scholarly journals Denosumab for the Treatment of Postmenopausal Women at Increased Risk of Osteoporotic Fractures

2011 ◽  
Vol 3 ◽  
pp. CMT.S6173
Author(s):  
Cesar E. Bogado
Keyword(s):  
Bone Mineral Density ◽  
Monoclonal Antibody ◽  
High Risk ◽  
Postmenopausal Osteoporosis ◽  
Human Monoclonal Antibody ◽  
Significant Risk ◽  
Osteoporotic Fractures ◽  
Mineral Density ◽  
Increased Risk ◽  
Formation Function

Denosumab is the first fully human monoclonal antibody that inhibits the formation, function and survival of osteoclasts by blocking the interaction of RANKL with its osteoclastic receptor RANK. Clinical studies have shown that the decreased bone resorption and increased bone mineral density resulting from the use of denosumab 60 mg twice yearly entail significant risk reduction of vertebral, hip and non-vertebral fractures in women with postmenopausal osteoporosis, with an acceptable rate of side effects so far. Denosumab offers a new choice for the treatment of postmenopausal osteoporosis in patients at high risk for fractures.

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 SUN-377 Efficacy of Low Dose Denosumab in Maintaining Bone Mineral Density in Postmenopausal Women with Osteoporosis: A Real World, Prospective Observational Study

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Aliya Aziz Khan ◽  
Hajar Abu Alrob ◽  
Iman M’Hiri ◽  
Hosay Said ◽  
Sharjil Hussain ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Monoclonal Antibody ◽  
Single Dose ◽  
Lumbar Spine ◽  
Postmenopausal Women ◽  
Low Dose ◽  
Human Monoclonal Antibody ◽  
Mineral Density ◽  
Percent Change ◽  
The Mean

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.

Osteoporosis in multiple sclerosis

2010 ◽  
Vol 16 (9) ◽  
pp. 1031-1043 ◽  
Author(s):  
Andrew P Hearn ◽  
Eli Silber
Keyword(s):  
Risk Factors ◽  
Multiple Sclerosis ◽  
Bone Mineral Density ◽  
Bone Mineral ◽  
Significant Risk ◽  
Mineral Density ◽  
Increased Risk ◽  
Review Management ◽  
Multiple Sclerosis Patients ◽  
Reduced Mobility

Fractures resulting from osteoporosis are a major cause of morbidity and mortality in the developed world. People with multiple sclerosis experience reduced mobility and are susceptible to falls. Glucocorticoid use and reduced mobility are known risk factors for osteoporosis. This paper is a review of osteoporosis in people with multiple sclerosis, looking at its prevalence, risk factors and possible mechanisms. We also review management guidelines for osteoporosis in the general population and use these to propose guidelines for osteoporosis management amongst multiple sclerosis patients. A number of studies have examined the incidence of reduced bone mineral density amongst people with multiple sclerosis; the majority provide convincing evidence that bone mineral density is significantly reduced in multiple sclerosis patients. The most significant risk factors appear to arise from the chronic disease process of multiple sclerosis and not from glucocorticoid use. There are currently no guidelines or consensus as how best to treat osteoporosis amongst multiple sclerosis patients despite their being at an increased risk. We propose an algorithm for the screening and treatment of osteoporosis in people with multiple sclerosis.

scholarly journals Bone mineral density status in urolithiasis patients with vitamin D inadequacy followed at a tertiary stone centre

2014 ◽  
Vol 8 (9-10) ◽  
pp. 323 ◽  
Author(s):  
Mohamed Aly Elkoushy ◽  
Mazen Jundi ◽  
Terence T.N. Lee ◽  
Sero Andonian
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
High Risk ◽  
Osteoporotic Fractures ◽  
Mineral Density ◽  
Stone Formers ◽  
Major Osteoporotic Fractures ◽  
Recurrent Stone ◽  
Dxa Scans ◽  
Recurrent Stone Formers

Introduction: We assessed abnormalities in bone mineral density (BMD) and the risk of hip and major osteoporotic fractures in urolithiasis patients with vitamin D inadequacy (VDI) followed at a tertiary stone centre.Methods: Stone-free patients with VDI were invited to undergo dual-energy x-ray absorptiometry (DXA) scans to assess for BMD abnormalities at the femoral neck and lumbar spine. The World Health Organization’s validated Fracture Risk Assessment Tool (FRAX) was used to calculate the risk of hip and major osteoporotic fractures within 10 years. Patients with primary hyperparathyroidism or hypercalcemia were excluded.Results: In total, 50 consecutive patients were included between June 2011 and August 2012, including 26 (52%) males. The median age was 51 years and the median 25-hydroxyl vitamin D (25[OH]D) was 18.8 ng/mL. Thirty patients (60%) had abnormal T-scores on DXA studies. This decreased to 22 (44%) when age-matched Z-scores were used; 36% had osteopenia and 8% had osteoporosis. Femoral neck and lumbar spines were affected in 24% and 32% of patients, respectively. Recurrent stone-formers had significantly lower BMD when compared with first-time stone-formers. Median serum 25(OH)D was comparable between patients with normal and abnormal DXA scans (18.6 vs. 18.8 ng/mL; p = 0.91). Five patients (10%) were at high risk (≥3%) of hip fractures within 10 years.Conclusion: A high prevalence of abnormal DXA scans was found in urolithiasis patients with VDI, including 5 patients (10%) at high risk of hip fractures. Future studies need to assess the economic impact of obtaining DXA scans on urolithiasis patients with VDI, especially in recurrent stone-formers.

