years of teriparatide has not been well studied or reported...
December 20, 2017: BMJ Case Reports
Christopher T Martin, Catherine B Niewoehner, Lynn A Burmeister
We present of a case of severe osteoporosis with thoracic myelopathy secondary to nontraumatic T8 compression fracture managed nonsurgically with 3.5 months of bed rest. Despite treatment with teriparatide starting at initial presentation, 1-year follow-up dual energy x-ray absorptiometry scan revealed a significantly greater than expected 19% reduction in lumbar spine bone mineral density (BMD) and a 6% reduction in total hip density. Daily alcohol consumption, severe osteoporosis at baseline, and immobilization secondary to transient myelopathy treated with strict bed rest all likely contributed to unexpected BMD findings...
June 1, 2017: Journal of the Endocrine Society
Richard Eastell, Jennifer S Walsh
Teriparatide is a safe and effective anabolic treatment for osteoporosis. In postmenopausal women, it increases BMD and decreases vertebral fractures by about 70% and non-vertebral fractures by about 45% (although there is no evidence that it prevents hip fractures). The current evidence indicates that it should be administered for a single course of 24 months, and followed with an anti-resorptive agent to maintain the BMD gain. There is no clear benefit to repeated or cyclical treatment. Combination treatment, particularly with denosumab achieves greater BMD increase than either agent alone, but there are no available fracture data for combination treatment...
May 2017: Clinical Cases in Mineral and Bone Metabolism
Paolo Tranquilli Leali, Massimo Balsano, Gianluca Maestretti, Matteo Brusoni, Veronica Amorese, Emanuele Ciurlia, Matteo Andreozzi, Gianfilippo Caggiari, Carlo Doria
Osteogenesis imperfecta (OI) is an hereditary disease characterized by low bone mass, increased bone fragility, short stature, and skeletal deformities, few treatment options are currently available. Neridronate is an amino-bisphosphonate, licensed in Italy for the treatment of OI and Paget's disease of bone. A characteristic property of neridronate is that it can be administered both intravenously and intramuscularly, providing an useful system for administration in homecare. Neridronate appears to increase Bone Mineral Density (BMD) in adults with OI and reduces bone resorption by inhibition of osteoclastic activity...
May 2017: Clinical Cases in Mineral and Bone Metabolism
Yuji Kasukawa, Naohisa Miyakoshi, Toshihito Ebina, Michio Hongo, Yoshinori Ishikawa, Daisuke Kudo, Koji Nozaka, Yoichi Shimada
The purpose of this retrospective clinical-based observational study was to evaluate the effects of teriparatide (TPTD) on clinical outcomes and radiologic findings of sacral insufficiency fractures (SIFs). Seven elderly women with SIFs received TPTD for at least 6 months. We evaluated the symptoms, pain, and radiological findings. At their initial clinic visit, 86% patients could not walk or sit. Computed tomography (CT) images revealed sacral wing fracture in 6 patients, and bone scintigram showed H-shaped uptake over the bilateral sacral wings in 1 patient...
May 2017: Clinical Cases in Mineral and Bone Metabolism
Vanna Bottai, Gaia De Paola, Fabio Celli, Ilaria Lazzerini, Valerio Ortenzi, Antonio Giuseppe Naccarato, Giulio Guido, Rodolfo Capanna, Stefano Giannotti
Purpose: Is it possible a correlation between some periprosthetic femoral fractures and atypical fractures? Case: We present a case of a 77-year-old woman with atypical periprosthetic femoral fracture. The patient had a history of long-term bisphosphonate use. We performed an open reduction, a synthesis of the fracture and a histological exam. The patient stopped the bisphosphonate (BF) therapy. Three months later, before starting the teriparatide treatment, the patient had a re-fracture so we did a second osteosynthesis and began a teriparatide therapy...
