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Thai Osteoporosis Foundation (TOPF) position statements on management of osteoporosis.

The adjusted incidence rate of hip fracture in Thailand has increased more than 31% from 1997 to 2006. Mortality and morbidity after hip fracture are also high. One year mortality after a hip fracture has increased from 18% in 1999 to 21% in 2007. The Thai Osteoporosis Foundation (TOPF) developed the first Clinical Practice Guideline (CPG) in 2002 and keeps updating the CPG since then. This latest version of the CPG is our attempt to provide comprehensive positional statement on the diagnosis, prevention and treatment of osteoporosis in Thailand. The study group who revised this position state

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… Weekly oral Alendronate or Risedronate plus vitamin D (2800 unit or 5600 unit per tablet) [93] , [94] has the same efficacy as once daily Alendronate and Risedronate administration. - Once monthly Risedronate can increase bone density and decrease risk of bone fracture similar to once weekly use and … VALUE study group Efficacy and safety of weekly alendronate plus vitamin D₃ 5600 IU versus weekly alendronate alone in Korean osteoporotic women: 16-week randomized trial Yonsei Med J 55 3 2014 715 724 24719139 10.3349/ymj.2014.55.3.715 PMC3990072 95 Chesnut C.H. III Skag A. Christiansen C. …

Osteoporosis: Current Concepts.

Osteoporosis is a worldwide disease characterized by reduction of bone mass and alteration of bone architecture resulting in increased bone fragility and increased fracture risk. Causes of osteoporosis include increasing age, female sex, postmenopausal status, hypogonadism or premature ovarian failure, low body mass index, ethnic background, rheumatoid arthritis, low bone mineral density (BMD), vitamin D deficiency, low calcium intake, hyperkyphosis, current smoking, alcohol abuse, immobilization, and long-term use of certain medications. The diagnosis of osteoporosis is established by measure

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… Serum TRACP 5b is a useful marker for monitoring alendronate treatment: comparison with other markers of bone turnover. J Bone Miner Res. 2005;20(10):1804–1812. doi: 10.1359/JBMR.050403. 21. Lee J, Vasikaran S. … Effects of teriparatide, alendronate, or both in women with postmenopausal osteoporosis. J Clin Endocrinol Metab. 2010;95(04):1838–1845. doi: 10.1210/jc.2009-1703. …

Editorial foreword.

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… Considerable evidence exists to support the use of the bisphosphonate alendronate sodium in the management of osteoporosis. … In addition, the authors present data relating to the role of alendronate in the management of male osteoporosis and in corticosteroid-induced osteoporosis. …

Changes of bone turnover markers and bone mineral density among postmenopausal Thai women with osteoporosis receiving generic risedronate.

BackgroundOsteoporosis has been recognized as a significant health issue in Thailand. Pharmacological interventions are important way to prevent fracture. However, one of the main challenges in selecting a medication is high cost, particularly for brand-name drugs. Data on generic bisphosphonate use in Thai are still lacking. Therefore, our study aimed to assess the efficacy and safety of generic risedronate in postmenopausal Thai women with osteoporosis.MethodsThis prospective study was conducted at King Chulalongkorn Memorial Hospital, Bangkok, Thailand, from December 2022 to January 2024. S

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… In Thailand, several types of bisphosphonates are available, including alendronate, risedronate, ibandronate, and zoledronate. … In Thailand, a few generic bisphosphonate agents are available, including alendronate and risedronate. Compared with risedronate, alendronate has greater bone affinity but lower potency for inhibiting farnesyl pyrophosphate synthase (FFP). …

The facial skeleton in patients with osteoporosis: a field for disease signs and treatment complications.