Bones of Contention: A Comprehensive Literature Review of Non-SSRI Antidepressant Use and Bone Health

2019 ◽  
Vol 33 (6) ◽  
pp. 340-352 ◽  
Author(s):  
Clodagh Power ◽  
Richard Duffy ◽  
James Mahon ◽  
Kevin McCarroll ◽  
Brian A. Lawlor
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Bone Health ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Age Groups ◽  
Osteoporotic Fractures ◽  
Risk Groups ◽  
Mineral Density ◽  
Increased Risk ◽  
Antidepressant Use

Osteoporotic fractures are associated with major morbidity and mortality, particularly among older age groups. In recent decades, selective serotonin reuptake inhibitors (SSRI) antidepressants have been linked to reduced bone mineral density and increased risk of fragility fracture. However, up to one-third of antidepressant prescriptions are for classes other than SSRIs. Older patients, who are particularly vulnerable to osteoporosis and its clinical and psychosocial consequences, may be prescribed non-SSRI antidepressants preferentially because of increasing awareness of the risks SSRIs pose to bone health. However, to date, the skeletal effects of non-SSRI antidepressants have not been comprehensively reviewed. In this article, we collate and review the available data and discuss the findings. Based on the current literature, we tentatively suggest that tricyclic antidepressants may increase the risk of fracture via mechanisms other than a direct effect on bone mineral density. The risk is apparently confined to current users only and is greatest in the earliest stage of treatment, diminishing thereafter. There is, as yet, insufficient data to conclusively determine the effects of other antidepressant classes on bone. Judicious prescribing of antidepressants among higher risk groups necessitates a thorough review of the individual’s risk factors for osteoporosis as well as attention to their falls risk. Further longitudinal, rigorously controlled studies are needed to answer some of the remaining questions on the effects of non-SSRI antidepressants on bone and the mechanisms by which they are exerted.

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 >=3 years as well as < 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 <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 <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 THE VALUE OF OSTEOPONTIN AS A DIAGNOSTIC BIOMARKER IN POSTMENOPAUSAL OSTEOPOROSIS; A REVIEW.

2020 ◽  
Vol 12 ◽  
pp. 27
Author(s):  
Amira A. Atta ◽  
Keyword(s):  
Bone Mineral Density ◽  
Early Detection ◽  
Postmenopausal Osteoporosis ◽  
Bone Mineral ◽  
Osteoporotic Fractures ◽  
Dual Energy ◽  
Diagnostic Biomarker ◽  
Mineral Density ◽  
Diagnosis Of Osteoporosis ◽  
X Ray

Although increased awareness of morbidity and costs related to osteoporotic fractures, real progress achieved only through early detection of osteoporosis before any fractures occur. Dual Energy X-ray Absorptiometry (DEXA) is commonly used for diagnosis of osteoporosis by measuring bone mineral density (BMD

Pilot Algorithm studying of regional features of the risk factors for osteoporosis and fractures in the Khanty-Mansiysk autonomous okrug-Yugra, TYumen region

10.12737/4787 ◽  
2014 ◽  
Vol 8 (1) ◽  
pp. 1-8
Author(s):  
Михайлин ◽  
A. Mikhaylin
Keyword(s):  
Risk Factors ◽  
Bone Mineral Density ◽  
Bone Mineral ◽  
Significant Risk ◽  
Osteoporotic Fractures ◽  
Mineral Density ◽  
Risk Of Fracture ◽  
X Ray ◽  
Identification Of Persons ◽  
Low Sensitivity

Modern methods of determination of bone mineral density by means of dual energy x-ray absorptiometry with sufficient specificity and a low sensitivity don’t always available. In this regard, to identify the patients for appointment of therapy, the search strategy consisting in the identification of persons with a high risk of fracture was carried out. As priority direction in the diagnosis is not the fact of having osteoporosis, but the assessment of the risk of fracture. Geographical feature of the Khanty-Mansiysk Autonomous Okrug – Yugra, the lack of equipment x-ray osteodensitometry in medical institutions and their absence in clinics indicate low diagnostic availability in the assessment of the bone mineral density of the population – this determines the importance of research in the region the significant risk factors of osteoporosis and important risk factors for osteoporotic fractures.

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