May 2017: Clinical Cases in Mineral and Bone Metabolism
Y H Cha, N Hong, Y Rhee, I-H Cha
Although osteoradionecrosis (ORN) is a serious complication of craniofacial radiotherapy, the current management methods remain suboptimal. Teriparatide (TPTD), a recombinant human parathyroid hormone (1-34), has shown beneficial effects on osseous regeneration in medication-related osteonecrosis of the jaw or periodontitis. However, TPTD therapy in irradiated bones has not been indicated yet because of the theoretical risk of osteosarcoma seen in rat models. Hence, we first report here two patients with tongue cancer with late-emerging ORN who were successfully treated with TPTD for 4-6 months with serum calcium and vitamin D supplementation...
December 16, 2017: Osteoporosis International
T D Htet, J A Eisman, G J Elder, J R Center
Teriparatide, used for treatment of osteoporosis in patients at high risk of fracture risk, sometimes results in mild and transient hypercalcemia. There have been two recent reports of worsening dystrophic calcification in patients with autoimmune disorders following teriparatide treatment. We report a patient with severe osteoporosis and without a pre-existing autoimmune disorder, who developed symptomatic worsening of dystrophic calcification 4 months after teriparatide was initiated. Symptoms resolved within 1 week of teriparatide cessation...
December 15, 2017: Osteoporosis International
Morgane Righetti, Jean Wach, Romain Desmarchelier, Fabienne Coury
Atypical femoral fractures are defined as atraumatic fractures located in the subtrochanteric region or femoral shaft. They have been mainly reported in patients taking bisphosphonates.We report the case of a 67-year-old female with osteoporosis treated by alendronate during ten years.Radiographies showed atypical femoral fractures. Serum levels of total and bone-specific alkaline phosphatase were low. In order to accelerate bone healing, teriparatide was introduced. After one year of teriparatide treatment, pain and functional difficulty have decreased, and alkaline phosphatase levels were normalised...
December 12, 2017: Joint, Bone, Spine: Revue du Rhumatisme
Akifumi Ijuin, Hiromi Yoshikata, Ryoko Asano, Taku Tsuburai, Ritsuko Kikuchi, Hideya Sakakibara
OBJECTIVE: Pregnancy and lactation-associated osteoporosis (PLO) is a rare disease, which can lead to vertebral fractures in women of reproductive age. No treatment strategy for PLO has been established. Here we report a case of PLO treated with teriparatide followed by denosumab, in which remarkable improvement in bone mineral density (BMD) was achieved. CASE REPORT: A 27-year-old woman experienced severe back pain two weeks after her first delivery. PLO was diagnosed from her low BMD and multiple vertebral compression fractures...
December 2017: Taiwanese Journal of Obstetrics & Gynecology
Eric G Boyce, Yvonne Mai, Christopher Pham
OBJECTIVE: To review the efficacy, safety, and economics of abaloparatide in the treatment of postmenopausal osteoporosis. DATA SOURCES: PubMed (1966 to October 2017), (October 2017), and Scopus (1970 to October 2017) were searched using abaloparatide, Tymlos, BA058, PTHrP 1-34 analog, and parathyroid hormone-related peptide 1-34 analog. STUDY SELECTION AND DATA EXTRACTION: Human studies published in peer-reviewed publications in English were the primary sources for efficacy, safety, and economic data...
December 1, 2017: Annals of Pharmacotherapy
Wen-Ling Yeh, Chun-Yi Su, Chia-Wei Chang, Chien-Hao Chen, Tsai-Sheng Fu, Lih-Huei Chen, Tung-Yi Lin
BACKGROUND: Atypical subtrochanteric fracture and femoral fracture have been considered to be rare complications related to long-term bisphosphonates use. A reduced bone turnover rate may lead to delayed bone healing. Limited data have revealed that teriparatide treatment may reverse the effect of bisphosphonates and be effective in bone healing. METHODS: We reviewed patients with atypical subtrochanteric and femoral fracture related to bisphosphonates use between January 2008 and December 2014...
