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Amir Qaseem, Mary Ann Forciea, Robert M McLean, Thomas D Denberg
Description: This guideline updates the 2008 American College of Physicians (ACP) recommendations on treatment of low bone density and osteoporosis to prevent fractures in men and women. This guideline is endorsed by the American Academy of Family Physicians. Methods: The ACP Clinical Guidelines Committee based these recommendations on a systematic review of randomized controlled trials; systematic reviews; large observational studies (for adverse events); and case reports (for rare events) that were published between 2 January 2005 and 3 June 2011...
May 9, 2017: Annals of Internal Medicine
Michel Laroche, Virginie Pécourneau, Hubert Blain, Véronique Breuil, Roland Chapurlat, Bernard Cortet, Bruno Sutter, Yannick Degboe
Osteoporosis and cardiovascular disease were long viewed as independent of each other. However, numerous epidemiological studies, which are discussed in the first part of this review, have provided incontrovertible evidence of a link. Thus, the risk of coronary artery disease and stroke is higher in patients with a history of osteoporotic fracture or low bone mineral density than in non-osteoporotic patients. In the other direction, patients with cardiovascular disease are at higher risk for bone loss and osteoporotic fracture...
November 9, 2016: Joint, Bone, Spine: Revue du Rhumatisme
W F Lems, K E Dreinhöfer, H Bischoff-Ferrari, M Blauth, E Czerwinski, Jap da Silva, A Herrera, P Hoffmeyer, T Kvien, G Maalouf, D Marsh, J Puget, W Puhl, G Poor, L Rasch, C Roux, S Schüler, B Seriolo, U Tarantino, T van Geel, A Woolf, C Wyers, P Geusens
The European League Against Rheumatism (EULAR) and the European Federation of National Associations of Orthopaedics and Traumatology (EFORT) have recognised the importance of optimal acute care for the patients aged 50 years and over with a recent fragility fracture and the prevention of subsequent fractures in high-risk patients, which can be facilitated by close collaboration between orthopaedic surgeons and rheumatologists or other metabolic bone experts. Therefore, the aim was to establish for the first time collaborative recommendations for these patients...
May 2017: Annals of the Rheumatic Diseases
JoAnn E Manson, Patsy M Brannon, Clifford J Rosen, Christine L Taylor
In recent years, numerous clinical research articles have concluded that large proportions of North American and global populations are "deficient" in vitamin D. Most of the evidence cited focuses on one of two observations: that many people have serum concentrations of vitamin D (i.e...
November 10, 2016: New England Journal of Medicine
Pauline M Camacho, Steven M Petak, Neil Binkley, Bart L Clarke, Steven T Harris, Daniel L Hurley, Michael Kleerekoper, E Michael Lewiecki, Paul D Miller, Harmeet S Narula, Rachel Pessah-Pollack, Vin Tangpricha, Sunil J Wimalawansa, Nelson B Watts
AACE = American Association of Clinical Endocrinologists AFF = atypical femur fracture ASBMR = American Society for Bone and Mineral Research BEL = best evidence level BMD = bone mineral density BTM = bone turnover marker CBC = complete blood count CI = confidence interval DXA = dual-energy X-ray absorptiometry EL = evidence level FDA = U.S. Food and Drug Administration FLEX = Fracture Intervention Trial (FIT) Long-term Extension FRAX® = Fracture Risk Assessment Tool GFR = glomerular filtration rate GI = gastrointestinal HORIZON = Health Outcomes and Reduced Incidence with Zoledronic Acid Once Yearly IOF = International Osteoporosis Foundation ISCD = International Society for Clinical Densitometry IU = international units IV = intravenous LSC = least significant change NBHA = National Bone Health Alliance NOF = National Osteoporosis Foundation 25(OH)D = 25-hydroxy vitamin D ONJ = osteonecrosis of the jaw PINP = serum carboxy-terminal propeptide of type I collagen PTH = parathyroid hormone R = recommendation RANK = receptor activator of nuclear factor kappa-B RANKL = receptor activator of nuclear factor kappa-B ligand RCT = randomized controlled trial RR = relative risk S-CTX = serum C-terminal telopeptide SQ = subcutaneous VFA = vertebral fracture assessment WHO = World Health Organization...