Osteoporosis affects all bones, including those of the facial skeleton. To date the facial bones have not drawn much attention due to the minimal probability of morbid fractures. Hearing and dentition loss due to osteoporosis has been reported. New research findings suggest that radiologic examination of the facial skeleton can be a cost-effective adjunct to complement the early diagnosis and the follow up of osteoporosis patients. Bone-mass preservation treatments have been associated with osteomyelitis of the jawbones, a condition commonly described as osteonecrosis of the jaws (ONJ). The fa

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… In the group of women who discontinued oral alendronate use after five years, the BMD and bone remodeling were maintained at higher levels than those obtained at baseline. … The BMD and bone marker changes suggested some residual effect from 5 years of alendronate treatment that is evident for at least 5 years after discontinuation [ 93 ]. …

Clinical practice guideline for management of osteoporosis and fracture prevention in Canada: 2023 update.

BACKGROUND: In Canada, more than 2 million people live with osteoporosis, a disease that increases the risk for fractures, which result in excess mortality and morbidity, decreased quality of life and loss of autonomy. This guideline update is intended to assist Canadian health care professionals in the delivery of care to optimize skeletal health and prevent fractures in postmenopausal females and in males aged 50 years and older. METHODS: This guideline is an update of the 2010 Osteoporosis Canada clinical practice guideline on the diagnosis and management of osteoporosis in Canada. We foll

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… For people who meet criteria for initiation of pharmacotherapy, we recommend bisphosphonates (alendronate, risedronate or zoledronic acid). … Surgically treated osteonecrosis and osteomyelitis of the jaw and oral cavity in patients highly adherent to alendronate treatment: a nationwide user-only cohort study including over 60,000 alendronate users . …

The anti-tumour effects of zoledronic acid.

Bone is the most common site for metastasis in patients with solid tumours. Bisphosphonates are an effective treatment for preventing skeletal related events and preserving quality of life in these patients. Zoledronic acid (ZA) is the most potent osteoclast inhibitor and is licensed for the treatment of bone metastases. Clodronate and pamidronate are also licensed for this indication. In addition, ZA has been demonstrated to exhibit antitumour effect. Direct and indirect mechanisms of anti-tumour effect have been postulated and at many times proven. Evidence exists that ZA antitumour effect i

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… ZA is reported to be more potent inhibitor of farnesyl diphosphate synthase than the other bisphosphonates risedronate, ibandronate, incadronate, alendronate, and pamidronate [4] . … In their work alendronate, ibandronate, and pamidronate induced significant expansion of γδ T cells (Vγ9Vδ2 subset) in peripheral blood mononuclear cell cultures of healthy donors. …

The Rationale for Using Neridronate in Musculoskeletal Disorders: From Metabolic Bone Diseases to Musculoskeletal Pain.

Neridronate or ((6-amino-1-hydroxy-1-phosphonohexyl) phosphonic acid) is an amino-bisphosphonate (BP) synthetized in Italy in 1986. Bisphosphonates are molecules with a P-C-P bond in their structure that allows strong and selectively binding to hydroxyapatite (HAP) as well as osteoclasts inhibition through different mechanisms of action. Neridronate was initially used to treat Paget disease of the bone, demonstrating effectiveness in reducing bone turnover markers as well as pain. The interesting molecular properties of neridronate foster its wide use in several other conditions, such as osteo

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… and +3.1–3.5%) [ 66 ] and ibandronate (+5.2% and +2.9%) [ 67 ], despite biochemical changes of BTM being lower than those observed with alendronate [ 68 ] or risedronate [ 69 ]. … Effect of oral alendronate on bone mineral density and the incidence of fractures in postmenopausal osteoporosis. N. Engl. J. Med. 1995;333:1437–1443. doi: 10.1056/NEJM199511303332201. 66. …

Managements of osteoporotic vertebral compression fractures: A narrative review.

Osteoporotic vertebral compression fractures (OVCFs) are the most common fragility fracture and significantly influence the quality of life in the elderly. Currently, the literature lacks a comprehensive narrative review of the management of OVCFs. The purpose of this study is to review background information, diagnosis, and surgical and non-surgical management of the OVCFs. A comprehensive search of PubMed and Google Scholar for articles in the English language between 1980 and 2021 was performed. Combinations of the following terms were used: compression fractures, vertebral compression frac

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… Alendronate, an aminobisphosphonate, is often the specific first-line treatment because its efficacy in reducing fracture risk and favorable safety profile[ 57 ]. … Alendronate significantly decreases the risk of fractures, specifically by 44% for radiographic vertebral fractures and 57% for osteoporotic women or those with an existing vertebral fracture[ 59 , 59 ]. …

Screening, assessment, and treatment of osteoporosis for the nurse practitioner: key questions and answers for clinical practice--a Canadian perspective.

