scholarly journals Cyclic intravenous pamidronate in treatment of osteoporosis

2004 ◽  
Vol 57 (11-12) ◽  
pp. 545-550 ◽  
Author(s):  
Nada Vujasinovic-Stupar ◽  
Nada Pilipovic ◽  
Slobodan Brankovic
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Placebo Group ◽  
Bone Mineral ◽  
Mineral Density ◽  
Severe Osteoporosis ◽  
Treatment Of Osteoporosis ◽  
Intravenous Pamidronate ◽  
The Mean ◽  
One Year

Objective To assess the efficacy and tolerability of cyclic intravenous pamidronate therapy in women with severe osteoporosis. Material and methods Bone mineral density (BMD) measurement was performed by dual-energy X-ray absorptiometry using LUNAR DPX-L device. Slow intravenous infusion regimens of pamidronate (30 mg) every three months were used in treatment of 240 women, in addition to supplemental Ca and vitamin D. Bone mineral density was measured from lumbar spine 1 year later (120 mg of pamidronate) in 195 women and 2 years later (240 mg of pamidronate) in 29 women. The placebo group included 63 women treated only with calcium and vitamin D. Results The average age of 240 women with severe osteoporosis was 61.2?9.5. All were postmenopausal, except for two of them. Their mean age at the onset of menopause was 46.2?5.6. Mean duration of menopause was 15.7?8.1. After 1 year of therapy, bone mineral density increased from 0.781 g/cm2 to 0.837 g/cm2 (p<0.001), the mean increase bone mass was 7.2% (p<0.0001). After 2 years, bone mineral density increased to 0,844 g/cm2, the improvement was 8.1% from baseline (p<0.001). Bone mineral density in the placebo group, after one year, significantly increased (p=0.046) from 0.966 g/cm2 to 1.004 g/cm2, the improvement was 3.9%. However, after two years, bone mineral density decreased to 0.973 g/cm2, and compared with baseline this change was 0.7% and not significant (p> 0.05). Conclusion Pamidronate prevented further decrease of BMD in our patients with severe osteoporosis and also increased BMD in these patients. This safe and efficient drug is well tolerated.

scholarly journals Transdermal Nitroglycerin Therapy May Not Prevent Early Postmenopausal Bone Loss

2009 ◽  
Vol 94 (9) ◽  
pp. 3356-3364 ◽  
Author(s):  
Sunil J. Wimalawansa ◽  
Julia P. Grimes ◽  
Alan C. Wilson ◽  
Donald R. Hoover
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Placebo Group ◽  
Postmenopausal Women ◽  
Bone Mineral ◽  
Single Center ◽  
Mineral Density ◽  
Once Daily ◽  
Secondary Outcomes ◽  
Adjusted Dose

Context: Osteoporosis is common among postmenopausal women; animal studies and human pilot studies support the concept of nitric oxide (NO) donors reducing bone mineral density loss. Objective: The objective of the study was to evaluate whether NO donor, nitroglycerin, prevents postmenopausal bone loss. Design: This was a 3-yr randomized, double blinded, single-center, placebo-controlled clinical trial. Setting: The single-center study was conducted at the University of Medicine and Dentistry-Robert Wood Johnson Medical School (New Brunswick, NJ). Participants: Participants included 186 postmenopausal women aged 40–65 yr, with lumbar bone mineral density (BMD) T-scores of 0 to −2.5. Intervention: Women, stratified by lumbar T-score (&lt;−1.50 and ≥−1.50) and years since menopause (≤5 and &gt;5 yr), were randomized to receive nitroglycerin ointment (22.5 mg as Nitro-Bid) or placebo ointment received daily for 3 yr. Both groups took 630 mg daily calcium plus 400 IU vitamin D supplements. Measurements: BMD was measured at 6 months and annually by dual-energy x-ray absorptiometry. Percent change in lumbar vertebrae BMD was the primary outcome. Hip BMD, total body bone mineral content, and height were secondary outcomes. Results: After 36 months of therapy, changes of −2.1% in the active group (n = 88) and −2.5% in the placebo group (n = 82) in lumbar spine BMD were seen (P = 0.59; 95% confidence interval −1.001, 1.975). Secondary outcomes also did not differ by intervention arm. The active group reported more headaches compared with the placebo group (57 vs. 14%, P &lt; 0.001). Other adverse and serious adverse events were not different. Conclusions: BMD changes did not substantially differ between postmenopausal women who received the dose of nitroglycerin tested, in comparison with a placebo. Once-daily dosing with 22.5 mg of transdermal-administered nitroglycerin was not effective (compliance adjusted dose was only ∼16 mg/d); a sub-therapeutic dose. No substantial bone mineral density changes were observed between postmenopausal women receiving once-daily 22.5 mg of transdermal nitroglycerin, compared to calcium plus vitamin D (compliance adjusted dose = 16 mg/day).

