Efficacy and safety of once-monthly ibandronate treatment in patients with low bone mineral density – ESTHER study: 24 months of follow-up

Introduction. Osteoporosis is a major health and economic problem worldwide. The use of new drugs, such as ibandronate, is aimed at improving treatment of osteoporosis and currently poor compliance with BP therapy. Objective. To investigate efficacy and safety of ibandronate applied monthly, orally, in women with low bone mineral density (BMD). Methods. The prospective study was conducted in 34 centers in Serbia and included 77 women treated for 24 months with monthly ibandronate. The efficacy of treatment was assessed by change in bone mass values obtained by BMD measurement at the end of 24 months follow-up versus baseline and 12-months follow-up values. Compliance and safety, i.e. adverse effects (AE) were recorded. Results. Participants were postmenopausal (96%), osteoporotic (79.7%) females, diagnosed by lumbar spine DXA measurement (81%), with history of prior BP therapy in 33.8% women. The physical activity level significantly increased to the substantial level of activity (5.2% vs. 21.3%, p=0.003) during the study. After 12 and 24 months of treatment, BMD values significantly increased (p=0.002 and p<0.001). BP experienced patients improved more than BP na?ve patients at both time points (p=0.012 and p=0.027, respectively). During the second 12 months of treatment the adherence was 96%; AE were recorded as mild gastrointestinal disturbances in 3.9%. Conclusion. Treatment by using ibandronate once monthly for 24 months was generally well tolerated and led to a significant increase in BMD in women with low BMD.

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Efficacy and safety of denosumab therapy for low bone mineral density in childhood cancer survivors: A report of preliminary experience

Yearbook of Paediatric Endocrinology ◽

10.1530/ey.17.9.15 ◽

2020 ◽

Author(s):

Huang TH ◽

Liu HC ◽

Hou JY ◽

Chang CY ◽

Sun FJ ◽

...

Keyword(s):

Bone Mineral Density ◽

Cancer Survivors ◽

Childhood Cancer ◽

Bone Mineral ◽

Childhood Cancer Survivors ◽

Efficacy And Safety ◽

Mineral Density ◽

Low Bone Mineral Density

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Physical Activity Level of Post-menopausal Women with Low Bone Mineral Density

Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics ◽

10.1055/s-0036-1583757 ◽

2016 ◽

Vol 38 (05) ◽

pp. 225-230 ◽

Cited By ~ 3

Author(s):

Glauber Dallanezi ◽

Beatriz Freire ◽

Eliana Nahás ◽

Jorge Nahás-Neto ◽

José Corrente ◽

...

Keyword(s):

Physical Activity ◽

Bone Mineral Density ◽

Bone Mineral ◽

Physical Activity Level ◽

Activity Level ◽

Mineral Density ◽

Low Bone Mineral Density ◽

Menopausal Women ◽

Post Menopausal

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TO DETERMINE THE PREVALENCE OF LOW BONE MINERAL DENSITY (OSTEOPENIA AND OSTEOPOROSIS) IN INDIAN PATIENTS WITH CIRRHOSIS OF LIVER AWAITING LIVER TRANSPLANTATION AS PER CURRENTLY USED HOLOGIC DXA DATABASE

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v5i4.1872 ◽

2021 ◽

Vol 5 (4) ◽

Author(s):

Sharad Deshmukh ◽

Suchita Deshmukh ◽

Sarojni A Parameswran ◽

P Pirmanayagam ◽

N Murgan ◽

...

Keyword(s):