December 13, 2017: BMC Musculoskeletal Disorders
Anne Drabkin, Micol S Rothman, Elizabeth Wassenaar, Margherita Mascolo, Philip S Mehler
Aim: To review current medical literature regarding the causes and clinical management options for low bone mineral density (BMD) in adult patients with eating disorders. Background: Low bone mineral density is a common complication of eating disorders with potentially lifelong debilitating consequences. Definitive, rigorous guidelines for screening, prevention and management are lacking. This article intends to provide a review of the literature to date and current options for prevention and treatment...
2017: Journal of Eating Disorders
Marta Arazzi, Giorgia Di Fulvio, Lorenzo Ottavio Di Pietro, Xhensila Grabocka, Maria Olimpia Longo, Gabriella Micioni, Alessandro Pezzutto, Luca Piscitani, Alessandra Schiazza, Simona Silvestri, Giacinta Vigilante, Luigi Amoroso, Mario Bonomini
Glucocorticoid-induced osteoporosis (GIO) is a major cause of secondary osteoporosis that starts early after the beginning of therapy even for low drug doses. Glucocorticoids are used for the treatment of immunologic nephropathies and in the setting of kidney transplant. In clinical practice, a number of algorithms are available; they allow us to estimate the long-term risk of major osteoporotic fracture; but none of them is specific for GIO. To date, the therapeutic approach comprises both general measures aimed at correcting calcium and vitamin D intake, and drugs (bisphosphonates, teriparatide, hormone replacement therapy, denosumab) that ameliorate bone mineral density and patient outcomes...
December 5, 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
E Martín-Merino, I Petersen, S Hawley, A Álvarez-Gutierrez, S Khalid, A Llorente-Garcia, A Delmestri, M K Javaid, T P Van Staa, A Judge, C Cooper, D Prieto-Alhambra
The venous thromboembolism risk among anti-osteoporotics is unknown. In this primary care study, the risk with other bisphosphonates [1.05 (0.94-1.18) and 0.96 (0.78-1.18)], strontium [0.90 (0.61-1.34) and 1.19 (0.82-1.74)], in the UK and Spain respectively, and denosumab [1.77 (0.25-12.66)] and teriparatide [1.27 (0.59-2.71)] in Spain, did not differ versus alendronate. INTRODUCTION: Most of the known adverse drug reactions described for anti-osteoporosis medication (AOM) have been described in studies comparing AOM users to non-users...
December 3, 2017: Osteoporosis International
Zhongjie Xie, Sheji Weng, Hang Li, Xia Yu, Shanshan Lu, Kate Huang, Zongyi Wu, Bingli Bai, Viraj Boodhun, Lei Yang
Accumulating evidence suggests that early angiogenesis has an important effect on the healing of injury. Teriparatide (PTH) is extensively applied for its potent anabolic activity on bone, while little is known about its angiogenic ability which may facilitate new bone formation. In this study, we tested the angiogenic ability of PTH and its effect on degradation of β-tricalcium phosphate (β-TCP) in an ovariectomized (OVX) rat distal femoral metaphysis model. After successful establishment of the OVX model was confirmed, a critical size defect was drilled into each distal femur of the OVX rats...
November 30, 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
Violet Lagari, Tara Gavcovich, Silvina Levis
PURPOSE: The American College of Physicians (ACP) published a set of guidelines on how to prevent fractures in men and women with low bone density or osteoporosis. As the population ages, the overall risk of fractures increases, thus burdening the health care system. These guidelines review current evidence for osteoporosis management, providing an update to the previous 2008 ACP's guidelines. METHODS: The ACP put forth 6 recommendations addressing the complexities in osteoporosis management based on evidence available through October 2016 with a focus on bisphosphonates, calcium, vitamin D, and estrogen...
November 28, 2017: Clinical Therapeutics
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