Bone Abstracts

Introduction: The correlation between the occurrence of atypical femur fractures (AFFs) and prolonged bisphosphonate use has been reported in many studies. However, the incidence of AFFs is extremely low, which results in the lack of studies illuminating its treatment and clinical results so far. In this study, we aim to elucidate the clinical outcomes of bisphosphonate-associated AFFs and the clinical results depending on the bisphosphonate therapy period.<p class="abstex...

Introduction: Osteoporosis is the most common bone disease embrittling. Prevention and treatment strategies are well defined and are always updated. The therapeutic decision is based on the individual risk of fracture, effectiveness and therapeutic tolerance. However, side effects attributed to treatment may exist. Thus, the benefit and risks of prescription drugs is optimized by the choice of the right time and the right treatment.The objective of the s...

Scope: Extended Forsteo Observational Study (ExFOS), a multinational, non-interventional, prospective, observational study aims to evaluate fracture outcomes, back pain (BP), compliance and health-related Quality of Life (QoL) in osteoporotic patients prescribed teriparatide (TPTD). We present treatment outcomes for patients (male or female) treated for up to 24 months in Greece.Methods: Of the 440 patients enrolled in the study 416 (mean age 69.9±9...

Objective: Bone is one of endocrine organ and osteocytes secretes FGF23, Sclerostin and DKK1. FGF23 inhibits renal phosphate reabsorption and suppresses 1-α hydroxylase activity. Calcitriol stimulates FGF23 synthesis in bone. We aimed to determine the effect of single bolus injection of vitamin D on serum FGF23, DKK1 and Sclerostin concentrations in vitamin D-deficient subjects.Design and methods: The study group was composed of placebo group with s...

Objectives: There are some studies that evaluated changes of bone marrow density (BMD) and re-fracture after zoledronic acid injection. However, there is no study that showed about the fracture on all of the body, fracture healing, and improvement of clinical symptom after zoledronic acid injection. In this study, authors evaluated the 1 year BMD change, changes of lumbar pain in lumbar spine fractures, effects on fracture healing, re-fracture and additional fracture on other ...

Background: In the National Osteoporosis Guide 2014 all the patients are first recommended adequate calcium and vitamin D intake. For additional treatment US FDA approves the use of medications within seven different drug groups, but no magnesium. We have therefore studied the beneficial effect of Mg added to a Ca/vitamin D regime.Study: Fifty healthy women aged above 70 years recruited from elderly center were randomized into a Mg supplementation group ...

Introduction: Acute vertebral compression fractures cause severe back pain and need long time to heal. The progression of fracture or nonunion is not rare. The teriparatide is a synthetic parathyroid hormone which has been used as anabolic agent and treatment of osteoporosis. It can also be used for promoting fracture healing in special condition. Periodic infusion of teriparatide enhances bone formation and increases bone strength. We evaluated the effect of periodic teripara...

Introduction: Bisphosphonates are the most commonly prescribed type of medication for the treatment of osteoporosis. This treatment, however, is not without adverse effects. Several case reports and case series have indicated an association between a unique fracture type, so-called ‘atypical femoral fractures,’ (AFF) and prolonged bisphosphonate use.Case report: We present a 77-year-old woman with no history of trauma, or associated with low-en...

Currently available osteoporosis treatment include antiresorptives and/or anabolic agents. Studies in animals have shown that beta-hydroxy-beta-methylbutyrate (HMB) administration affects anabolically bone tissue metabolism and improves morphological, densitometric and mechanical properties of bones in axial and appendicular skeleton. Thus, the aim of the study was to present first data on effects of 61-week treatment with HMB on volumetric bone mineral density (vBMD) of lumba...

Inhibition of an increase of osteoclasts has become the most important treatment for osteoporosis. The CXCR4 antagonist, AMD3100, plays an important role in the mobilization of osteoclast precursors within bone marrow (BM). However, the actual therapeutic impact of AMD3100 in osteoporosis has not yet been ascertained. Here we demonstrate the therapeutic effect of AMD3100 in the treatment of ovariectomy-induced osteoporosis in mice. We found that treatment with AMD3100 resulted...

