scholarly journals Use of teriparatide in treatment of severe osteoporosis in geriatric practice: a clinical case review

2020 ◽  
Vol 16 (4) ◽  
pp. 80-89
Author(s):  
Ekaterina N. Dudinskaya ◽  
Olga N. Tkacheva ◽  
Liubov V. Machekhina ◽  
Valentina S. Ostapenko ◽  
Natalya V. Brailova
Keyword(s):  
Clinical Case ◽  
Osteoporotic Fractures ◽  
Case Review ◽  
Mineral Density ◽  
Severe Osteoporosis ◽  
Treatment Of Osteoporosis ◽  
Drug Of Choice ◽  
Age Related ◽  
Risk Of Falls ◽  
Anabolic Therapy

Elderly and senile people are characterized by a high prevalence of osteoporosis, which, in turn, increases the risk of fractures, including the repeated ones. Fractures in osteoporosis are an extremely unfavorable complication of the disease, leading to catastrophic consequences in old age. The prevalence of osteoporotic fractures progressively increases with age. At present, the cumulative frequency of hip fractures in women over 80 is about 30%. The proportion of vertebral fractures in women older than 80 years is up to 40% of all vertebral osteoporotic fractures. Despite the tremendous successes achieved in the diagnosis and treatment of osteoporosis, the disease itself and related fractures remain a serious medical, economic and social problem. Prevention of recurrent fractures in geriatric patients is a system of preventive, rehabilitative and therapeutic measures aimed at reducing the risk of falls, choosing an effective therapy, and reducing the risk of recurring fractures. A serious problem in the treatment of osteoporosis in older people is the inefficiency of the antiresorptive therapy due to an age-related decrease in bone formation. There are frequent cases of a continuing decrease in bone density, the occurrence of repeated fractures during ongoing therapy of osteoporosis. Often the therapy of choice in this case is bone-anabolic therapy with teriparatide, which allows one to achieve good results in the accumulation of bone mineral density. In this article, we will present the clinical case of an elderly patient with severe osteoporosis, in which teriparatide became the drug of choice.

scholarly journals Zoledronic Acid Once-yearly: What Role in the Prevention of Non-vertebral Osteoporotic Fractures?

2010 ◽  
Vol 2 ◽  
pp. CMT.S4947
Author(s):  
Sheila Anne Doggrell
Keyword(s):  
Zoledronic Acid ◽  
Osteoporotic Fractures ◽  
Primary Osteoporosis ◽  
Mineral Density ◽  
Glucocorticoid Treatment ◽  
Oestrogen Treatment ◽  
Treatment Of Osteoporosis ◽  
Hormone Sensitive ◽  
Low Levels ◽  
Single Intravenous Administration

Osteoporosis is the most common bone disease. Low levels of oestrogens or testosterone are risk factors for primary osteoporosis. The most common cause of secondary osteoporosis is glucocorticoid treatment, but there are many other secondary causes of osteoporosis. Osteoporosis can be secondary to anti-oestrogen treatment for hormone-sensitive breast cancer and to androgen-deprivation therapy for prostate cancer. Zoledronic acid is the most potent bisphosphonate at inhibiting bone resorption. In osteoporosis, zoledronic acid increases bone mineral density for at least a year after a single intravenous administration. The efficacy and safety of extended release (once-yearly) zoledronic acid in the treatment of osteoporosis is reviewed.

Romosozumab: A first-in-class sclerostin inhibitor for osteoporosis

2020 ◽  
Vol 77 (23) ◽  
pp. 1949-1956
Author(s):  
Caitlin Prather ◽  
Erin Adams ◽  
Whitney Zentgraf
Keyword(s):  
Clinical Trials ◽  
High Risk ◽  
Bone Resorption ◽  
Bone Formation ◽  
English Language ◽  
Safety Concern ◽  
Osteoporotic Fractures ◽  
Mineral Density ◽  
Treatment Of Osteoporosis ◽  
Poster Presentations

