scholarly journals Bisphosphonates prevents the bone mineral loss in lymphoma patients treated with glucocorticoids: a prospective, randomized controlled phase 3 trial in China

Author(s):  
Chunli Yang ◽  
Chunxi Fu ◽  
Huawei Weng ◽  
Liqun Zou

Abstract Background Glucocorticoids-containing regimens are the standard first line treatment for most lymphoma patients, however, as the improvement of overall survival in these cases, glucocorticoids related osteopenia or osteoporosis attracted attention in clinical administration. We aim to investigate the efficacy of bisphosphonates in prevention bone mineral loss in glucocorticoids-treated lymphoma patients. Methods This is a prospective, randomized controlled phase 3 trial. Eligible lymphoma adults from China with first line glucocorticoids involved treatment, were randomly assigned 1:1 to receive either Zoledronic acid (ZA) for twice infusion or not. All patients received daily oral calcium and vitamin D3 for one year. The primary endpoint, alternations of bone mineral loss from enrollment to the twelfth month at the lumbar spine (L1-L4), left hip and left femoral neck, measured by the dual-energy, x-ray absorptiometry scanners, recorded as T score; and new bone fractures during the first year, were analyzed by intent-to-treat. This trial was registered with www.Chictr.org, number ChiCTR-INR-17010771. Results Between May, 2016 to July, 2019, 84 patients were randomly assigned to both Zoledronic acid and control groups, 29 patients completed the study and were on follow-up. We found a marked improvement of T score in ZA group compared with the control in a year at lumbar spine, T score changes of L1-4 in ZA group and control group were as following: L1, 0.14±0.61 vs. -0.33±0.40, p=0.009; L2, 0.28±0.41 vs. -0.35±0.54, p=0.003; L3, 0.23±0.42 vs. -0.23±0.66, p=0.020; L4, 0.28±0.44 vs. -0.35±0.54, p=0.020. Meanwhile, no severe adverse event was observed on both groups. Conclusions Glucocorticoids-treatment lymphoma patients that prophylactic ZA infusion could relieve BMD loss to prevent osteoporosis without increasing severe adverse effects in Chinese population, providing reference for clinicians to consider ZA application in this situation.

2018 ◽  
Vol 7 (7) ◽  
pp. 468-475 ◽  
Author(s):  
Q-F. He ◽  
H. Sun ◽  
L-Y. Shu ◽  
Y. Zhu ◽  
X-T. Xie ◽  
...  

Objectives Researchers continue to seek easier ways to evaluate the quality of bone and screen for osteoporosis and osteopenia. Until recently, radiographic images of various parts of the body, except the distal femur, have been reappraised in the light of dual-energy X-ray absorptiometry (DXA) findings. The incidence of osteoporotic fractures around the knee joint in the elderly continues to increase. The aim of this study was to propose two new radiographic parameters of the distal femur for the assessment of bone quality. Methods Anteroposterior radiographs of the knee and bone mineral density (BMD) and T-scores from DXA scans of 361 healthy patients were prospectively analyzed. The mean cortical bone thickness (CBTavg) and the distal femoral cortex index (DFCI) were the two parameters that were proposed and measured. Intra- and interobserver reliabilities were assessed. Correlations between the BMD and T-score and these parameters were investigated and their value in the diagnosis of osteoporosis and osteopenia was evaluated. Results The DFCI, as a ratio, had higher reliability than the CBTavg. Both showed significant correlation with BMD and T-score. When compared with DFCI, CBTavg showed better correlation and was better for predicting osteoporosis and osteopenia. Conclusion The CBTavg and DFCI are simple and reliable screening tools for the prediction of osteoporosis and osteopenia. The CBTavg is more accurate but the DFCI is easier to use in clinical practice. Cite this article: Q-F. He, H. Sun, L-Y. Shu, Y. Zhu, X-T. Xie, Y. Zhan, C-F. Luo. Radiographic predictors for bone mineral loss: Cortical thickness and index of the distal femur. Bone Joint Res 2018;7:468–475. DOI: 10.1302/2046-3758.77.BJR-2017-0332.R1.


PM&R ◽  
2014 ◽  
Vol 6 (8) ◽  
pp. S155
Author(s):  
Belgin Erhan ◽  
Ebru Yilmaz Yalcinkaya ◽  
Berrin Gunduz ◽  
Hulya Aslan ◽  
Fatih Kahraman

Author(s):  
Saba Shamim ◽  
Manju Lal ◽  
Rana Shamim

Background: Osteoporosis is considered as a major public health issue with fragility fractures of the hip, vertebrae and distal radius being the most important consequences. It has been said to be an age-related degenerative process. However, postmenopausal women develop this disease due to age-related bone mineral loss as well as due to declining levels of estrogen in the body following menopause leading to increased risk of fractures. Objectives of this study were to find out the prevalence of osteoporosis in hysterectomised and non-hysterectomised postmenopausal women in 7th decade of life.Methods: Descriptive cross-sectional study done on a total of 66 postmenopausal women who were in their 7th decade of life. They were divided into two groups, one consisting of 36 women who underwent natural menopause and the other group of 30 women who had surgical menopause. The bone mineral density of both the groups was measured using DEXA scan and comparison was done between these study groups.Results: Out of 30 hysterectomised subjects, 24 (80%) were found to be having osteoporosis, 6 (20%) had osteopenia and none had normal BMD. While out of 36 subjects in the non-hysterectomised group, 14 (38.88%) had osteoporosis, 16 (44.44%) had osteopenia and 6 (16.66%) subjects had normal BMD. Significant relation (p-value 0.001) was found on comparison of the study groups. In addition, significant positive correlation was between BMD and BMI whereas negative correlation was seen between BMD and parity.Conclusions: Hysterectomy was found to increase the incidence of osteoporosis. Obesity was found to have protective effect against bone mineral loss while increasing parity had a negative relation with BMD.