Bone Mineral Density ◽

Liver Transplantation ◽

Lumbar Spine ◽

Bone Mineral ◽

Mineral Density ◽

Low Bone Mineral Density ◽

Indian Patients ◽

History Of ◽

The Mean ◽

Cirrhosis Of Liver

Background: Abnormalities in the bone metabolism observed in chronic liver disease are referred to as hepatic osteodystrophy. Osteoporosis and osteopenia are each part of this condition. Both conditions have a significant impact on morbidity, causing fractures that may result in chronic pain, long-lasting immobility, and deformity. Prevalence of fracture in patients with liver transplantation ranges from 15% - 65%. A high rate of fracturing is seen within the initial 1–2 years after transplantation. Aim: To determine the prevalence of low bone mineral density (osteopenia and osteoporosis) in Indian patients with cirrhosis of liver awaiting liver transplantation as per currently used Hologic DXA database Methods: This was a prospective observational study done at the department of gastroenterology and hepatology, Apollo Hospitals, Chennai from April 2011 to March 2013. All patients who fulfilled the inclusion criteria underwent detailed history taking, physical examination and relevant laboratory investigations. One hundred patients were selected for the scope of the study. Results: Sixty-eight per cent of patients were in the age group of 45 to 65 years. The mean age ± SD of the study subjects was 51.2 ± 9.7 years. The mean age for male patients was 50.5 ± 10.1 years, and for females was 54 ± 7.3 years. Cirrhosis was due to alcohol in 36% of the patients, viral hepatitis in 28% (HBV in 10% and HCV in 18%) patients. 42% were in Child’s class B, and the remaining 58% were in Child’s class C. MELD score was less than 20 in 62% patients. One third was diabetic; one third gave the history of backache. History of smoking was present in one fifth (20%) patients, and a history of fracture (most of them were traumatic) was present in 13% of patients. By using Hologic DXA database at the lumbar spine, osteopenia and osteoporosis were diagnosed in 44% and 38 % patients respectively. At the femoral neck, osteopenia and osteoporosis were diagnosed in 45% and 9% of patients. By using ICMR database at the lumbar spine, osteopenia and osteoporosis were diagnosed in 38% and 17% patients respectively. Similarly, at the femoral neck, osteopenia and osteoporosis were diagnosed in 34% and 5%. By using the Hologic DXA database, osteopenia and osteoporosis were diagnosed in 42% and 40 % patients. By using ICMR database, osteopenia and osteoporosis were diagnosed in 43% and 19% patients respectively. Conclusion: In light of the above results, the present study revealed a high prevalence of low bone mineral density (osteopenia and osteoporosis) in Indian patients with cirrhosis of liver awaiting liver transplantation. The lumbar spine was the most frequently and severely affected site in hepatic osteodystrophy. Keywords: Osteopenia, Osteoporosis, Low Bone Mineral Density, Liver Cirrhosis

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Low Regional Tibial Bone Density in Athletes with Medial Tibial Stress Syndrome Normalizes after Recovery from Symptoms

The American Journal of Sports Medicine ◽

10.1177/03635465030310042001 ◽

2003 ◽

Vol 31 (4) ◽

pp. 596-600 ◽

Cited By ~ 31

Author(s):

Håkan I. Magnusson ◽

Henrik G. Ahlborg ◽

Caroline Karlsson ◽

Fredrik Nyquist ◽

Magnus K. Karlsson

Keyword(s):

Bone Mineral Density ◽

Bone Mineral ◽

Medial Tibial Stress Syndrome ◽

Mineral Density ◽

Male Athletes ◽

Tibial Bone ◽

Control Subjects ◽

Low Bone Mineral Density ◽

Stress Syndrome

Background Although the exact cause of medial tibial stress syndrome is unclear, changes in bone metabolism are likely to be involved. Hypothesis Localized low bone mineral density at the junction of the middle and distal thirds of the tibia in patients with medial tibial stress syndrome develops in conjunction with the symptoms; these changes are reversible and are not inherited. Study Design Prospective cohort study. Methods Bone mineral density in 14 adult male athletes with long-standing medial tibial stress syndrome was measured when they were symptomatic and after recovery (mean follow-up, 5.7 years). Repeat measurements were also made prospectively in 13 nonathlete control subjects and single measurements were made in 18 healthy athletes. Results Bone mineral density was 9% ± 11% higher in the proximal tibia but 11% ± 12% lower in the tibial region corresponding to pain in patients when compared with nonathlete control subjects. It increased by 19% ± 11% in the region of pain after recovery from symptoms and, at follow-up, was no lower than in nonathlete control subjects. Conclusion Athletes with medial tibial stress syndrome and increased scintigraphic uptake regain normal tibial bone mineral density after recovery from symptoms. Initially localized low bone mineral density is not an inherited condition, but instead may develop in conjunction with the symptoms.

