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https://www.readbyqxmd.com/read/28733136/unexpected-bone-formation-produced-by-rankl-blockade
#1
REVIEW
Sergio Portal-Núñez, Aranzazu Mediero, Pedro Esbrit, Olga Sánchez-Pernaute, Raquel Largo, Gabriel Herrero-Beaumont
Denosumab (Dmab) is a humanized monoclonal antibody that blocks RANKL (receptor activator for nuclear factor κB ligand), thereby exerting a potent bone antiresorptive action. Dmab treatment leads to a dramatic and sustained increase in bone mass through mechanisms that are currently under debate. It is also a matter of controversy whether this potent action of Dmab could lead to intrabone dystrophic mineralization. Recent research has uncovered a possible anabolic role of Dmab involving RANKL-dependent reverse signaling in osteoblasts, and that bone marrow adipocytes can modulate osteoclastogenesis through the production of RANKL...
July 19, 2017: Trends in Endocrinology and Metabolism: TEM
https://www.readbyqxmd.com/read/28732103/denosumab-current-use-in-the-treatment-of-primary-bone-tumors
#2
Olga D Savvidou, Ioanna K Bolia, George D Chloros, John Papanastasiou, Panagiotis Koutsouradis, Panayiotis J Papagelopoulos
Denosumab, a human monoclonal antibody that inhibits bone resorption by binding on the receptor activator of the nuclear factor kappa-β ligand, has recently emerged as an additional option in the treatment of musculoskeletal osteolytic tumors. This article focuses on the recent literature regarding the effectiveness of denosumab in the management of giant cell tumor, multiple myeloma, aneurysmal bone cyst, and osteosarcoma. The mechanism of action of denosumab in the management of these tumors and the associated side effects are discussed in detail...
July 1, 2017: Orthopedics
https://www.readbyqxmd.com/read/28727345/-denosumab-in-clinical-practice-beware-before-during-and-after
#3
Olivier Lamy, Elena Gonzalez-Rodriguez, Delphine Stoll, Bérengère Aubry-Rozier
Denosumab is a very effective treatment of osteoporosis, easy to use and very well tolerated. Due to some associated risks, a close clinical follow-up is necessary. Before the first injection, it is necessary to correct hypocalcaemia or vitamin D deficiency when present. Calcemia has to be followed in case of renal insufficiency. Injections of denosumab should be done scrupulously every 6 months (± 3 weeks). Discontinuation of denosumab is associated with a severe rebound effect characterized by increased markers of bone remodeling, a rapid decrease of bone density values, and a risk of multiple spontaneous vertebral fractures...
April 19, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28727344/-to-where-and-until-when-handle-the-osteoporosis
#4
Brigitte Uebelhart, Serge Ferrari
Estrogen replacement therapy, selective modulators of the estrogen receptor (SERMs), bisphophonates and denosumab are antiresorptive therapies which can be used for several years. Teriparatide is still the only bone forming agent available, its use is limited to 24 months. Except the absence of new fragility fractures, there is no well defined target in the treatment of osteoporosis. Nevertheless persistence of high fracture risk (prevalent fractures and/or low BMD) on therapy indicates to maintain or intensify the treatment...
April 19, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28726429/-osteoprotective-therapy-with-bisphosphonates-or-denosumab-in-patients-with-multiple-myeloma-benefit-and-risks
#5
Zdeněk Adam, Jan Straub, Marta Krejčí, Luděk Pour, Dagmar Brančíková, Lenka Ostřížková, Viera Sandecká, Martin Štork
Bisphosphonates have been used during the complete treatment of multiple myeloma for more than twenty years. They slow osteolysis and thereby contribute to the improvement of quality of life. Their long-term use, however, is related to 2 serious, usually later appearing complications: osteonecrosis of the jaw, occurring in 6-9 % of patients, and rarer atypical bone fractures. Both these complications are very difficult to heal, and all the more emphasis is therefore laid on prevention. This first of all includes discussion about the risk with the patient, followed by a dental checkup before the commencement of therapy and then repeated during its course, as well as reduced use of these drugs for a necessary period of time...
