scholarly journals Bisphosphonates in Postmenopausal Women with Osteoporosis to Prevent Future Fractures

2019 ◽  
Vol 3 (2) ◽  
pp. 1-8
Author(s):  
Bashir I
Keyword(s):  
Bone Mineral Density ◽  
Postmenopausal Women ◽  
Bone Mineral ◽  
Fracture Prevention ◽  
Bisphosphonate Therapy ◽  
Placebo Control ◽  
Mineral Density ◽  
Increased Risk ◽  
Review Study ◽  
Clinical Experiments

Postmenopausal women who have osteoporosis are at increased risk of future fractures. Bisphosphonates are drugs that are used to treat osteoporosis by acting on the osteoclasts to inhibit bone resorption. Several studies have shown that bisphosphonate s can maintain or even increase bone mineral density in osteoporosis patients. This review study analyzed the literature on clinical experiments with bisphosphonate therapy in postmenopausal women to determine if these drugs are efficacious in preventing f uture fractures. Four out of five studies found that women treated with bisphosphonates were at decreased risk of future fractures, and six of six studies found that bisphosphonate therapy increases bone mineral density relative to placebo control. Althoug h further work is warranted to understand the level of bone mineral density increase that is associated with fracture prevention, this study implies that bisphosphonate therapy can be used to help prevent future fractures in postmenopausal osteoporotic wom en. The study is significant in that it helps to underscore the efficacy of bisphosphonate therapy in postmenopausal women, and it may be generalizable to other populations with osteopo s rosis who are at increased risk of fractures.

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.

scholarly journals Association Between moleculars and Osteoporotic Fracture Risk:A systematical review

2020 ◽  
Author(s):  
Jie-Yu Liu ◽  
Jia-Xiang Wang ◽  
Li Xu ◽  
Shu-Feng Lei ◽  
Fei-Yan Deng
Keyword(s):  
Bone Mineral Density ◽  
Postmenopausal Women ◽  
Bone Mineral ◽  
Elderly Population ◽  
Early Recognition ◽  
Osteoporotic Fractures ◽  
Middle Aged ◽  
Mineral Density ◽  
Low Bone Mineral Density ◽  
Increased Risk

AbstractOsteoporosis is a systemic chronic skeletal disease, which is characterized by low bone mineral density (BMD) and increased risk to osteoporotic fractures (OFs). OFs are associated with high mortality and morbidity, and seriously affect the life quality of patients. Osteoporosis is prevalent in the middle-aged and elderly population, especially the postmenopausal women. With population aging, osteoporosis becomes a world-wide serious public health problem. Early recognition of the high-risk population followed by timely and efficient intervention and/or treatment is important for preventing OFs. In light of the high heritability and complex pathogenesis of OP, comprehensive consideration of significant biological/biochemical factors is necessary for accurate risk evaluation. For this purpose, we reviewed recent research progress on moleculars which are diagnostic and/or predictive of OFs risk. Future integrative analyses and systematic evaluation of these moleculars may facilitate developing novel methodologies and/or test strategies, i.e., biochips, for early recognition of osteoporosis, hence to contribute to preventing OFs in the world.Graphical AbstractOsteoporosis, which is characterized by low bone mineral density (BMD) and increased risk to osteoporotic fractures (OFs), is prevalent in the middle-aged and elderly population, especially in the postmenopausal women. We focused on several types of important molecules, including proteins/peptides, RNAs, lipids, to gain comprehensive understanding and to generate novel perspectives in predicting and diagnosing OFs.

scholarly journals Comparison of Bone Mineral Density, T-Scores and Serum Zinc between Diabetic and Non Diabetic Postmenopausal Women with Osteoporosis

2015 ◽  
Vol 7 (01) ◽  
pp. 043-048 ◽  
Author(s):  
Priyanka R Siddapur ◽  
Anuradha B Patil ◽  
Varsha S Borde
Keyword(s):  
Bone Mineral Density ◽  
Fracture Risk ◽  
Postmenopausal Women ◽  
Bone Mineral ◽  
Mineral Density ◽  
T Score ◽  
Increased Risk ◽  
Serum Zn ◽  
Type 2 Diabetic

ABSTRACT Context: Postmenopausal osteoporosis is a public health problem. Diabetics are at increased risk of osteoporosis-related fractures. Zinc (Zn) has a role in collagen metabolism, and its levels are altered in diabetes. Aims: The aim was to compare bone mineral density (BMD), T-score and serum Zn between diabetic and nondiabetic postmenopausal women with osteoporosis to see if they influence increased fracture risk in diabetes. Settings and Design: It is a cross-sectional study conducted at Department of Biochemistry, Jawaharlal Nehru Medical College, Belgaum. Materials and Methods: Thirty type 2 diabetic and 30 age-matched (aged 45-75 years) nondiabetic Dual energy X-ray absorptiometry (DEXA) confirmed postmenopausal osteoporotics were included from January 2011 to March 2012. Serum Zn was analyzed by atomic absorption spectrophotometry. Statistical Analysis Used: Mean and standard deviation of the parameters of the two groups were computed and compared by unpaired Student's t-test. Relationship between variables was measured by Karl Pearson's correlation co-efficient. A statistical significance is set at 5% level of significance (P < 0.05). Results: T-score was significantly higher in diabetics compared with nondiabetics(−2.84 ± 0.42 vs. −3.22 ± 0.74) P < 0.05. BMD and serum Zn of diabetics showed a significant positive correlation with body mass index (BMI). Conclusions: Type 2 diabetic postmenopausal osteoporotics have a higher T-score than the nondiabetics. High BMI in type-2 diabetes mellitus (T2DM) may contribute to high BMD and may be a protective factor against zincuria. Increased fracture risk in T2DM could be due to other factors like poor bone quality due to hyperglycemia rather than BMD. Strict glycemic control is of paramount importance.