September 2, 2016: Endocrine Practice
Nelson B Watts, JoAnn E Manson
No abstract text is available yet for this article.
January 17, 2017: JAMA: the Journal of the American Medical Association
Laura E Targownik, Andrew L Goertzen, Yunhua Luo, William D Leslie
OBJECTIVES: Multiple studies have reported an association between proton pump inhibitor (PPI) use and fracture. However, the causality of this association is questionable, as there is not a well defined mechanism of action, nor is there evidence of an effect on PPIs on areal bone mineral density (aBMD) using dual photon X-ray absorptiometry (DXA). It is possible that PPIs may induce changes in bone structure which would predispose to fracture in the absence of changes in aBMD. We used three-dimensional quantitative computed tomography (3D-QCT) imaging to determine if long-term PPI use was associated with structural changes in bone independent of aBMD...
January 2017: American Journal of Gastroenterology
Stephen L Kopecky, Douglas C Bauer, Martha Gulati, Jeri W Nieves, Andrea J Singer, Peter P Toth, James A Underberg, Taylor C Wallace, Connie M Weaver
Description: Calcium is the dominant mineral present in bone and a shortfall nutrient in the American diet. Supplements have been recommended for persons who do not consume adequate calcium from their diet as a standard strategy for the prevention of osteoporosis and related fractures. Whether calcium with or without vitamin D supplementation is beneficial or detrimental to vascular health is not known. Methods: The National Osteoporosis Foundation and American Society for Preventive Cardiology convened an expert panel to evaluate the effects of dietary and supplemental calcium on cardiovascular disease based on the existing peer-reviewed scientific literature...
December 20, 2016: Annals of Internal Medicine
Mei Chung, Alice M Tang, Zhuxuan Fu, Ding Ding Wang, Sydne Jennifer Newberry
Background: Conflicting evidence exists regarding potential cardiovascular risks associated with high levels of calcium intake. Purpose: To update and reanalyze 2 systematic reviews to examine the effects of calcium intake on cardiovascular disease (CVD) among generally healthy adults. Data Sources: MEDLINE; Cochrane Central Register of Controlled Trials; Scopus, including EMBASE; and previous evidence reports from English-language publications from 1966 to July 2016...
December 20, 2016: Annals of Internal Medicine
Felicia Cosman, Daria B Crittenden, Jonathan D Adachi, Neil Binkley, Edward Czerwinski, Serge Ferrari, Lorenz C Hofbauer, Edith Lau, E Michael Lewiecki, Akimitsu Miyauchi, Cristiano A F Zerbini, Cassandra E Milmont, Li Chen, Judy Maddox, Paul D Meisner, Cesar Libanati, Andreas Grauer
BACKGROUND: Romosozumab, a monoclonal antibody that binds sclerostin, increases bone formation and decreases bone resorption. METHODS: We enrolled 7180 postmenopausal women who had a T score of -2.5 to -3.5 at the total hip or femoral neck. Patients were randomly assigned to receive subcutaneous injections of romosozumab (at a dose of 210 mg) or placebo monthly for 12 months; thereafter, patients in each group received denosumab for 12 months, at a dose of 60 mg, administered subcutaneously every 6 months...
October 20, 2016: New England Journal of Medicine
Christian Roux, Karine Briot
Bone mineral density (BMD) measurement using dual-energy X-ray absorptiometry (DXA) is a key contributor to the management of bone fragility syndromes, most notably postmenopausal osteoporosis. Experimental studies of bone biomechanics have established that an accurate marker for mechanical strength is areal BMD (aBMD, g/cm(2)). Areal BMD contributes 70% of mechanical strength at the femur and 40% at the spine. Two decades after the T-score was first introduced (World Health Organization, 1994), changes have occurred in the indications of DXA and in the interpretation of its results for the diagnosis, prognosis, and treatment of osteoporosis...