2017: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28723476/charting-recent-progress-and-challenges-in-metastatic-castration-resistant-prostate-cancer-is-there-an-optimal-treatment-sequence
#6
REVIEW
Stéphane Oudard, Pablo Maroto, Gaston Demonty, Winald R Gerritsen
CONTEXT: Recent developments in the treatment of metastatic castration-resistant prostate cancer (mCRPC) have led to uncertainty about the optimal sequence of agents. OBJECTIVE: To review and assess treatment options and sequence in patients with mCRPC. EVIDENCE ACQUISITION: To identify data on the optimal use of approved treatments, we searched PubMed for studies on the use of recently approved agents for men with mCRPC published before March 2015...
October 2016: European Urology Focus
https://www.readbyqxmd.com/read/28721134/osteoporosis-in-men
#7
REVIEW
Waldemar Misiorowski
Osteoporotic fractures are the leading cause of morbidity and mortality among aging men. 30% of all hip fractures occur in men, and mortality resulting from not only the hip fracture, but also the spine and other major osteoporotic fractures, is significantly higher in men than in women. As in women, hypogonadism is the best documented risk factor for developing osteoporosis in men. In older men, testosterone levels are negatively correlated with the risk of fractures, and it seems that this age-related testosterone deficiency should not be considered as one of the many causes of secondary osteoporosis, rather one of the major and most important mechanisms of senile osteoporosis...
June 2017: Przeglad Menopauzalny, Menopause Review
https://www.readbyqxmd.com/read/28714038/one-and-two-year-persistence-with-different-anti-osteoporosis-medications-a-retrospective-cohort-study
#8
C Reyes, C Tebe, D Martinez-Laguna, M S Ali, A Soria-Castro, C Carbonell, D Prieto-Alhambra
Adherence to anti-osteoporosis medications is poor. We carried out a cohort study using a real-world population database to estimate the persistence of anti-osteoporosis drugs. Unadjusted 2-year persistence ranged from 10.3 to 45.4%. Denosumab users had a 40% lower risk of discontinuation at 2 years compared to alendronate users. PURPOSE: The purpose of this study was to estimate real-world persistence amongst incident users of anti-osteoporosis medications. METHODS: This is a retrospective cohort using data from anonymised records and dispensation data ( www...
July 16, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28707576/new-strategies-for-the-prevention-and-treatment-of-systemic-and-local-bone-loss-from-pathophysiology-to-clinical-application
#9
A Fassio, Maurizio Rossini, Ombretta Viapiana, Luca Idolazzi, Camilla Benini, Elisabetta Vantaggiato, Davide Gatti
Bone loss is the result of a negative unbalance between bone formation ad bone resorption. In the last years, the studies on the Wnt canonical pathway have highlighted its crucial role in bone balance through its influence on the activity and maturation of the osteoblast line and in the Receptor Activator of Nuclear Factor κ B (RANK) - RANK ligand (RANKL)/Osteoprotegerin (OPG) system. These mechanisms are involved not only in the pathological processes inducing not only systemic bone loss (ie. Postmenopausal osteoporosis, glucocorticoid-induced osteoporosis, etc...
July 13, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28706360/osteoporosis-prevention-and-management
#10
Muralidhar V Pai
Osteoporosis, defined by BMD at the hip or lumbar spine that is less than or equal to 2.5 standard deviations below the mean BMD of a young-adult reference population, is the most common bone disease in humans affecting both sexes and all races. It's a silent killer affecting the quality of life due to fractures and postural changes. In osteoporosis there is an imbalance between bone formation and bone resorption in favor of latter. Preventive measures and treatments are available to combat this evil. Counseling is the integral part of prevention as well as treatment of osteoporosis...