Abstract Purpose The purpose of this article is to review the pharmacology, efficacy, and safety of the sclerostin inhibitor romosozumab for the treatment of osteoporosis, including data from clinical trials of the drug. Summary A review of the literature was performed by searching PubMed and MEDLINE for all relevant articles published between January 2014 and February 2020 using the keywords romosozumab, romosozumab-aqqg, osteoporosis, and fracture. All relevant English-language articles evaluating the pharmacology, efficacy, or safety of romosozumab for the treatment of osteoporosis in humans were included; poster presentations were excluded. Romosozumab has been approved by the Food and Drug Administration and is considered both safe and effective for the treatment of osteoporosis in high-risk postmenopausal females. Phase 2 and phase 3 clinical trials have shown a statistically significant decrease in new vertebral fractures and an increase in bone mineral density with romosozumab use, as compared with both placebo use and use of alternative osteoporosis therapies. The primary safety concern is a potential risk of cardiovascular events; additionally, hypocalcemia must be corrected prior to initiation. Romosozumab is the first anabolic medication that both increases bone formation and decreases bone resorption. Data suggest that romosozumab is more effective than oral bisphosphonates in preventing osteoporotic fractures, though cost and safety concerns must be considered. Conclusion Romosozumab is a novel, 12-month treatment option for postmenopausal women at high risk for osteoporotic fracture that both increases bone formation and decreases bone resorption.

scholarly journals HYPOVITAMINOSIS D AND MENOPAUSE: STILL AN ISSUE IN 2016?

2016 ◽  
Vol 63 (3) ◽  
pp. 209-210
Author(s):  
Adina Ghemigian ◽  
◽  
Otilia Radu ◽  
Ana Valea ◽  
Nicoleta Dumitru ◽  
...  
Keyword(s):  
Vitamin D ◽  
Bone Loss ◽  
Meta Analysis ◽  
Osteoporotic Fractures ◽  
Hypovitaminosis D ◽  
Mineral Density ◽  
Level Of Evidence ◽  
Knowing That ◽  
Risk Increase ◽  
Risk Of Falls

Vitamin D in menopause is essential for skeleton and metabolic involvement. Our purpose is to introduce the level of evidence regarding menopause – related hypovitaminosis D through a brief review of papers published on PubMed in 2016. The correlation between low vitamin D and risk of falls is a traditional observation. Lack of vitamin D remains one of the major contributors to osteoporotic fractures which have an annual incidence of 8.9 million worldwide. Yale FIT trial referring to menopausal cancer survivors after 12 months of aerobic physical exercise confirmed the bone loss under aromatase inhibitors opposite to tamoxifen is significant, a bone loss that is lower if vitamin D ranges are low. Arzoxifene Generations Trial followed for 5 years menopausal women treated only with vitamin D and calcium and found a fracture risk increase by 46% for each unit of lumbar T-score that decreases. A meta-analysis of 34 studies on 11,090 patients treated with ibandronate showed that hypovitaminosis D at baseline is a predictor of bone mineral density improvement only at lumbar spine. Another study revealed that 77% of menopausal females have 25-hydoxyvitamin D (25-OH D) less than 30 ng/mL while a negative correlation between 25-OH D and waist circumference was found knowing that android fat disposition in women with hipovitaminosis D is a hallmark of metabolic syndrome. Overall, in 2016, PubMed published papers regarding vitamin D in menopause still reflect its deficiency and associated metabolic risk.

scholarly journals Age-related changes in bone tissue in men

2021 ◽  
Vol 11 (2) ◽  
pp. 62-69
Author(s):  
A.S. Musiienko ◽  
N.V. Zaverukha
Keyword(s):  
Lumbar Spine ◽  
Femoral Neck ◽  
Bone Tissue ◽  
Clinical Signs ◽  
Osteoporotic Fractures ◽  
State Institution ◽  
Mineral Density ◽  
Healthy Men ◽  
Age Related ◽  
Age Related Changes