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Low Bone Mineral Density in Elite Female Athletes With a History of Secondary Amenorrhea in Their Teens

Clinical Journal of Sport Medicine ◽

10.1097/jsm.0000000000000571 ◽

2018 ◽

Vol Publish Ahead of Print ◽

Cited By ~ 4

Author(s):

Sayaka Nose-Ogura ◽

Osamu Yoshino ◽

Michiko Dohi ◽

Mika Kigawa ◽

Miyuki Harada ◽

...

Keyword(s):

Bone Mineral Density ◽

Bone Mineral ◽

Female Athletes ◽

Mineral Density ◽

Secondary Amenorrhea ◽

Low Bone Mineral Density ◽

History Of

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Low Bone Mineral Density and Risk for Osteoporotic Fractures in Patients with Chronic Pancreatitis

Nutrients ◽

10.3390/nu13072386 ◽

2021 ◽

Vol 13 (7) ◽

pp. 2386

Author(s):

Miroslav Vujasinovic ◽

Lorena Nezirevic Dobrijevic ◽

Ebba Asplund ◽

Wiktor Rutkowski ◽

Ana Dugic ◽

...

Keyword(s):

Risk Factors ◽

Bone Mineral Density ◽

Chronic Pancreatitis ◽

Bone Mineral ◽

Cox Regression ◽

Pancreatic Enzyme ◽

Fracture Rate ◽

Mineral Density ◽

Low Bone Mineral Density

Introduction: Chronic pancreatitis (CP) can lead to malnutrition, an established risk factor for low bone mineral density (BMD) and fractures. This study aims to determine the prevalence of low BMD, assess fracture incidence and explore risk factors for fractures in patients with CP. Patients and methods: We performed a retrospective analysis of all patients treated for CP at Karolinska University Hospital between January 1999 and December 2020. Electronic medical records were retrieved to assess demographic, laboratory and clinical data. Patients subjected to dual-energy X-ray absorptiometry (DXA) were categorised as either low BMD or normal BMD. We investigated whether the rate of fractures, defined by chart review, differed between these groups using Cox regression, adjusting the model for age, sex and body mass index (BMI). Additional within-group survival analysis was conducted to identify potential risk factors. Results: DXA was performed in 23% of patients with definite CP. Some 118 patients were included in the final analysis. Low BMD was present in 63 (53.4%) patients. Mean age at CP diagnosis in the total cohort was 53.1 years and was significantly lower in patients with normal BMD than in patients with low BMD (45.5 vs. 59.8, p < 0.001). Significant differences were observed in smoking status and disease aetiology, i.e., a higher proportion of patients with low BMD were current or former smokers, with nicotine or alcohol being a more common cause of CP (p < 0.05). Total follow-up time was 898 person-years. Fractures were found in 33 (28.0%) patients: in 5 of 55 patients (16.7%) with normal DXA and in 28 of 63 patients (44.4%) with low BMD (adjusted hazard ratio = 3.4, 95% confidence interval (CI) = 1.2–9.6). Patients with at least 3 months of consecutive pancreatic enzyme replacement therapy (PERT) or vitamin D treatment had a longer median time to fracture after CP diagnosis. Conclusion: DXA was only performed in 23% of patients with definite CP in this study, indicating a low adherence to current European guidelines. A low BMD was found in 53.4% of patients with CP, and 44% of the patients with a low BMD experienced a fracture during follow-up. Moreover, the fracture rate in patients with low BMD increased compared to those with normal BMD.

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Efficacy and Safety of Denosumab in Osteoporosis or Low Bone Mineral Density Postmenopausal Women

Frontiers in Pharmacology ◽

10.3389/fphar.2021.588095 ◽

2021 ◽

Vol 12 ◽

Author(s):

Yi Chen ◽

Jun Zhu ◽

Yiqin Zhou ◽

Jinhui Peng ◽

Bo Wang

Keyword(s):