January 2017: Joint, Bone, Spine: Revue du Rhumatisme
Caroline Barranco
No abstract text is available yet for this article.
March 2016: Nature Reviews. Rheumatology
H Sato, N Kondo, Y Wada, T Nakatsue, S Iguchi, J Fujisawa, J J Kazama, T Kuroda, M Nakano, N Endo, I Narita
SUMMARY: The incidence of beaking, which has been reported to precede atypical femoral fracture, was high and increased over 2 years in patients with autoimmune diseases who were taking bisphosphonates and glucocorticoids. Regular femoral X-rays are strongly recommended to screen for beaking, and bisphosphonate drug holidays should be considered. INTRODUCTION: Atypical femoral fractures (AFFs) have been recently recognized as complications associated with bisphosphonate (BP) use...
March 2016: Osteoporosis International
Karine Briot, Bernard Cortet, Christian Roux, Laurence Fardet, Vered Abitbol, Justine Bacchetta, Daniel Buchon, Francoise Debiais, Pascal Guggenbuhl, Michel Laroche, Erik Legrand, Eric Lespessailles, Christian Marcelli, Georges Weryha, Thierry Thomas
OBJECTIVES: To update the recommendations on the prevention and treatment of glucocorticoid-induced osteoporosis issued in 2003 by the French National Authority for Health (HAS). This update was performed under the aegis of the Bone Section of the French Society for Rheumatology (SFR) and Osteoporosis Research and Information Group (GRIO), in collaboration with four French learned societies (primary-care, gastroenterology, internal medicine, and nephrology). METHODS: A task force composed of members of the medical specialties involved in managing patients with glucocorticoid-induced osteoporosis conducted a systematic literature review according to the method developed by the HAS then used the results to develop updated recommendations...
December 2014: Joint, Bone, Spine: Revue du Rhumatisme
Michael P Jeremiah, Brian K Unwin, Mark H Greenawald, Vincent E Casiano
Osteoporosis-related fractures affect approximately one in two white women and one in five white men in their lifetime. The impact of fractures includes loss of function, significant costs, and increased mortality. The U.S. Preventive Services Task Force recommends using dual energy x-ray absorptiometry to screen all women 65 years and older, and younger women who have an increased fracture risk as determined by the World Health Organization's FRAX Fracture Risk Assessment Tool. Although guidelines are lacking for rescreening women who have normal bone mineral density on initial screening, intervals of at least four years appear safe...
August 15, 2015: American Family Physician
René Rizzoli, Emmanuel Biver
Among the adverse events of glucocorticoid treatment are bone loss and fractures. Despite available, effective preventive measures, many patients receiving or initiating glucocorticoid therapy are not appropriately evaluated and treated for bone health and fracture risk. Populations with, or at risk of, glucocorticoid-induced osteoporosis (GIOP) to target for these measures are defined on the basis of dose and duration of glucocorticoid therapy and bone mineral density. That patients with GIOP should be treated as early as possible is generally agreed upon; however, diversity remains in intervention thresholds and management guidelines...
February 2015: Nature Reviews. Rheumatology
Sundeep Khosla, John P Bilezikian, David W Dempster, E Michael Lewiecki, Paul D Miller, Robert M Neer, Robert R Recker, Elizabeth Shane, Dolores Shoback, John T Potts
CONTEXT: There has been considerable concern recently in the scientific and lay media regarding the benefits vs. the risks of bisphosphonates for the treatment of osteoporosis. Risks include possible associations with osteonecrosis of the jaw (ONJ) and atypical femur fractures. In this perspective, we review the use of bisphosphonates for the treatment of osteoporosis, including an objective assessment of the risks vs. the benefits of these drugs. EVIDENCE ACQUISITION: Authors' knowledge of the field and results of focused literature searches are presented...
July 2012: Journal of Clinical Endocrinology and Metabolism
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