The purpose of the study was to establish age-related changes of male bone tissue. Materials and methods. The study was conducted by the Department of Clinical Physiology and Pathology of the Musculoskeletal System of the State Institution “D.F. Chebotarev Institute of Gerontology by the National Aca­demy of Medical Sciences of Ukraine”. It involved 342 healthy men aged 20 to 89 years without osteoporosis and osteoporotic fractures or any pathology with a confirmed impact on bone tissue, as well as any somatic pathology in the sub- and decompensation. The following methods of examination were used: questionnaire, anthropometric measurements, clinical and instrumental examination. Bone mineral density (BMD) was measured by the dual-energy X-ray absorptiometry machine “Prodigy, GEНС Lunar” at the level of the entire skeleton, lumbar spine (L1-L4), proximal femur and femoral neck, distal and ultra-distal forearm bones. Results. We have detected a significant 14.8 % decrease of BMD at the level of femoral neck in the group of men aged 60–69 years, by 20 % in the group of men aged 70–79 years, and by 24.1 % in the group of men aged 80–89 years compared to the men aged 20–29 years; at the same time, at the lumbar spine there was re­gistered a decrease of this parameter by 1.6 % in men aged 60–69 years, by 1.9 % in men of 70–79 years and by 0.8 % in men of 80–89 years, respectively. Among the examined practically healthy men, the bone tissue remained at the normal level relative to age in 67.8 %; osteopenia was detected in 27.8 %, and osteoporosis in 4.4 %. Conclusions. An age-associated BMD reduction was registered at various skeletal sites in the practically healthy men wi­thout any clinically significant factors affecting bone tissue metabolism. The most pronounced BMD loss was observed at the level of fe­moral neck. At the same time, 4.4 % of examined had osteoporosis without any clinical signs.

scholarly journals Severe osteoporosis treatment: anabolic therapy options

2021 ◽  
pp. 236-240
Author(s):  
L. V. Matchekhina ◽  
E. N. Dudinskaya ◽  
O. N. Tkacheva ◽  
N. O. Khovasova
Keyword(s):  
Older Patients ◽  
Osteoporosis Treatment ◽  
Low Energy ◽  
World Health ◽  
Mineral Density ◽  
Severe Osteoporosis ◽  
Public Health Burden ◽  
Significant Public Health ◽  
Anabolic Therapy ◽  
Health Organization

The world's population is aging rapidly, with increasing prevalence of many chronic diseases that are more common in older people. Osteopenia and osteoporosis are two chronic conditions often diagnosed in frail older patients, and both seem to be a significant public health burden. In Russia, osteoporosis (in accordance with the criteria of the World Health Organization) was detected in 33.8% of women and 26.9% of men aged 50 and over. Every minute in the country, 7 vertebral fractures happen, and every 5 minutes — a fracture of the proximal femur occurs. According to the latest data, about 34 million people in Russia are at high risk of developing low-energy fractures. The use of anabolic therapy in older patients with severe osteoporosis can achieve optimal results in the accumulation of bone mineral density and significantly reduce the risk of repeated low-energy fractures.

scholarly journals Safety of belimumab in association with denosumab in a patient affected by Lupus Erythematosus: a case report

2017 ◽  
Vol 11 (1) ◽  
Author(s):  
Marco Scarati ◽  
Simone Parisi ◽  
Richard Borrelli ◽  
Maria Bruzzone ◽  
Marta Priora ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
Clinical Case ◽  
Fragility Fractures ◽  
Underlying Disease ◽  
Mineral Density ◽  
Viable Option ◽  
Severe Osteoporosis ◽  
Combined Administration ◽  
Immunologic Disease ◽  
Chronic Autoimmune Disease

Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease characterized by multisystemic involvement. Owing to multifactorial etiologies, low bone mineral density (BMD) osteoporosis (OP) and fragility fractures (FFx) have been very frequently documented in these patients. Appropriate treatments to minimize underlying immunologic disease activity remain mandatory, and the development of strategies to prevent and treat important complications as osteoporosis is needed.We present the clinical case of a female SLE patient treated simultaneously with belimumab (anti-BLyS) for the underlying disease, and denosumab (anti-RANKL) for concomitant severe osteoporosis. As these monoclonal antibodies have been recently introduced into the market, their combination has not been reported in literature yet. In this case, the combined administration proved a viable option for a SLE patient with osteoporosis and bisphosphonates contraindications.

scholarly journals CHANGE OF MINERAL DENSITY OF BONE TISSUE IN WOMEN IN PRE - AND POSTMENPAUSA AND ITS CORRECTION

ASJ. ◽  
2021 ◽  
Vol 1 (56) ◽  
pp. 28-33
Author(s):  
O. Kalinkina ◽  
Yu. Tezikov ◽  
I. Lipatov
Keyword(s):  
Bone Mineral Density ◽  
Hormone Therapy ◽  
Bone Mineral ◽  
Premenopausal Women ◽  
Menopausal Hormone Therapy ◽  
Age Group ◽  
Mineral Density ◽  
Treatment Of Osteoporosis ◽  
Age Related ◽  
Prevention And Treatment