Intravenous pamidronate in combination with calcium and vitamin D is highly effective for the treatment of low bone mineral density in Crohns disease

2003 ◽  
Vol 124 (4) ◽  
pp. A520
Author(s):  
Pieter Strokkers ◽  
Tim Schreuder ◽  
Maartje Deley ◽  
Mirjam Van der Spek ◽  
Sander Van Deventer ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Bone Mineral ◽  
Mineral Density ◽  
Crohns Disease ◽  
Low Bone Mineral Density ◽  
Highly Effective ◽  
Intravenous Pamidronate

scholarly journals Vitamin D deficiency and low bone status in adult female garment factory workers in Bangladesh

2008 ◽  
Vol 99 (6) ◽  
pp. 1322-1329 ◽  
Author(s):  
Md Zahirul Islam ◽  
Abu Ahmed Shamim ◽  
Virpi Kemi ◽  
Antti Nevanlinna ◽  
Mohammad Akhtaruzzaman ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Mineral Density ◽  
Bone Mineral Status ◽  
Garment Factory ◽  
High Prevalence ◽  
The Mean

The manufacture of garments is the main industry in Bangladesh and employs 1·6 million female workers. Due to the indoor lifestyle and low dietary intake of calcium, we hypothesised that they are at risk of low vitamin D and bone mineral status. Two hundred female garment workers (aged 18–36 years) were randomly selected. Serum 25-hydroxyvitamin D (S-25OHD), serum intact parathyroid hormone (S-iPTH), serum calcium (S-Ca), serum phosphate (S-P) concentration and serum alkaline phosphatase activity (S-ALP) were measured from fasting samples. Bone indexes of hip and spine were measured by dual-energy X-ray absorptiometry. The mean S-25OHD (36·7 nmol/l) was low compared to that recommended for vitamin D sufficiency. About 16 % of the subjects were found to be vitamin D-deficient (S-25OHD < 25 nmol/l). We observed a high prevalence (88·5 %) of vitamin D insufficiency (S-25OHD < 50 nmol/l) as well as a significant inverse relationship between S-25OHD and S-iPTH (r − 0·25, P ≤ 0·001). A decrease in S-25OHD ( < 38 nmol/l) and an increase in S-iPTH (>21 ng/l) was associated with progressive reduction in bone mineral density at the femoral neck and lumbar spine. According to the WHO criteria, the mean T-score of the femoral neck and lumbar spine of the subjects were within osteopenic range. We observed that subjects with a bone mineral density T-score < − 2·5 had a trend of lower values of BMI, waist–hip circumference, mid-upper-arm circumference, S-25OHD and higher S-iPTH and S-ALP. The high prevalence of hypovitaminosis D and low bone mineral density among these subjects are indicative of higher risk for osteomalacia or osteoporosis and fracture.