August 2017: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/28697987/update-mronj-and-perspectives-of-its-treatment
#11
P J Voss, P Poxleitner, R Schmelzeisen, A Stricker, W Semper-Hogg
Antiresorptive agents are widely used in catabolic bone diseases. Not only bisphosphonates but also new drugs like Denosumab may induce osteonecrosis of the jaw as a side effect. The present review describes the current effect mechanisms of commonly used antiresorptives, pathogenetic theories for the development of antiresorptive-related osteonecrosis of the jaw (ARONJ), and potential risk factors. Furthermore, diagnostic modalities and treatment options as well as new and innovative strategies are discussed...
July 8, 2017: Journal of Stomatology, Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28695563/bone-targeted-therapies-in-advanced-breast-cancer
#12
Ewelina Biskup, Fengfeng Cai, Marcus Vetter
Bone targeted therapies are of increasing importance, not only for bone health in the clinical course of breast cancer, but recently also in the adjuvant setting as preventative, anticancer and prognosis-improving agents. It is well established that women with advanced breast cancer receive bisphosphonates or denosumab to prevent therapy-related osteoporosis. As many as 70% of these patients suffer from bone metastases and receive bone targeted agents in order to prevent skeletal related events (SREs), which are debilitating or diminish the quality of life...
July 11, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28693379/incidence-of-osteonecrosis-of-the-jaw-in-patients-with-bone-metastases-treated-sequentially-with-bisphosphonates-and-denosumab
#13
Tine Loyson, Thomas Van Cann, Patrick Schöffski, Paul M Clement, Oliver Bechter, Isabel Spriet, Ruxandra Coropciuc, Constantinus Politis, Raf O Vandeweyer, Joseph Schoenaers, Herlinde Dumez, Patrick Berteloot, Patrick Neven, Kristiaan Nackaerts, Feng J S H Woei-A-Jin, Kevin Punie, Hans Wildiers, Benoit Beuselinck
OBJECTIVES: Osteonecrosis of the jaw (ONJ) is a serious adverse event of bone resorption inhibitors (BRIs), such as bisphosphonates and denosumab. Bisphosphonates and denosumab inhibit osteoclast function through different pharmacological effects and bisphosphonates are retained in bone for several months to years. Sequential treatment with bisphosphonates and denosumab might lead to an overlapping treatment effect, due to the addition of the effect of denosumab on the residual bisphosphonate effect...
July 10, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28693144/denosumab-related-osteonecrosis-of-the-jaw-in-a-patient-with-bone-metastases-of-prostate-cancer-a-case-report-and-literature-review
#14
Hitoshi Yoshimura, Seigo Ohba, Hisato Yoshida, Kyoko Saito, Kazuyoshi Inui, Rie Yasui, Dai Ichikawa, Minako Aiki, Junichi Kobayashi, Shinpei Matsuda, Yoshiaki Imamura, Kazuo Sano
Denosumab, a human monoclonal antibody directed against the receptor activator of nuclear factor-κβ ligand (RANKL), is used for the treatment of patients with metastatic cancer of the bone or osteoporosis. Recent reports have demonstrated that denosumab can induce osteonecrosis of the jaw (ONJ), but reported cases of this are uncommon. The present study reports the case of an 86-year-old male with prostate cancer patient exhibiting bone metastases who developed ONJ whilst receiving denosumab. To elucidate the influence of denosumab on the development of ONJ, the present study also reviewed the literature, including clinical trials and case reports...
July 2017: Oncology Letters
https://www.readbyqxmd.com/read/28692232/-osteoporosis-in-menopausal-women-between-40-and-65-years-old-an-algorithm-for-the-gynaecologist
#15
Anna Surbone, Nicolas Vulliemoz, Elena Gonzalez-Rodriguez, Jean-Paul Chatelain, Olivier Lamy
Osteoporosis is a bone disease that promotes the development of fragility fractures. An algorithm is proposed for the gynaecologists'use to diagnose and treat osteoporosis in young menopausal women. The fracture risk can be calculated with the FRAX tool. If the 10-year fracture risk is ≥ 10 %, a bone densitometry is recommended, and the result is integrated in the FRAX tool. If the risk is between 10 and 20 %, a treatment should be discussed individually and, in some cases, a pharmacologic preventive treatment, by menopause hormonal treatment or SERMs, can be initiated...