PurposeUsing a case-based approach, we review key clinical questions relevant to nurse practitioners (NPs) regarding the screening, assessment, and treatment of patients at risk for osteoporosis and fractures in a Canadian general practice setting.Data sourcesA case presentation with relevant questions and answers to guide management of a patient.ConclusionsOsteoporosis is a common condition in both the aging male and female populations. Screening, diagnosis, and treatment of osteoporosis is lagging behind relative to other chronic disease states. NPs have a unique opportunity to help reduce t

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… For men who require treatment for osteoporosis, alendronate, risedronate, zoledronic acid, and denosumab have been approved for use as first-line therapies. … Freemantle N, Satram-Hoang S, Tang ET, Kaur P, Macarios D, Siddhanti S, DAPS Investigators Final results of the DAPS (Denosumab Adherence Preference Satisfaction) study: A 24-month, randomized, crossover comparison with alendronate in postmenopausal women. …

Bisphosphonate induced osteonecrosis of jaw in breast cancer patients: A systematic review.

BackgroundBisphosphonate therapy is widely used for the treatment of bone metastasis in breast cancer patients.AimThe aim of this study is to estimate the overall prevalence of bisphosphonate induced osteonecrosis of jaw (BONJ) in breast cancer patients with bone metastasis.Materials and methodsA literature review was conducted to search and evaluate all the articles that contained original data on the prevalence of BONJ in breast cancer patients from the year 2003-2009. Pubmed search terms used were bisphosphonate, osteonecrosis, breast cancer and jaw. Eleven publications that fulfilled the i

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… The treatment protocol is alendronate 70 mg given once weekly and risedronate 35 mg once weekly. … Approximately 50% intravenous bisphosphonates are available for incorporation into the bone matrix compared to an average of 1% of oral bisphosphonates absorbed by the gastrointestinal tract.[ 26 ] About 170 cases of alendronate, 12 cases of risedronate and only one case of ibandronate-induced osteonecrosis …

Targeting strategies for bone diseases: signaling pathways and clinical studies.

Since the proposal of Paul Ehrlich's magic bullet concept over 100 years ago, tremendous advances have occurred in targeted therapy. From the initial selective antibody, antitoxin to targeted drug delivery that emerged in the past decades, more precise therapeutic efficacy is realized in specific pathological sites of clinical diseases. As a highly pyknotic mineralized tissue with lessened blood flow, bone is characterized by a complex remodeling and homeostatic regulation mechanism, which makes drug therapy for skeletal diseases more challenging than other tissues. Bone-targeted therapy has b

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… In Vanderburgh et al.’s research, 10 mol% alendronates exhibited the highest accumulation ratio at the bone tumor site. 247 In addition, BPs can serve as the primary framework of the vector. … In view of this, an improvement strategy was recently proposed by TIAN et al. 251 By conjugating alendronate with HER2-targeted antibody Tras using pClick technology, bone metastasis-targeted Tras-Alen was synthesized. …

Radiographic Patterns and Clinical Correlates of Medication-Related Osteonecrosis of the Jaw (MRONJ): A Retrospective Analysis.

Objectives: This study aimed to evaluate the radiographic characteristics of medication-related osteonecrosis of the jaw (MRONJ) by digital panoramic radiographs and to investigate the associations between radiographic findings and clinical, demographic, and treatment-related variables in patients receiving antiresorptive therapy. Methods: A retrospective analysis was performed on 55 patients receiving antiresorptive therapy, categorized into a tooth-extraction group (n = 20) and an MRONJ group (n = 35). Standardized panoramic radiographs obtained at baseline (T0) and during the 6-month follow

Drug-induced herpes zoster: a pharmacovigilance analysis of FDA adverse event reports from 2004 to 2024.