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 Effects of alendronate on bone mass in women with osteoporosis

2006 ◽  
Vol 59 (9-10) ◽  
pp. 427-435
Author(s):  
Nada Pilipovic ◽  
Slobodan Brankovic ◽  
Nada Vujasinovic-Stupar
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Lumbar Spine ◽  
Bone Mass ◽  
Bone Mineral ◽  
Mineral Density ◽  
Control Groups ◽  
T Score ◽  
Second Year ◽  
One Year

This paper presents the results of a two-year study of the effects of alendronate (Fosamax?) on bone mass in 187 women with osteoporosis, mean age 57.68 years. Bone mass, i.e. bone mineral density (BMD) was measured at the lumbar spine. Measurements were performed prior to treatment, one year and two years after treatment using the DEXA method. The BMD was examined in 65 women, mean age 54.02, taking calcium and vitamin D, and in 75 women mean age 57.16, without any therapy. The baseline BMD (T score) in the alendronate group was -2.87 SD, whereas in the two control groups it measured -1.86 SD and -2.02 SD, respectively. A significant improvement of bone mass, by 5.8%, was registered after a year of treatment with alendronate, and by 8.3% after two years. In patients receiving calcium and vitamin D, a significant increase of bone mass was established as well: by 2.9% after a year, but the values declined back to the baseline after the second year. In patients without any treatment the bone mass decreased by 0.6% after a year, and by 0.9% after the second year. .

scholarly journals Levetiracetam monotherapy effect on serum calcium and serum vitamin D in patient of epilepsy

2017 ◽  
Vol 5 (2) ◽  
pp. 503 ◽  
Author(s):  
Anubha Garg ◽  
Surekha Dabla ◽  
Sandeep Nagenhalli ◽  
Sanjay Fotedar
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Bone Mineral ◽  
Serum Calcium ◽  
Serum Vitamin ◽  
Total Leukocyte Count ◽  
Mineral Density ◽  
Serum Vitamin D ◽  
Vitamin D Levels ◽  
One Year

Background: Objective of the study was to determine the Levetiracetam monotherapy effect on serum calcium and serum vitamin D levels in tertiary care hospital in Haryana, India.Methods: A total of 110 patients with epilepsy, were enrolled to the study for one year between April 2013 to August 2014. All male patients aged 15-60 years and premenopausal females with epilepsy were included in the study. The study was a interventional prospective study design. The antiepileptic drug levetiracetam was administered starting from a dose of 20 mg/kg and dose was titrated according to the clinical response. During the follow up period, the subjects were asked about the seizure frequency and other side effects. The patients were be subjected to questionnaires based proforma. Baseline investigations, Hemogram, renal and liver function tests, calcium, phosphate, vitamin D and bone mineral density and T scores were noted. All investigations were repeated after one year of levetiracetam monotherapy.Results: The mean age of onset of seizures in the study group was 23.22±6.62 years. 58% (n=29) were seizure free after 1 year of levetiracetam monotherapy, 28% patients had adequate control and 14% patients had poor control of their seizure episodes. There was an insignificant change in Hemoglobin, total leukocyte count, platelet count, renal parameters and Liver enzymes from baseline over a year of levetiracetam therapy. Serum calcium levels increased insignificantly from baseline levels of 9.68±0.59 mg/dl to 9.72±0.56mg/dl. Vitamin D levels increased from baseline of 39.35±14.91ng/ml to 39.84±14.07 ng/ml. Bone mineral density increased insignificantly from baseline of 0.92±0.13 g/cm2 to 0.93±0.13 g/cm2.Conclusions: Present study has shown an overall beneficial effect on serum calcium, Vitamin D level, bone mineral density and T scores on DEXA scan.

scholarly journals AB0480 INFLUENCE OF ANTI TNF THERAPIES AND HYPERHOMOCYSTEINEMIA ON BONE MINERAL DENSITY IN ANKILOSING SPONDYLITIS PATIENTS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1267-1267
Author(s):  
D. Anghel ◽  
E. M. Hoinoiu ◽  
M. M. Negru ◽  
O. G. Petrache ◽  
N. O. Costache ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Bone Mineral ◽  
Hla B27 ◽  
Mineral Density ◽  
Severe Osteoporosis ◽  
Hydroxyvitamin D ◽  
Tnf Α ◽  
25 Hydroxyvitamin D ◽  
The Mean