87 patients aged 40-69 years in the period of pre- and postmenopause were examined. In the analysis of age-related dynamics of bone mineral density (BMD) It was found that densitometry indicators corresponding to osteoporosis directly correlate with age and duration of the postmenopausal period. It is advisable in women of this age group with a decrease in bone mineral density, the combined appointment of menopausal hormone therapy (MGT) and non-hormonal therapy affecting bone metabolism (calcitonin). For the purpose of MGT in premenopausal women, the use of femostone 2/10 is effective, in postmenopausal women - femostone 1/10 and femostone 1/5, which does not cause withdrawal bleeding. If there are contraindications to menopausal hormone therapy, the prevention and treatment of osteoporosis should be guided by the appointment of nonhormonal drugs, in particular, calcitonin.

scholarly journals Primary hyperparathyroidism: case report

2021 ◽  
Vol 14 (2) ◽  
pp. 21-24
Author(s):  
Leila M. Farkhutdinova ◽  
Salam Yu. Mohammad ◽  
Ildar M. Yamaev ◽  
Bulat I. Abdulguzhin
Keyword(s):  
Primary Hyperparathyroidism ◽  
Clinical Case ◽  
Severe Form ◽  
Laboratory Studies ◽  
Mineral Density ◽  
Severe Osteoporosis ◽  
Multiple Fractures ◽  
Endocrine Diseases ◽  
The Russian Federation ◽  
The Common

Primary hyperparathyroidism is one of the common endocrine diseases, which is an actual medical and social problem. Bone disorders are the most common manifestations of primary hyperparathyroidism and are characterized by increased bone metabolism with a progressive decrease in mineral density and a high risk of fractures. In the Russian Federation, most cases are manifest forms of the disease (70%), which is mainly due to the low level of diagnosis, including due to the lack of awareness of doctors. At the same time, timely detection of the disease is based on relatively accessible laboratory studies, characterized by elevated levels of calcium and parathyroid hormone in the blood, and ultrasound and scintigraphy in most cases provide visualization of the paraadenoma. A clinical case of a severe form of primary hyperparathyroidism, the late diagnosis of which caused the development of severe osteoporosis with multiple fractures, is considered. The presented case indicates that an important role in the timely detection of the disease belongs to the analysis of the clinical picture.

scholarly journals SAT0463 SEVERE OSTEOPOROSIS IN COLOMBIAN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1188.2-1189
Author(s):  
J. C. Diaz-Coronado ◽  
S. Herrera ◽  
D. Hernandez-Parra ◽  
L. Betancur-Vasquez ◽  
D. Gonzalez-Hurtado ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Systemic Lupus Erythematosus ◽  
Bone Mineral ◽  
Lupus Erythematosus ◽  
Osteoporotic Fractures ◽  
Mineral Density ◽  
Systemic Lupus ◽  
Severe Osteoporosis ◽  
The Mean ◽  
Prevalence Of Osteoporosis