Purpose: Denosumab is commonly used as an anti-resorptive agent to treat osteoporosis. After discontinuation of denosumab, however, bone resorption increases again, and the bone mass gained during therapy is lost within a year.Methods: We present a case report of asymptomatic hypoparathyroid hypercalcemia in a patient who discontinued long-term treatment with denosumab.Results: A 67-year old women with osteoporosis was treated with...

Clinical trials suggest that denosumab (DEN) therapy results in greater increases in bone mineral density (BMD) in treatment-naive patients than in patients switched from bisphosphonates.We retrospectively reviewed charts of all patients treated with DEN at an osteoporosis referral centre in Vancouver, Canada including all patients treated with DEN 60 mg SC every 6 months for 1 year or more, and in whom baseline and follow-up BMDs were available. BMD was...

Background: In 2004, we reported a 48.1% prevalence of osteoporosis in an Ibansung cohort. The current prospective intervention study was undertaken in order to estimate the prevalence of osteoporosis from 2004 to 2015 and the increasing treatment rate of osteoporosis following osteoporosis screening tests with ultrasound bone densitometry and education in the same cohort.Methods: From November 1, 2014 to August 31, 2015, 960 adults ≥50 years of ag...

Pradaxa (dabigatran etexilate) is a new anticoagulant, which recently has been approved for clinical use. Dabigatran etexilate (DE) is a direct thrombin inhibitor, which in addition to its effect on blood clotting, may have an anabolic effect on bone. Recently, it has been reported that DE could significantly reduce bone resorption and enhance bone formation resulting in a significant and substantial increase in trabecular bone mass in mice.The aim of th...

Background: Resveratrol (RSV), a natural polyphenolic compound, stimulates osteoblasts and inhibits osteoclast activation in vitro. Conflicting results have emerged from short-term studies in rodents but a recent study in men suggests a positive effect on BMD.Aim: To evaluate effects of short- and long-term high-dose RSV supplementation on bone in immobilized and non-immobilized rats.Methods: A total of 72 female Wistar ra...

The aim of the study was to evaluate effects of 6-month-long administration with nanopartical calcium on morphological and densitometric properties of axial skeleton in pigs subjected to osteoporosis induction with dexamethasone. Male newborn piglets (N=28) were divided after birth into four equal groups (control group receiving placebo, Dex group receiving dexamethasone, NanoCa group receiving orally nanopartical calcium and NanoCa/Dex group) receiving simultaneously...

Safety data on zoledronic acid (ZA) administration for osteoporosis suggest potential kidney toxicity; indeed, it is not indicated in patients with impaired renal function. Patients’ clinical monitoring usually includes glomerular filtration rate (GFR) evaluation; no study addressed the issue of the early kidney injury. We evaluated the early (within 3 months) effect of iv ZA on renal function defining the potential role of AKI biomarkers in unveiling subtle damage.<p...

Objective: Good oral health is important for well being especially in the elderly. Osteonecrosis of Jaw is rare side effect of bisphosphonates and Denosumab. Patients need adequate dental precautions and appropriate advice from doctors and dentists to reduce the chance of this condition. Aim of the study was to assess the dental health of patients with osteoporotic fractures receiving bisphosphonate or denosumab treatments.Methods: Single person administ...

Objective: With increasing usage of bisphosphonates and increasing longevity, many elderly patients are on long term bisphosphonates and may require some dental procedure. We wanted to determine the dental risk status based on Scottish guidance for Dental practitioners 2011.Methods: An interviewer recorded information needed to classify risk status amongst a randomly selected database of bisphosphonate users.Setting: Teaching hospi...

Objective: From April 2012, pre- and post-operative cognitive assessment amongst hip fracture patients is one of the criteria for enhanced payment to hospitals in England in UK. Aim of the study was to assess the prevalence of dementia amongst hip fractures and assessments from specialist mental health services.Methods: Prospective study.Setting: Acute hip unit at a UK hospital in Wales(not England).Subjects:...