Background:Ankylosing spondylitis (AS) is a chronic inflammatory disease associated with an important risk factor of osteoporosis. A high serum level of Homocysteine (Hcy) has been recently recognized as a risk factor for osteoporosis and osteoporotic fractures. Treatment with TNF-α blockers might influence bone metabolism and prevent structural bone damage in AS.Objectives:The aim of the study was to evaluate the influence of anti-TNF therapies and hyperhomocysteinemia on bone mineral density in AS patients.Methods:In our retrospective study were enrolled 73 AS patients with anti TNF-α therapies (29 Adalimumab 40mg/2weeks, 24 Etanerceptum50mg/week, 20 Infliximabum5 mg/kg/8 weeks) and 45 AS patients non anti TNF-α therapies. All patients included in this study met the modified New York criteria. The current medications used by the non anti TNF-α therapies patients were nonsteroidal anti-inflammatory drugs.We used Dual energy x ray absorptiometry (DXA) method for measuring bone mineral density (BMD). Osteoporosis is defined as a T score of ≤ −2.5 SD, according to the WHO criteria. BMD of the hip and lumbar spine (L1-L4) was determined at baseline and after 6 months. Hcy concentrations were measured by using a chemiluminescence immunoassay method. The normal serum Hcy level is considered to be below 15mmol/L. In both group we followed the activities disease (C reactive protein-CRP, eritrocytes sedimentation rate-ESR, Bath ankylosing spondylitis disease activity index-BASDAI score) and determined vitamin D3 level.All parameters were determined at baseline and after 6 months.Results:The mean age of study group1 was 47.4±11.1 years and 42±9,8year in group2. The mean disease duration was 11.9 ± 6.1 years. 83,5% of patients were HLA-B27 positive in group1 and 71,1% in group2.BMD measurements revealed more severe osteoporosis in patients with positive HLA-B27 in both groups at baseline. After 6 months in group1 BMD increased by 0.4% at lumbar spine and 0.1% in the hip and in group2 decreased by 0.9% and 0.6% in the same sites. No significant differences between type of anti-TNF therapies and BMD. In group 1, HLA-B27 positive status was positive correlated with decrease BMD(p=0.001) after 6 months. Hcy levels were found significantly increased (14.8 ± 3.8 mg/mL vs. 12.4 ± 4.2 mg/mL; P < 0.001) at baseline in both groups. Serum levels of Hcy were inversely correlated to lumbar spine BMD (p< 0.005) and femur neck BMD(p=0,001) after 6 months in group1. At baseline the mean level of 25-hydroxyvitamin D3 was 22.8 ± 14.1 ng/mL in group1 and 26.6 ± 12.5 ng/mL in group2. In anti TNF patients group, we found a positive correlation between decrease BMD, low level of 25-hydroxyvitamin D3 and high level of Hcy(p=0,001) after six months. No correlation was found between BMD and BASDAI score and inflammatory parameters (ESR, CRP).Conclusion:Bone mineral density measurements revealed more severe osteoporosis in positive HLA-B27 AS patients and hyperhomocysteinemia. Association of low level of 25-hydroxyvitamin D3 and hiperhomocysteinemia is correlated with high-risk fracture in positive HLA-B27 patients. Anti TNF therapies reduce this risk.References:[1]Kim JI, Moon JH, Chung HW, Kong MH, Kim HJ. Association between homocysteine and bone mineral density according to age and sex in healthy adults. J Bone Metab 2016; 23:129-34.[2]Fratoni V, Brandi ML. B Vitamins, homocysteine and bone health. Nutrients 2015; 7:2176-92.[3]Jahn O, Wex T, Klose S, Kropf S, Adolf D, Piatek S, et al. Cathepsin K in treatment monitoring following intravenous zoledronic acid. Biomed Rep 2014; 2:915-7.Disclosure of Interests:None declared.

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