The influence of bone mineral density and bisphosphonate therapy on the determinants of oral health and changes on dental panoramic radiographs in postmenopausal women

2016 ◽  
Vol 21 (1) ◽  
pp. 151-157 ◽  
Author(s):  
Olja Grgić ◽  
Branka Kovačev-Zavišić ◽  
Tanja Veljović ◽  
Jovanka Novaković-Paro ◽  
Tatjana Maravić ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Oral Health ◽  
Postmenopausal Women ◽  
Bone Mineral ◽  
Bisphosphonate Therapy ◽  
Mineral Density ◽  
Panoramic Radiographs

scholarly journals Efficacy of Low Dose Denosumab in Maintaining Bone Mineral Density in Postmenopausal Women With Osteoporosis Switching From 60mg to 30mg 6 Monthly: A Real World, Prospective Observational Study

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A240-A241
Author(s):  
Aliya Khan ◽  
Hajar Abu Alrob ◽  
Hosay Said ◽  
Salman Iqbal ◽  
Ismail Hweija ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Observational Study ◽  
Postmenopausal Women ◽  
Bone Mineral ◽  
Low Dose ◽  
Human Monoclonal Antibody ◽  
P Value ◽  
Mineral Density ◽  
Risk Of Fracture ◽  
Increased Risk

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 fracture in postmenopausal women with osteoporosis. Cessation of denosumab is associated with rises in bone remodelling, reductions in BMD and an increased risk of fracture. The primary objective of this study is to evaluate the efficacy of low dose denosumab (30mg/6 months) in preventing bone loss in postmenopausal women with osteoporosis switching from 60mg to 30mg every 6 months. We report the effects of low dose denosumab for upto 2years in patients previously treated with denosumab for &gt;=3 years as well as &lt; 3years. Methods: Following informed consent, postmenopausal women with osteoporosis who had been on denosumab 60mg every 6 months were switched to receive 30mg of denosumab every 6 months.. 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 and 24 months. Secondary outcomes were adverse effects and fracture Results: 127 patients were included in the study. 44 patients had received 60 mg for 3 years or longer before transitioning to 30mg and 83 patients switched before completing 3 years on full dose therapy. Patients on less than 3yrs of 60mg therapy before the switch showed a significant improvement in BMD at LS (+2.00%, 95% CI 0.49% to 3.51%, n = 55, p-value = 0.01) 1 year post transition. There were no significant changes at the FN, TH or 1/3 radial sites 1 year post transition compared to baseline. At 2 years post transition (n=35) significant changes were noticed at LS (+4.65%, 95% CI 2.29% to 7.01%, p value &lt;0.001), FN (+ 4.87%, 95% CI 1.46% to 8.28%, p value = 0.006) and 1/3 radial sites (+4.95%, 95% CI 0.73% to 9.17%, p value = 0.02). No significant changes were noted at TH. Similar results were seen with prior denosumab therapy for &lt;3years No fractures were observed in this observational study. Conclusions: Switching from 60mg of denosumab to 30 mg every 6 months was not associated with reductions in BMD and may be a valuable treatment option in patients who have completed long term denosumab therapy.

scholarly journals Should denosumab treatment for osteoporosis be continued indefinitely?

2021 ◽  
Vol 12 ◽  
pp. 204201882110100
Author(s):  
Jane A. Noble ◽  
Malachi J. McKenna ◽  
Rachel K. Crowley
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Fracture Prevention ◽  
Mineral Density ◽  
Major Osteoporotic Fracture ◽  
Osteoporosis Therapy ◽  
Increased Risk ◽  
Turnover Markers ◽  
Denosumab Treatment ◽  
Multiple Vertebral Fractures

Denosumab was approved for the treatment of postmenopausal osteoporosis in 2010, based on the FREEDOM study, which indicated a benefit in terms of increased bone mineral density and reduced risk of major osteoporotic fracture. In the initial clinical studies it was noted that discontinuation of denosumab can lead to a rebound of bone turnover markers and loss of accrued bone mineral density. An increased risk of fractures (multiple vertebral fractures in particular) associated with discontinuation was noted after approval and marketing of denosumab. For many patients experiencing gain in bone mineral density and fracture prevention while taking denosumab, there is no reason to stop therapy. However, discontinuation of denosumab may happen due to non-adherence; potential lack of efficacy in an individual; where reimbursement for therapy is limited to those with bone mineral density in the osteoporosis range, when assessment reveals this has been exceeded; or patient or physician concern regarding side effects. This review paper aims to discuss these concerns and to summarize the data available to date regarding sequential osteoporosis therapy following denosumab cessation to reduce the risk of multiple vertebral fracture.

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