2020 ◽  
Vol 13 (2) ◽  
pp. 153-161
Author(s):  
Lejla Milisic ◽  
Sandra Vegar-Zubovic ◽  
Amina Valjevac ◽  
Suada Hasanovic-Vučković

Objectives: Although Dual-energy X-ray Absorptiometry (DXA) is gold standard for osteoporosis diagnosis, several reports have shown discordant T-score values measured by Quantitative Computed Tomography (QCT) and DXA especially in obese subjects, but it is still not clear whether BMD measurement by two modalities is affected by overall obesity or central obesity in postmenopausal females. Therefore, the aims of this study were to compare BMD and T-scores by DXA and QCT and to evaluate whether these two osteoporosis assessment modalities yield different T-score values in postmenopausal females with obesity and central obesity. Methods: This cross-sectional study enrolled 44 postmenopausal females, referred for osteoporosis screening. Anthropometric indices (BMI-body mass index, WC-waist circumference and ICOindex of central obesity) were measured and females underwent an assessment of bone mineral density by DXA and QCT. Results: Lumbar Spine (LS) T-score values were observed to be significantly lower by DXA compared to qCT in females with BMI >25 kg/m2, (-1.9±1.5 vs. -2.3±1.2; p=0.039), in females with WC>88 cm(-1.9±1.5 vs. -2.4±1.2; p=0.008) and in females with ICO>0.5(-1.96±1.4 vs. -2.5±1.2; p=0.004). However, in normal-weight females and in those without central obesity, LS T-scores by DXA were not different than qCT. DXA at lumbar spine and proximal femur revealed osteoporosis in 47.7% and 11.4% respectively, while QCT detected osteoporosis in 61.4% of females (p<0.001). Measures of central obesity; ICO and WC were not associated with QCT bone mineral density (BMD) (r=0.14 and r=0.21, respectively), but were positively associated with both DXALS BMD (r=0.29 and r=0.31; p<0.05) and DXA proximal femur BMD (r=0.41 and r=0.44; p<0.01). Conclusion: Our results suggest that obesity is associated with lower T-scores by DXA compared to QCT. Caution is needed when assessing osteoporosis status in obese postmenopausal females. However, further studies with larger sample size are needed to confirm the findings.


Medicine ◽  
2018 ◽  
Vol 97 (41) ◽  
pp. e12755 ◽  
Author(s):  
Hyun Goo Kang ◽  
Hyun Young Park ◽  
Han Uk Ryu ◽  
Seung-Han Suk

1992 ◽  
Vol 39 (2) ◽  
pp. 155-155
Author(s):  
C Di Carlo ◽  
Z Shoham ◽  
J MacDougall ◽  
A Patel ◽  
ML Hall ◽  
...  

1992 ◽  
Vol 19 ◽  
pp. S49-S56 ◽  
Author(s):  
G.B. Melis ◽  
A.M. Paoletti ◽  
R. Bartolini ◽  
M. Tosti Balducci ◽  
G.B. Massi ◽  
...  

2016 ◽  
Vol 65 (1) ◽  
pp. 53-56 ◽  
Author(s):  
Ben-Chung Cheng ◽  
Ying-Chou Chen

This study investigated whether bone mineral density (BMD) affects readmission risk in patients with chronic kidney diseases (CKD) who received denosumab therapy. The study design was a retrospective case review of patients with CKD. Baseline age, sex, and body mass index were recorded for all patients included in the study. All comorbidities were recorded. All subjects underwent dual energy X-ray absorptiometry assay of the lumbar spine and right hip for BMD. The primary outcome was readmission. Predictive variables were categorized and compared between readmitted and non-readmitted patients. Logistic regression was used for multivariable analysis. A total of 121 patients with CKD who received denosumab therapy were enrolled. Of these, 29 were readmitted within 2 years, and 92 had no readmission. The lumbar BMD differed between the readmission (−2.94±0.68) and non-readmission (−2.09±1.48) groups. The readmission group had a lower T score than the non-readmission group. When adjusted for potential confounding factors, a decreased lumbar BMD had a higher readmission risk. When the cut-off points determined by receiver operating characteristic curve analysis were applied, the most precise point was set at a T score of −3. Osteoporosis in patients with CKD is associated with a high risk of readmission; the best predictor after denosumab therapy was the lumbar spine T score. A lower T score (especially if <−3) was associated with a higher probability of fracture readmission. It is essential to optimize primary and secondary prevention in these patients to improve their quality of life.


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