scholarly journals Incomplete atypical femoral fractures after bisphosphonate use in postmenopausal women

2019 ◽  
Vol 27 (3) ◽  
pp. 230949901987526
Author(s):  
Umut Canbek ◽  
Ulas Akgun ◽  
Deniz Soylemez ◽  
Tugba Dubektas Canbek ◽  
Nevres Hurriyet Aydogan

Purpose: This study aimed to determine the prevalence of incomplete atypical femoral fractures (iAFFs) in postmenopausal women using bisphosphonates and to investigate the potential risk factors for the development of iAFF. Methods: The national health-care records system indicated that 2746 postmenopausal women in our region aged ≥50 years were taking bisphosphonates. Using an assumed iAFF prevalence of 10% and levels of 5% α significance and ±5% precision, we calculated that a sample size of 132 participants was needed for this study. The patients were randomly selected and invited to the hospital. Radiographs and bone scans were used to evaluate each patient for iAFF. Bone mineral density, 25-hydroxy vitamin D, parathyroid hormone, and alkaline phosphatase measurements were performed. Results: The mean age of the study population was 72.79 ± 7.35 years, and the mean duration of bisphosphonate use was 7.7 ± 3.4 years. We found iAFF in 14 (10.6%) patients, and 3 patients had bilateral involvement. Of the 17 femurs with iAFF, a proximal third location was seen in 2 patients (11.8%), a mid-third location in 14 (82.4%), and a distal third location in 1 (5.9%). The duration of bisphosphonate use was longer, and parathyroid hormone levels were higher in patients with iAFF compared to those without an incomplete fracture. Conclusion: We found a relatively higher prevalence of iAFF in postmenopausal women using bisphosphonate. Early identification and treatment of iAFF is crucial for reducing potential patient morbidity and hospital costs.

2016 ◽  
Vol 17 (2) ◽  
pp. 138-141
Author(s):  
Samira Sharmin ◽  
Mabubul Haque ◽  
Syedur Rahman Miah ◽  
Md Mahbub Ur Rahman ◽  
Jasmine Ara Haque ◽  
...  

Objectives: Low bone mass is a common disorder in elderly population which predisposes to fracture with minimal trauma. This study was performed to find out the association between the Body Mass Index (BMI) and Bone Mineral Density (BMD) in postmenopausal women.Materials and Methods: This cross sectional study was carried out at Institute of Nuclear Medicine and Allied Sciences Comilla and Mitford, Dhaka over a period of 12 months from January 2013 to December 2013. A total 93 postmenopausal women were enrolled for this study. All postmenopausal women underwent a BMD scan of femoral neck and lumbar vertebrae using a Dual Energy X-ray Absorptiometry (DEXA). Participants were categorized into three groups according to their age and BMI. BMD were expressed base on T-score according to WHO criteria. The relation among BMI, age and BMD were assessed.Results: The results of this study showed that the mean age of the study group was 57.13±7.49 years with range of 46 to 75 years. The most postmenopausal women were in age group 55-65years. The mean BMI of the study subjects were 24.18±5.08 kg/m2 with a range of 15.62 to 36.20 kg/m2. Among 93 subjects osteopenia was greater at lumbar spine (45.2%) with T-score mean±SD-1.83±0.33 and osteoporosis at femoral neck (51.6%) with T-score mean ±SD-3.36±-0.67. Pearson’s correlation coefficient test showed inverse relationship between age and BMD both lumbar spine (r = -0.301, p = 0.003) and femoral neck (r = -0.303, p=0.003) whereas the positive relation between BMI and BMD both at lumbar spine (r=0.338, p=0.001) and femoral neck (r =0.343, p=0.001). These showed that with advancing age, BMD decreases and the risk of osteoporosis increases and with increasing BMI, BMD increases and risk of osteoporosis decreases.Conclusion: The findings of this study portrait that aging and low BMI are risk factors associated with bone loss. So preventive measure should be taken for high risk post menopausal women.Bangladesh J. Nuclear Med. 17(2): 138-141, July 2014


2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Aliya Aziz Khan ◽  
Hajar Abu Alrob ◽  
Iman M’Hiri ◽  
Hosay Said ◽  
Sharjil Hussain ◽  
...  