Bone Mineral Density ◽

Adverse Events ◽

Postmenopausal Women ◽

Bone Mineral ◽

Human Monoclonal Antibody ◽

Safety Data ◽

Cochrane Library ◽

Efficacy And Safety ◽

Mineral Density ◽

Low Bone Mineral Density

Denosumab, a human monoclonal antibody, acts against the receptor activator of nuclear factor-κB ligand and is a promising antiresorptive agent in patients with osteoporosis. This study aimed to update the efficacy and safety of denosumab vs. placebo in osteoporosis or low bone mineral density (BMD) postmenopausal women. PubMed, Embase, Cochrane library, and ClinicalTrials.gov were searched for randomized controlled trials (RCTs) reporting the efficacy and safety data of denosumab vs. placebo in osteoporosis or low BMD postmenopausal women. A random-effects model was used to calculate pooled weight mean differences (WMDs) or relative risks (RRs) with corresponding 95% confidence intervals (CIs) for treatment effectiveness of denosumab vs. placebo. Eleven RCTs including 12,013 postmenopausal women with osteoporosis or low BMD were preferred for the final meta-analysis. The summary results indicated that the percentage change of BMD in the denosumab group was greater than that of BMD in placebo at 1/3 radius (WMD: 3.43; 95%CI: 3.24–3.62; p < 0.001), femoral neck (WMD: 3.05; 95%CI: 1.78–4.33; p < 0.001), lumbar spine (WMD: 6.25; 95%CI: 4.59–7.92; p < 0.001), total hip (WMD: 4.36; 95%CI: 4.07–4.66; p < 0.001), trochanter (WMD: 6.00; 95%CI: 5.95–6.05; p < 0.001), and total body (WMD: 3.20; 95%CI: 2.03–4.38; p < 0.001). Moreover, denosumab therapy significantly reduced the risk of clinical fractures (RR: 0.57; 95%CI: 0.51–0.63; p < 0.001), nonvertebral fracture (RR: 0.83; 95%CI: 0.70–0.97; p = 0.018), vertebral fracture (RR: 0.32; 95%CI: 0.25–0.40; p < 0.001), and hip fracture (RR: 0.61; 95%CI: 0.37–0.98; p = 0.042). Finally, denosumab did not cause excess risks of adverse events. These findings suggested that postmenopausal women receiving denosumab had increased BMDs and reduced fractures at various sites without inducing any adverse events.

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Asymptomatic vertebral fractures in patients with low bone mineral density

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.62.02.145 ◽

2016 ◽

Vol 62 (2) ◽

pp. 145-150 ◽

Cited By ~ 1

Author(s):

Caio Cesar Leite de Negreiros ◽

Marina Guareschi Berigo ◽

Robson Luiz Dominoni ◽

Deisi Maria Vargas

Keyword(s):

Bone Mineral Density ◽

Bone Mineral ◽

Vertebral Fractures ◽

Cross Sectional Study ◽

Vertebral Fracture Assessment ◽

Mineral Density ◽

Cross Sectional ◽

Test Technique ◽

Low Bone Mineral Density ◽

History Of

Summary Objective: Vertebral fracture assessment (VFA) is a test technique that can be used to detect asymptomatic vertebral fractures (AVF). It uses dual energy X-ray bsorptiometry (DXA) and can be performed concurrently with bone densitometry. This study aims to assess the prevalence of AVF in patients with low bone mass. Methods: Cross-sectional study including 135 individuals with low bone mineral density (BMD) with a T-score < -2.0 standard deviation (SD) in a densitometry clinic located in the city of Blumenau (state of Santa Catarina). Anthropometric, clinical and lifestyle variables were obtained from history-taking and physical examination. Densitometric variables were obtained by bone mineral densitometry and VFA (Explorer, Hollogic®). Vertebral fractures were classified according to the Genant criteria. Student's t, chi-square and logistic regression were performed for statistical analysis. Results: AVFs occurred in 24.4% of the subjects. They were older compared to those without AVF (65±9.25 versus 60.1±8.66; p=0.005), and had a history of lowimpact fractures (38.24% versus 19.8%; OR 2.5; p=0.03). Half of the patients that reported steroid therapy had AVFs, compared to one fifth of those who did not use steroids (50% versus 21.49%; OR 3.6; p=0.01). Conclusion: Asymptomatic vertebral fractures were present in approximately one fourth of patients. The risk factors associated were history of low-impact fracture, use of steroids and age > 61 years.

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