scholarly journals Unexpected rapid increase in bone mineral density by bisphosphonate therapy after multiple spinal fractures: a case report

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
Hidefumi Koiwai ◽  
Mikio Kamimura ◽  
Jun Takahashi ◽  
Yukio Nakamura ◽  
Hiroyuki Kato
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Fragility Fractures ◽  
Spinal Fractures ◽  
Lumbar Bone Mineral Density ◽  
Bone Fragility ◽  
Bisphosphonate Therapy ◽  
Japanese Woman ◽  
Mineral Density ◽  
Multiple Fractures

Abstract Background Osteoporosis is a serious disease that causes bone fragility fractures and increases mortality. Bisphosphonates are the first-line drugs for osteoporosis. However, the gains in bone mineral density by use of bisphosphonates alone are limited. Case presentation We describe the clinical outcome of a Japanese woman with osteoporosis treated with bisphosphonates after multiple spinal fractures. After 3 years of treatment with the bisphosphonate alendronate, her lumbar bone mineral density and bilateral hip bone mineral density markedly increased by 61.9% and 32.5%, respectively. Conclusion We considered that our patient’s multiple fractures had caused a decrease in bone mineral density, which naturally improved with fracture healing to enhance the increase in bone mineral density with bisphosphonate treatment.

scholarly journals Effects of Bisphosphonate Therapy on Bone Mineral Density in Boys with Duchenne Muscular Dystrophy

2020 ◽  
Vol 13 ◽  
pp. 117955142097240
Author(s):  
Rebecca Ronsley ◽  
Nazrul Islam ◽  
Mehima Kang ◽  
Helen Nadel ◽  
Christopher Reilly ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Duchenne Muscular Dystrophy ◽  
Muscular Dystrophy ◽  
Bone Mineral ◽  
Comparative Effectiveness ◽  
Fragility Fractures ◽  
Estimating Equation ◽  
Treated Group ◽  
Bisphosphonate Therapy ◽  
Mineral Density

The objective of this study was to estimate the comparative effectiveness of bisphosphonate therapy on bone mineral density (BMD) in patients with corticosteroid-treated Duchenne muscular dystrophy (DMD). A retrospective, comparative effectiveness study evaluating changes in BMD and fragility fractures in patients with DMD presenting to British Columbia Children’s Hospital from 1989 to 2017 was conducted. Marginal structural generalized estimating equation models weighted by stabilized inverse-probability of treatment weights were used to estimate the comparative effectiveness of therapy on BMD. Of those treated with bisphosphonates (N = 38), 7 (18.4%), 17 (44.7%), and 14 (36.8%) cases were treated with pamidronate, zoledronic acid, or a combination of both, respectively, while 36 cases of DMD were untreated. Mean age of bisphosphonate initiation was 9.2 (SD 2.7) years. Mean fragility fractures declined from 3.5 to 1.0 following bisphosphonate therapy. Compared to the treated group, the untreated group had an additional 0.63-SD decrease (95% confidence interval [CI]: −1.18, −0.08, P = .026) in total BMD and an additional 1.04-SD decrease (95% CI: −1.74, −0.34; P = .004) in the left hip BMD, but the change in lumbar spine BMD (0.15, 95% CI: −0.36, 0.66; P = .57) was not significant. Bisphosphonate therapy may slow the decline in BMD in boys with corticosteroid-treated DMD compared to untreated counterparts. Total number of fragility fractures decreased following bisphosphonate therapy.

Intravenous pamidronate for treatment of osteogenesis imperfecta in Indian children

2021 ◽  
pp. 004947552098269
Author(s):  
Ira Shah ◽  
Akshat Goel ◽  
Naman S Shetty ◽  
Ashok Johari
Keyword(s):  
Bone Mineral Density ◽  
Osteogenesis Imperfecta ◽  
Bone Mineral ◽  
Fragility Fractures ◽  
Bone Fragility ◽  
Fracture Rate ◽  
Spinal Bone Mineral Density ◽  
Mineral Density ◽  
Indian Children ◽  
Intravenous Pamidronate