BACKGROUND: Herpes zoster severely impacts patients' quality of life and therapeutic results. This research utilized data from the FDA Adverse Event Reporting System (FAERS) to examine the prevalence and attributes of drug-induced herpes zoster. METHODS: We analyzed FAERS reports about zoster from Q1 2004 to Q3 2024 and developed a list of possible pathogenic agents. Ranked the 30 medicines with the greatest incidence of reported herpes zoster cases. Statistical disproportionality analysis was employed to identify an elevated reporting frequency of herpes zoster linked to a particular medicat

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… These seven drugs were secukinumab, interferon β-1a, human immunoglobulin g, golimumab, alendronate sodium, pregabalin, and ibrutinib. TABLE 3 Top 30 drugs with the highest number of reported herpes zoster. … Alendronate sodium, a bisphosphonate drug, is used to treat osteoporosis and other metabolic bone diseases. Its adverse reactions typically include gastrointestinal discomfort, bone and joint pain ( Biswas et al., 2003 ). …

Up to 7% of referrals to oral and maxillofacial surgery are related to medication-related osteonecrosis of the jaws: how much is really out there?

INTRODUCTION: Medication-related osteonecrosis of the jaws (MRONJ) is generally described as rare; therefore, firm incidence data are challenging to ascertain. AIM: Using two sites in Northwest England, ascertain the number of referrals to oral and maxillofacial surgery involving: Suspected MRONJ. Patients at risk of MRONJ requiring a dentoalveolar procedure. METHOD: All sequential referrals over a 2-year period were analysed. The referrals were categorised into 'type' of referral (stage 1). Any referral for MRONJ, or patient at risk, was then further examined (stage 2). RESULTS: A total of

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… Eiken PA Prieto-Alhambra D Eastell R Abrahamsen B Surgically treated osteonecrosis and osteomyelitis of the jaw and oral cavity in patients highly adherent to alendronate treatment: a nationwide user-only cohort study including over 60,000 alendronate users Osteoporos Int. 2017 28 2921 8 10.1007/s00198 … Iwamoto J Uzawa M Experience with alendronate treatment for 7 years among Japanese men with osteoporosis or osteopenia and clinical risk factors for fractures Clin Rheumatol. 2016 35 205 12 10.1007/s10067-014-2812-y 25367347 6. …

Asia-Pacific consensus statement on medication-related osteonecrosis of the jaw in patients with osteoporosis.

A unified consensus statement on medication-related osteonecrosis of the jaw (MRONJ) has not yet been established among the Asian member countries or regions of the Asian Federation of Osteoporosis Societies (AFOS). This study aimed to develop a consensus on MRONJ in patients with osteoporosis across these countries and regions. In this study, the term "Asia-Pacific" refers specifically to the Asian member countries and regions of AFOS. A structured survey consisting of nine MRONJ-related questions was distributed across 10 countries and regions to assess the level of agreement and summarize r

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… In our randomized controlled trial comparing teriparatide with alendronate, tooth mobility decreased in the teriparatide group but increased significantly in the alendronate group among patients with periodontitis [ 22 ]. … The influence of alendronate and tooth extraction on the incidence of osteonecrosis of the jaw among osteoporotic subjects PLoS One 13 2018 e0196419 10.1371/journal.pone.0196419 PMC5918995 29694412 50 Liu F.C. Luk K.C. Chen Y.C. …

Clinical Performance of Implant-Supported Prostheses in the Rehabilitation of Patients Previously Treated for Medication-Related Osteonecrosis of the Jaws (MRONJ): A Systematic Review.