Objective: From April 2012, pre- and post-operative cognitive assessment amongst hip fracture patients is one of the criteria for enhanced payment to hospitals in England in UK. Aim of the study was to assess the association between dementia and hip fracturesMethods: Setting – Acute hip unit at a UK hospital in Wales (not England).Subjects – patients admitted following hip fracturesA single research...

Background: It is important to increase bone mineral density (BMD) by the treatment with bisphosphonates (BPs), as lower BMD has been revealed to be one of the risk factors for the subsequent fragility fracture in patients with osteoporosis treated with BPs.Methods: The two independent populations of the patients with postmenopausal osteoporosis who were treated for 2y by BPs with active vitamin D analogue (aVD) were enrolled in Study 1 (n=93) a...

Objective: Describe UK regional variation in prescription of anti-osteoporosis drug therapy before and after a primary hip fracture during 1999–2013.Materials and Methods: We used primary care data (Clinical Practice Research Datalink) to identify patients with a hip fracture and primary-care prescriptions of any anti-osteoporosis drugs (bisphosphonates, strontium, denosumab, oestrogen therapy, SERMS, teriparatide) prior to primary hip fracture and ...

Lactation in both humans and mice is associated with a substantial bone loss, in mice this bone loss is recovered within 4 weeks after weaning. This recovery is considered to be the most rapid physiological bone formation in adult life. The aim of the study was to investigate the effect of the post-lactational anabolic response on a disuse bone loss induced by Botulinum toxin (BTX).Forty-eight NMRI mice were divided into the following groups: pregnan...

Teriparatide is an anabolic agent given to reduce fracture risk in osteoporosis; it increases BMD and bone turnover. For monitoring treatment efficacy, serum PINP shows the greatest increase and low variability; it has been proposed as a marker of individual treatment response. We aimed to evaluate the utility of PINP to monitor teriparatide treatment in clinical practice.We performed a retrospective evaluation of 91 patients treated with teriparatide si...

Delayed healing of stress fractures constitutes a significant clinical problem causing prolonged pain and disability for the patients affected. All stress fractures exhibit Bone Marrow (edema) Lesions (BMLs) with and without fracture lines on MRI, and in cases of delayed union these lesions persist. Previous studies on transient osteoporosis and osteoarthritis have demonstrated that bisphosphonates can reduce BMLs. We therefore wanted to test, whether treatment with iv. zoledr...

Osteoporotic patients have poor bone quality and high risk of dental and orthopaedic implant failure. Lithium chloride (LICl) has been reported to enhance osteogenesis. However, the role of LiCl in bone formation and implant osseointegration in osteoporotic condition is still unknown. Therefore, we aimed to investigate the effect of LiCl on bone formation and implant osseointegration in osteoporotic rats.Three months old Sprague–Dawley female rats (...

Introduction: Osteoporosis affects the bones causing weak or brittle bones and increasing the risk of fracture. Efficacy of anti-osteoporotic treatment is based on drug potency and adherence and persistence. Teriparatide (TPTD) is the first anabolic agent developed for the treatment of osteoporosis. It is usually given as a daily subcutaneous injection for a two-year treatment course.Aim: To evaluate adherence and persistence to TPTD treatment in patient...

Clinical trials involving drug therapies for postmenopausal osteoporosis typically compare effects of the active drug combined with vitamin D (vit D) and calcium (Ca) vs vit D and Ca supplementation on its own. Bone strength is estimated based on the amount of bone, frequently expressed as bone mineral density determined by dual X-ray absorptiometry, and quality of bone, hardly measured in clinical practice.The purpose of the present study was to compare...

Objective: To define, by expert consensus, the criteria for the application of a Treat-to-Target (T2T) strategy in osteoporosis, in Spain, and to assess the adequacy of current treatments for it.Material and methods: Six Spanish experts in osteoporosis formed the Scientific Committee that led the project and designed the questionnaire used in two Delphi rounds. The 24 items included in the questionnaire assessed the experts’ wish (W) and prognosis (...