Osteogenesis imperfecta is characterised by low bone mineral density, bone fragility, fractures and deformity. We present five such children treated with intravenous pamidronate, which resulted in a decrease of fracture rate and increase in spinal bone mineral density.

scholarly journals DXA parameters, Trabecular Bone Score (TBS) and Bone Mineral Density (BMD), in fracture risk prediction in endocrine-mediated secondary osteoporosis

Endocrine ◽  
2021 ◽  
Author(s):  
Enisa Shevroja ◽  
Francesco Pio Cafarelli ◽  
Giuseppe Guglielmi ◽  
Didier Hans
Keyword(s):  
Bone Mineral Density ◽  
Trabecular Bone ◽  
Bone Mineral ◽  
Trabecular Bone Score ◽  
Bone Microarchitecture ◽  
Fragility Fractures ◽  
Endocrine Disorders ◽  
Mineral Density ◽  
Increased Risk

AbstractOsteoporosis, a disease characterized by low bone mass and alterations of bone microarchitecture, leading to an increased risk for fragility fractures and, eventually, to fracture; is associated with an excess of mortality, a decrease in quality of life, and co-morbidities. Bone mineral density (BMD), measured by dual X-ray absorptiometry (DXA), has been the gold standard for the diagnosis of osteoporosis. Trabecular bone score (TBS), a textural analysis of the lumbar spine DXA images, is an index of bone microarchitecture. TBS has been robustly shown to predict fractures independently of BMD. In this review, while reporting also results on BMD, we mainly focus on the TBS role in the assessment of bone health in endocrine disorders known to be reflected in bone.

The Clinical Use of Denosumab for the Management of Low Bone Mineral Density in Postmenopausal Women

2012 ◽  
Vol 25 (3) ◽  
pp. 310-318 ◽  
Author(s):  
Kira B. Harris ◽  
Kimberly L. Nealy ◽  
Delilah J. Jackson ◽  
Phillip L. Thornton
Keyword(s):  
Bone Mineral Density ◽  
Postmenopausal Women ◽  
Bone Mineral ◽  
Hip Fractures ◽  
Nuclear Factor Κb ◽  
Bisphosphonate Therapy ◽  
Mineral Density ◽  
Osteoporosis Therapy ◽  
Cost Of Health Care ◽  
Therapy Studies

Osteoporosis is a leading cause of debility and declining quality of life in postmenopausal women worldwide. Treatment of osteoporosis has been ubiquitous throughout the developed world since the mid-1990s, most notably with the introduction of bisphosphonates in 1995. Nonetheless, the incidence of hip fractures increased by 25% between 1990 and 2000, despite advances in osteoporosis therapy. Studies indicate that bone density increases over the first 3 years of bisphosphonate therapy and then plateaus or perhaps even declines, placing these patients at greater risk of fracture. Since hip fractures are associated with increased morbidity, mortality, and increased cost of health care, improvements in treating osteoporosis are critical. Denosumab is a novel monoclonal antibody targeted against the receptor activator of nuclear factor-κB ligand (RANKL) that inhibits osteoclast activity. Initial data suggest that denosumab increases bone mineral density for greater than 3 years. Of greater importance, denosumab has been shown to decrease vertebral fractures by 68%, nonvertebral fractures by 19%, and hip fractures by 42% for at least 36 months. Data also indicate that the safety profile of denosumab is equivalent to other drugs used in osteoporosis management, but potential risks of immunosuppression and cancer have been hypothesized.

93 Does Spinal Bone Mineral Density Predict An Absolute 10 Year Probability of Sustaining A Major Osteoporotic Fracture

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
A Nandi ◽  
N Obiechina ◽  
A Timperley ◽  
F Al-Khalidi
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Osteoporotic Fracture ◽  
Negative Correlation ◽  
Pearson Correlation ◽  
Fragility Fractures ◽  
Mineral Density ◽  
Major Osteoporotic Fracture ◽  
T Score ◽  
The Mean