Background:Osteoporosis predominantly affects post-menopausal women. There is an important percentage of the population that have additional risk factors that decrease bone mineral density. Patients with Systemic Lupus Erythematosus (SLE) have an increased risk for osteoporosis due to corticosteroid use and chronic inflammation. This population could have a higher prevalence of osteoporosis when compared to post-menopausal women of equal or older age. There is a paucity of information regarding bone mineral density and SLE in Latin America.Objectives:To describe the prevalence and incidence of osteoporosis and osteoporotic fractures in a Colombian population with Systemic Lupus ErythematosusMethods:We collected 464 clinical records of patients who met either the American College of Rheumatology 1997 or Systemic Lupus International Collaborating Clinics (SLICC) 2012 classification criteria for systemic lupus erythematosus between January 2015 and June 2019. The clinical and immunoserological characteristics, and damage accrual were monitored for one year. The diagnosis of osteoporosis was confirmed with densitometry by energy x-ray absorptiometry (DXA) and the presence of fragility fractures according to the rheumatologist’s report in the clinical history. The description of proportions and incidence rate of osteoporosis and fragility fracture is performed.Results:The mean age was 45 years, 96.5% were women and the mean disease duration was 12 years. Others clinical characteristics in table 1. The prevalence of osteoporosis was 13.8% with an incidence of 1.1 fractures / 100 person-months in the general population with SLE. In postmenopausal women, over 50 years the prevalence of osteoporosis was 28.4% with an incidence of 0.8 fractures / 100 months person. In the densitometric characteristics, the mean bone mineral density was 0.772 gr / cm2, T-score spine -2.9 and T-score femoral -2.6. SLEDAI mean 1.5 (SD 2.92) and SLICC mean 1.Table 1.clinical characteristicsn%Active Smoking8317.9Premature gonadal failure81.7Lupic Nephritis17838.4Proteinuria >2.5grams/24hours347.3End Stage Renal Disease163.4Anti-dsDNA14631.4Anti-Sm11023.7Anti-Ro13829.7Prednisone Cumulative Dose2.8grAntimalarial5712Conclusion:Low bone mineral density and severe osteoporosis are prevalent in our cohort with SLE. We have found a fracture rate of 1080 per 100.000 people, which is well over what has been reported in the general population (53-443 per 100.000 people in women). Osteoporotic fractures are part of damage accrual and thus have an association with morbidity and mortality. Data regarding osteoporotic fractures are necessary in order to develop guidance and health policy in the region. SLE is an important risk factor for severe osteoporosis and must be kept in mind when developing guidance and health policyReferences:[1]Jumei Xia, Ran Luo, Shuiming Guo, et al. Prevalence and Risk Factors of Reduced Bone Mineral Density in Systemic Lupus Erythematosus Patients: A Meta-Analysis. BioMed Research International. Volume 2019, Article ID 3731648, 10 pages.[2]Irene E.M. Bultinka, Willem F. Lemsa. Lupus and fractures. Curr Opin Rheumatol 2016, 28:426–432.Disclosure of Interests:Juan camilo Diaz-Coronado: None declared, Sebastian Herrera Speakers bureau: academic conference, Deicy Hernandez-Parra: None declared, Laura Betancur-Vasquez: None declared, Daniel Gonzalez-Hurtado: None declared, Juanita Gonzalez-Arango: None declared, laura Uribe-Arango: None declared, Maria Fernanda Saavedra Chacón: None declared, Jorge Lacouture-Fierro: None declared, Sebastian Guerra-Zarama: None declared, Santiago Monsalve: None declared, Jose David Serna Giraldo: None declared, Juan david Serna: None declared, Julian Barbosa: None declared, Ricardo Pineda.Tamayo: None declared

scholarly journals RISK FACTORS OF LOW-ENERGY FRACTURES IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

2018 ◽  
Vol 25 (4) ◽  
pp. 115-123
Author(s):  
G. M. NURULLINA ◽  
G. I. AKHMADULLINA ◽  
O. V. KRASNOPEROVA ◽  
M. M. ALEKSEEVA ◽  
O. V. ALEKSANDROVA ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Large Scale ◽  
Osteoporotic Fractures ◽  
Diabetic Patients ◽  
Social Significance ◽  
Mineral Density ◽  
Increased Risk ◽  
Long Time ◽  
Risk Of Falls

Osteoporosis is a metabolic disease of the bone tissue, which is characterized by a violation of the qualitative (microarchitecture  change) and quantitative characteristics (decreased bone mass) of  the skeleton, and, as a result, lowenergy fractures. The medical and  social significance of osteoporosis is due to its consequences:  fractures of the femoral neck, vertebral bodies, radius and other  large bones of the skeleton, which significantly reduces the quality of patients’ lives and entails significant financial costs for treatment and rehabilitation.  Prevalence of diabetes mellitus (DM) significantly  increases in all countries of the world, including the Russian  Federation. Diabetes and osteoporosis were considered to be  individual diseases for a long time. In many prospective large-scale studies it was proved that patients with T2DM have a greater risk of  falls and fractures in contrast with the overall population. Despite the increased risk of fractures in diabetic patients, there is still no risk  stratification in these patients. The link between the classic risk  factors of osteoporotic fractures (such as chronic intake of  glucocorticoids, use of alcohol, tobacco, etc.) and the occurrence of  fractures is similar in patients with both T2DM and without it.  However, it is necessary to take into account other characteristics of  diabetes. The specific risk factors of fractures in T2DM patients are  duration of the diabetes for more than 10 years, diabetes decompensation, the severity of diabetes, obesity, the frequency of  falls, hypoglycemia, insulin, thiazolidinedione, exenatide, sulfonylureas, canagliflozin therapy, and, most likely, the reduction  of 25 (OH) vitamin D, functional hypoparathyroidism, the increase of sclerostin, pentosidine, decreased bone mineral density (BMD) of the hip.

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