Abstract Introduction: Denosumab, a fully human monoclonal antibody to RANK-ligand, has been shown to increase bone mineral density (BMD) and reduce the risk of hip, vertebral and non-vertebral fractures in postmenopausal women with osteoporosis (1-3). Varying doses of denosumab including 30mg/3months have demonstrated a decrease in bone remodelling in a dose-dependent manner (2,4-6). The primary objective of this study is to evaluate the efficacy of low dose denosumab (30mg/6 months) in postmenopausal women with osteoporosis who are reluctant to consider or continue the full dose of denosumab due to adverse events (AE) or concerns of potential AE. Methods: Following informed consent, postmenopausal women with a T-score of ≤ -2.5 at the lumbar spine (LS) or at the total hip (TH) received denosumab 30mg/6months. Patients with an additional skeletal disorder, prior fragility fracture, or on oral steroids (daily in the past 12 months) were excluded. The primary endpoint was the percent change in BMD at the lumbar spine (LS), total hip (HP), femoral neck (FN) and 1/3 radius (1/3R) at 12 months. Secondary outcomes were 1) percent change in BMD at the LS, TH, FN, and 1/3R at 24 months and 2) AE. Results: We enrolled 183 patients. The mean age was 69 years (SD= 7.07), 80% of patients had a moderate fracture risk (CAROC tool), 3% were current smokers and 9% consumed alcohol daily. 14.4% of patients were on SSRI/SNRI, 9.6% were on PPI, and no patient was on an aromatase inhibitor. At 12 months (n=125), the mean BMD significantly increased by +2.0% (95% CI 2.8%-1.3%) at the LS (p<0.001). There was no significant change in BMD at the FN, TH, AND 1/3R. At 24 months (n=65), the percent change in BMD was +3.4% (95% CI 4.8%-2.0%: p<0.001) at the LS, +1.5% (95% CI 2.9%-0.15%: p=0.031) at the FN, +1.9% (95% CI 3.5%-0.24%: p=0.025) at the 1/3R. There was no significant change in BMD at the TH. Conclusion: Low dose denosumab appears to be effective in maintaining BMD in postmenopausal women with a moderate fracture risk and may be of benefit in individuals who are experiencing side effects or concerns of side effects. This may also be of value following 10 years of therapy in order to maintain BMD. References 1.Bekker, PJ, Holloway DL, Rasmussen AS, Murphy R, Martin SW, Leese PT... Depaoli AM. A Single-Dose Placebo-Controlled Study of AMG 162, a Fully Human Monoclonal Antibody to RANKL, in Postmenopausal Women. JBMR, 2004;19(7), 1059-1066. 2.Kumagai Y, Hasunuma T, Padhi D. A randomized, double-blind, placebo-controlled, single-dose study to evaluate the safety, tolerability, pharmacokinetics and pharmacodynamics of denosumab administered subcutaneously to postmenopausal Japanese women. Bone, 2011;49(5), 1101-1107. 3.Lewiecki EM, Miller PD, Mcclung MR, Cohen SB, Bolognese MA, Liu Y, . . . Fitzpatrick LA. Two-Year Treatment With Denosumab (AMG 162) in a Randomized Phase 2 Study of Postmenopausal Women With Low BMD. JBMR, 2007;22(12), 1832-1841.


2001 ◽  
Vol 344 (19) ◽  
pp. 1434-1441 ◽  
Author(s):  
Robert M. Neer ◽  
Claude D. Arnaud ◽  
Jose R. Zanchetta ◽  
Richard Prince ◽  
Gregory A. Gaich ◽  
...  

2019 ◽  
pp. 1197-1205
Author(s):  
Khalid Ghanim Majeed ◽  
Husham A Thanon ◽  
Basim Idrees Dhannoon ◽  
Haitham B. Fathi