Abstract Introduction Spine and hip bone mineral density (BMD) have previously been shown to predict the risk of sustaining future fractures. Although these have been shown in population studies, there is a paucity of trials looking at the relationship between BMD and 10 year probability of major osteoporotic fractures (Using FRAX UK without BMD) in patients with previous fragility fractures. Aims To evaluate the correlation between spinal T-score and an absolute 10 year probability of sustaining a major osteoporotic fracture (using FRAX without BMD) in patients with prior fragility fractures. Methods A retrospective cross-sectional analysis of 202 patients (29 males and 173 females) with prior fragility fractures attending a fracture prevention clinic between January and August 2019 was performed. Patients with pathological and high impact traumatic fractures were excluded. The BMD at the spine was determined using the lowest T-score of the vertebrae from L1 to L4. Using the FRAX (UK) without BMD, the absolute 10 year probability of sustaining a major osteoporotic fracture was calculated for each patient. Statistical analysis was performed using SPSS 26 software. Results The mean T-score at the spine was −1.15 (SD +/− 1.90) for all patients, −0.68 (SD +/− 0.45) for males and − 1.23 (SD +/− 0.14) for females. The mean FRAX score without BMD for major osteoporotic fracture was 18.5% (SD +/− 8.84) for all patients, 11.41% (SD +/−0.62) and 19.7% (SD +/−0.68) for males and females respectively. Pearson correlation coefficient showed a statistically significant, slightly negative correlation between spinal T- score and the FRAX (UK) without BMD (r = −0.157; p < 0.05). Correlation was not statistically significant when males (r = 0.109; p = 0.59) and females (r = 0.148; p = 0.053) were considered independently. Conclusion In patients with prior fragility fracture spinal BMD has a statistically significant negative correlation with an absolute 10 year probability of sustaining a major osteoporotic fracture.

scholarly journals LOW BONE MINERAL DENSITY IN BRAZILIAN PATIENTS AT DIAGNOSIS OF CELIAC DISEASE

2015 ◽  
Vol 52 (3) ◽  
pp. 176-179 ◽  
Author(s):  
Joyce Timmermans Pires da SILVA ◽  
Renato M NISIHARA ◽  
Luís Roberto KOTZE ◽  
Márcia OLANDOSKI ◽  
Lorete Maria da Silva KOTZE
Keyword(s):  
Bone Mineral Density ◽  
Celiac Disease ◽  
Bone Mineral ◽  
Disease Diagnosis ◽  
Bone Fragility ◽  
Mineral Density ◽  
X Ray ◽  
Low Bone Mineral Density ◽  
Celiac Disease Diagnosis ◽  
Male Subjects

BackgroundLow bone mineral density is considered an extra-intestinal manifestation of celiac disease with reduced bone mass, increased bone fragility, and risk of fractures. Celiac disease is considered a condition at high risk for secondary osteoporosis and the evaluation of bone density is very important in the clinical management of these patients.ObjectiveThe present study aimed to investigate bone alterations in celiac patients from Curitiba, South Region of Brazil at diagnosis, correlating the findings with age and gender.MethodsPatients who were included in the study were attended to in a private office of the same physician from January 2009 to December 2013. The diagnosis of celiac disease was done through clinical, serological and histological findings. All data were collected from the medical charts of the patients. After the diagnosis of celiac disease, evaluation for low bone mineral density was requested by dual-energy X-ray absorptiometry (DEXA). DEXA bone densitometer was used to estimate low bone mineral density at the lumbar spine and femur.ResultsA total of 101 patients, 82 (81.2%) female and 19 (18.8%) male subjects, with mean age of 39.0±3.03 years were included. At celiac disease diagnosis, 36 (35.6%) were younger than 30 years, 41 (40.6%) were between 31 and 50 years, and 24 (23.8%) were older than 50 years. Among the evaluated patients, 69 (68.3%) presented low bone mineral density, being 47% with osteopenia and 32% with osteoporosis. Patients who were older than 51 years and diagnosed with celiac disease presented low bone mineral density in 83.3% (20/24) of the cases. As expected, age influenced significantly the low bone mineral density findings. Among women, low bone mineral density was present with high frequency (60%) from 30 to 50 years. In patients diagnosed older than 60 years (n=8), all the women (n=5) and two of the three men had osteoporosis.ConclusionThis study demonstrated that 69% of Brazilian patients with celiac disease at diagnosis had low bone mineral density, being more frequent in women older than 50 years.

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