There is a lack of consensus on managing resultant bone and soft tissue defects or on restoring oral function and aesthetics following medication-related osteonecrosis of the jaws (MRONJ) lesion healing. This clinical challenge presents a dilemma for practitioners. Removable prostheses pose a recurrence risk if poorly fitted and may inadequately restore function or aesthetics in cases of significant bone defect. Dental implant-supported prostheses could enhance function and quality of life, though their risks and indications are not well-defined. This systematic review examines the clinical ou

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… Authors | Study type | Antiresorptive therapy | MRONJ location | MRONJ treatment Goker et al., 2023 [ 54 ] | Case report | Alendronate | Right maxillary region | Resection surgery Rahim et al., 2024 [ 55 ] | Case report | Alendronate | Right body of the mandible | Partial mandibulectomy with titanium … reconstruction plate Hjortholt et al., 2023 [ 51 ] | Prospective (observational) study | Pamidronate, Zoledronate, Alendronate, Ibandronate or Denosumab | NA | Block resection Lee et al., 2023 [ 56 ] | Case report | Alendronate | Right posterior mandible | Sequestrectomy, saucerization, and removal …

Zoledronic Acid Modulation of TRPV1 Channel Currents in Osteoblast Cell Line and Native Rat and Mouse Bone Marrow-Derived Osteoblasts: Cell Proliferation and Mineralization Effect.

Bisphosphonates (BPs) reduce bone pain and fractures by balancing the osteoblast/osteoclast ratio. The behavior of ion channels in the presence of BPs is not known. To investigate this, the effect of zoledronic acid BP (ZOL) (3 × 10-8 to 5 × 10-4 M) treatment, on ion channels, cell proliferation, and mineralization, has been investigated on preosteoclast-like cells, RAW264.7, preosteoblast-like cells MC3T3-E1, and rat/mouse native bone marrow-derived osteoblasts. In whole-cell patch clamp on cell line- and bone marrow-derived osteoblasts, ZOL potentiated outward currents. On RAW264.7, ZOL (10-

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… In vitro, human prostate cancer PC3 cells and human osteosarcoma MG63 cells treated with zoledronic acid, alendronate, or risedronate [ 6 ] show attenuated proliferation. … Inhibitory effects of osteoclastogenesis by alendronate (ALE), risedronate (RIS), and zoledronic acid (ZOL) tested at 10 −4 M concentrations are shown at 10× magnification. …

Adult hypophosphatasia treated with reduced frequency of teriparatide dosing.

We report a 41-year-old man diagnosed with the adult form of hypophosphatasia (HPP) and treated for 4 years with less frequent than conventional daily doses of teriparatide (TPTD). He presented with a history of three low-energy fractures and low bone mineral density (BMD) ineffectively treated with bisphosphonate. We identified within ALPL, the gene that encodes the homodimeric "tissue-nonspecific" isoenzyme of alkaline phosphatase (ALP) and underlies HPP, a heterozygous missense mutation (c.455 G>A→R135H). Characteristic painful periarticular calcification removed at a shoulder did not recur

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… Based on these BMD values, he had commenced treatment (September 2015) elsewhere with a weekly combination of alendronate (70 mg) and cholecalciferol (5600 IU) administered orally. … Administration of teriparatide for four years cyclically compared to two years daily in treatment Naïve and alendronate treated women. Bone. 2019;120:246–53. doi: 10.1016/j.bone.2018.10.020. 20. …

The impact of incident vertebral and non-vertebral fractures on health related quality of life in postmenopausal women.

BACKGROUND: Little empirical research has examined the multiple consequences of osteoporosis on quality of life. METHODS: Health related quality of life (HRQL) was examined in relationship to incident fractures in 2009 postmenopausal women 50 years and older who were seen in consultation at our tertiary care, university teaching hospital-affiliated office and who were registered in the Canadian Database of Osteoporosis and Osteopenia (CANDOO) patients. Patients were divided into three study groups according to incident fracture status: vertebral fractures, non-vertebral fractures and no fract

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… group. b others may have included one of the following Asian, Black, Aboriginal North American, Oriental, and Middle Eastern/North African White c includes breast, ovarian, uterine or cervical, colon cancer; and multiple myeloma. d includes hyper, hypo, nodular and other thyroid diseases. e includes alendronate … Effect of alendronate on limited-activity days and bed-disability days caused by back pain in postmenopausal women with existing vertebral fractures. Arch Intern Med. 2000;160:77–85. doi: 10.1001/archinte.160.1.77. Bergner M, Bobbitt RA, Carter WB, Gilson BS. …