In this research, we discussed bone density for women taking into consideration the method of research, we measure the total body mass of women in premenopausal and comparing it with postmenopausal, since the amount of the bone mineral content and bone mineral density, fat mass and lean mass.A cross sectional study conducted at DXA laboratory, Physiology Department, College of Medicine, University of Ninevah, Mosul-Iraq from Jan. 1 - Dec. 31, 2013. Since 174 healthy women recruited from reviewing of college medical academic center. They were divided into two groups: pre menopause group (n = 42) and post menopause group (n= 130). Detailed anthropometric data were gathered from study subjects. The mean age SD of pre-menopause group was (43.37 7.49) year while the mean age SD postmenopausal group (63.63 9.23) years .The T-score, Z-score, Bone Mineral Density (BMD), Bone Mineral Content (BMC), Fat Mass and Lean Mass were measured in the supine position by the use of DXA bone densitometer scanner type (STRATOS) from (DMS) group, France.Bone Mineral Content (BMC) was significantly lower in arm, rib, and thoracic spines. Bone Mineral Density (BMD) in arm, rib, leg and total were significantly low in postmenopausal women. Non-significant differences were noticed between both groups for lean mass. Postmenopausal women having more fat mass than pre menopause group. Both T-score and Z-score for pre menopause and post menopause groups were from class of osteopenia, but it was significantly lower in post menopause group (p-value =0.001, 0.008 respectively).Postmenopausal women were at higher risk of osteoporosis due to lowered Bone Mineral Density , T & Z scores.


2018 ◽  
Vol 86 (4) ◽  
pp. 292
Author(s):  
Grażyna Bączyk ◽  
Dorota Formanowicz ◽  
Paweł Kleka ◽  
Włodzimierz Samborski

Introduction and objective: The aim of the study was to evaluate the effect of treatment on the quality of life (QoL) in postmenopausal women characterized by the reduced BMD.Material and methods: Postmenopausal women (n=102), mean age (65.09±5.6 years) were included in this study. The participants were divided into two groups, depending on the treatment or lack of treatment. For assessment of their QoL, QUALEFFO-41 scale and WHOQOL-100 scale were used.Results: Mean values of the QUALEFFO-41 scale of women who used alendronate were significantly lower than those found in subjects not treated with this drug in the following areas: pain (p=0.03), ADL (p=0.03), jobs around the house (p=0.01), mobility (p=0.01), health perception (p=0.03), emotional function (p= 0.007) and total QoL  (p=0.005). The mean values of the WHOQOL-100 scale almost did not differ significantly between both groups of studied patients. An exception was the level of independence, with mean values of women not receiving bisphosphonates being significantly higher than those of patients using bisphosphonates therapy (p=0.04).Conclusions. Quality of life assessment of women with osteoporosis and osteopenia using a specific scale and general scale can be a valuable clue in the planning of treatment, nursing care and psychological care.


2016 ◽  
Vol 175 (2) ◽  
pp. 95-100 ◽  
Author(s):  
Jessica Pepe ◽  
Daniele Diacinti ◽  
Emanuela Fratini ◽  
Italo Nofroni ◽  
Antonella D’Angelo ◽  
...  

Objective The prevalence of abdominal aortic calcification (AAC) in primary hyperparathyroidism (PHPT) is unknown. We assessed both prevalence and severity of AAC in PHPT postmenopausal women. Methods In this study 70 PHPT postmenopausal women and 70 age- and sex-matched controls were enrolled. Each participant underwent biochemical evaluation, lateral spine radiograph, bone mineral density (BMD) measurement (lumbar, femoral, radial sites), and kidney ultrasound. Lateral lumbar films were analyzed in the region of L1–L4 vertebrae and the Kauppila score (a semi-quantitative grading system) was used to assess the severity of AAC. Results There were no differences regarding demographic and cardiovascular risk factors in the two groups. PHPT patients had higher prevalence of kidney stones (30% vs 7%, P=0.0008) and lower radial BMD values (0.558±0.071 vs 0.588±0.082 g/cm2, P<0.05) compared with controls. PHPT patients showed higher prevalence of AAC (31 vs 18, P=0.03), with more severe calcifications (Kauppila score 7.35±6.1 vs 5.05±3.5, P=0.007). PHPT patients with AAC were older and had been suffering from the disease for a longer period compared with those without ACC. Moreover, PHPT patients with severe AAC had mean higher serum parathyroid hormone levels compared with patients with moderate or mild calcifications. In PHPT patients with AAC, multiple regression analysis, adjusted for age and years since diagnosis, showed that only parathyroid hormone significantly correlated with Kauppila score. Conclusion We found a higher prevalence and severity of AAC in PHPT related to parathyroid hormone effect.


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