Background: Long-term use of bisphosphonates has raised concerns about the association with Atypical Femur Fractures (AFFs) that have been reported mainly in postmenopausal women.Clinical case: An 18-year-old patient with juvenile osteoporosis based on X-linked osteoporosis due to a PLS3 mutation developed a low trauma femoral fracture after seven years of intravenous and two years of oral bisphosphonate use, fulfilling the revised ASBMR diagnostic crite...

Background: On cessation of bisphosphonate treatment, while bone mineral density decreases slowly, bone resorptive markers such as C-terminal telopeptide (CTX) increase more quickly and may be useful in monitoring ‘offset’ of action. Our aim was to analyse changes in CTX on stopping long-term bisphosphonate treatment to guide clinical decision-making on the duration of treatment cessation (‘drug holidays’).Subjects and methods: A tota...

Patients with osteoporotic fractures are frequently treated in trauma surgery. While fracture fixation is at the center of patient care, treatment of the underlying bone disorder is often not considered, thereby increasing the risk for subsequent fractures. Closing this treatment gap is therefore among the greatest challenges in modern trauma surgery. To address this problem, we established a fully structured, multidisciplinary, sector-spanning fracture liaison service (FLS), ...

Purpose: To study the value of the central vertebral height restoration by kyphoplasty for treatment of biconcave vertebral compression fractures.Method: Review the patients with the single biconcave vertebral compression fracture receiving kyphoplasty treatment from 2006 to 2013 (49 cases, 13 males and 36 females) According to Genant classification, with the central vertebral compression ratio, they are divided into type II (<25%, 11 cases), type II...

Background: Surgical and conservative treatments are both crucial method to deal with osteoporotic fracture, anti-osteoporotic therapy is the most important among conservative treatments and diphosphonate medicine is the first-line choice. The pharmacological action of diphosphonate medicine is to inhibit the function of osteoclast, so there is no consensus if it will inhibit porosis and union of fracture.Purpose: To find out the influence of diphosphona...

Objectives: Treatment outcomes in patients treated with teriparatide were compared to standard care in patients with severe osteoporosis (bone mineral density T score of −4 or less).Methods: An observational study was performed of patients attending a specialist osteoporosis service and who were initiated on teriparatide (n=324). Patients that met criteria for teriparatide but declined treatment, were already established on a bisp...

Atypical femoral fractures (AFF) of the subtrochanteric region are rare. Bisphosphonates account to a large extent to their occurrence, however AFF also occur without exposure to bone medication. We here assessed the genetic factors associated with AFF among subtrochanteric fractures. Cases of subtrochanteric or femoral shaft fractures were identified through ICD-10 codes in three French academic centers from 2007 to 2010. Medical records were analyzed by two investigators tha...

Hydrogen sulfide (H2S) is a gaseous molecule produced endogenously in mammalian cells. H2S was recently found to play important roles in the regulation of inflammation, redox homeostasis and cell lifespan. Moreover, H2S was shown to maintain mesenchymal stem cell (MSC) function and stimulate osteogenic differentiation of MSC. However, it is unclear whether H2S plays any role in the bone loss induced by estrogen deficiency.<p clas...

Introduction: Percutaneous vertebroplasty is a well known surgical method to put the bone cement at osteoporotic vertebrae. There was a few report concerning about bone cement related complication such as dislodgment of injected cement. There are some contradictory study for long term reaction to bone cement in osteoporotic bone, especially injected cement features. This study is to assess the radiographic features of patients who underwent percutaneous vertebroplasty (PVP) in...

Adiponectin has recently been shown to influence skeletal metabolism. Over-expression of adiponectin gene suppresses bone resorption and increases trabecular bone mass. Bone marrow stromal cells from adiponectin-null mice had reduced mineralized nodule formation ability compared with wild type mice. Adiponectin, signalling via the adiponectin receptor 1 (AdipoR1) stimulates osteoblast differentiation and inhibits osteoclastogenesis. We have shown that the globular for...