October 26, 2016: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28690911/two-year-clinical-outcome-of-denosumab-treatment-alone-and-in-combination-with-teriparatide-in-japanese-treatment-naive-postmenopausal-osteoporotic-women
#16
Yukio Nakamura, Takako Suzuki, Mikio Kamimura, Shota Ikegami, Kohei Murakami, Shigeharu Uchiyama, Akira Taguchi, Hiroyuki Kato
This randomized prospective study aimed to evaluate the clinical outcome of denosumab treatment alone and in combination with teriparatide in treatment-naive postmenopausal Japanese female patients with osteoporosis. Thirty patients were randomly assigned to two groups: (1) denosumab group (denosumab alone, n=13); and (2) combination group (denosumab+teriparatide, n=17). Serum bone-specific alkaline phosphatase (BAP), serum tartrate-resistant acid phosphatase (TRACP)-5b, urinary cross-linked N-terminal telopeptides of type I collagen (NTX), and bone mineral density (BMD) of L1-4 lumbar vertebrae (L-BMD) and bilateral total hips (H-BMD) were determined at the first visit and at various time points up to 24 months post-treatment to determine percentage changes...
2017: Bone Research
https://www.readbyqxmd.com/read/28689769/osteoporosis-treatment-recent-developments-and-ongoing-challenges
#17
REVIEW
Sundeep Khosla, Lorenz C Hofbauer
Osteoporosis is an enormous and growing public health problem. Once considered an inevitable consequence of ageing, it is now eminently preventable and treatable. Ironically, despite tremendous therapeutic advances, there is an increasing treatment gap for patients at high fracture risk. In this Series paper, we trace the evolution of drug therapy for osteoporosis, which began in the 1940s with the demonstration by Fuller Albright that treatment with oestrogen could reverse the negative calcium balance that developed in women after menopause or oophorectomy...
July 6, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28689307/long-term-follow-up-in-osteogenesis-imperfecta-type-vi
#18
P Trejo, T Palomo, K Montpetit, F Fassier, A Sato, F H Glorieux, F Rauch
This retrospective study on long-term outcomes in osteogenesis imperfecta type VI found that patients who received intravenous bisphosphonate treatment had an increase in lumbar spine areal bone mineral density, a higher final height z-score, and some reshaping of vertebral bodies. INTRODUCTION: Osteogenesis imperfecta (OI) type VI is an ultra-rare bone fragility disorder caused by recessive mutations in SERPINF1. Here, we describe long-term outcomes in OI type VI and compare the clinical phenotypes caused by different types of SERPINF1 mutations...
July 9, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28686517/clinical-update-osteoporosis-management
#19
Pelin Batur, Sheila Rice, Paola Barrios, Andrea Sikon
The clinical update serves as a brief review of recently published, high-impact, and potentially practice changing journal articles summarized for our readers. Topics include menopause, sexual dysfunction, breast health, contraception, osteoporosis, and cardiovascular disease. In this clinical update, we selected recent publications relevant to osteoporosis management. We highlight articles on the safety of long-term use of denosumab and bisphosphonates, fracture risk after discontinuing menopausal hormone therapy, calcium intake and cardiovascular risk, as well as the value of repeat dual X-ray absorptiometry scanning to monitor those on osteoporosis treatment...
July 7, 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/28684826/aggressive-denosumab-related-jaw-necrosis-a-case-series
#20
M Badr, E Kyriakidou, A Atkins, S Harrison
Medication related osteonecrosis of the jaw is becoming a repeatedly seen complication in cancer patients. Stage 0 of the disease is more likely to be seen by the patients' general dental practitioners. We are presenting four cases of MRONJ related to denosumab treatment showing increasingly aggressive pictures of the disease. Nevertheless, we also present a good response to a drug holiday arranged by the patients' treating oncologists.
July 7, 2017: British Dental Journal
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