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Повышение риска заражения и смертности в результате повреждений в миеломе: общенациональное исследование по изучению коортных изменений на основе народонаселения.

АНАЛИЗ И АИСЮ: для определения того, подвергаются ли пациенты с ММ более высокому риску госпитализированных инфекций и долгосрочной полной смертности после первого перелома, чем больные, не имеющие перелома ММ, на уровне населения. МЕТОДЫ: Мы провели общенациональное ретроспективное когортное исследование с использованием базы данных национальных исследований в области медицинского страхования Тайваня 2001 в адрес 2019. Были выявлены и сопоставлены взрослые люди с ММ и взрослыми лицами, не являющимися ММ, с индексом госпитализированных переломов 1::10 по меркам. Модели пропорциональных рисков

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… M., et al., “First‐Line Treatment With Zoledronic Acid as Compared With Clodronic Acid in Multiple Myeloma (MRC Myeloma IX): A Randomised Controlled Trial,” Lancet 376 (2010): 1989–1999. 9. Terpos E., Ntanasis‐Stathopoulos I., Gavriatopoulou M., and Dimopoulos M. …

Patient-reported pain severity and health-related quality of life in patients with multiple myeloma in real world clinical practice.

BACKGROUND: The association between patient self-reported pain severity and health-related quality-of-life (HRQoL) is poorly understood. AIMS: This real-world study of symptomatic multiple myeloma (MM) patients sought to determine how pain severity from a single question asked during routine clinical consultation was associated with HRQoL. METHODS AND RESULTS: Point-in-time data on HRQoL of 330 patients with MM (median age 70 years) receiving anti-myeloma therapy in Germany and Italy from November 2017 through February 2018 were analyzed. HRQoL was assessed using validated questionnaires (Wo

Contribution of Macrophages and T Cells in Skeletal Metastasis.

Bone is a common site for metastases with a local microenvironment that is highly conducive for tumor establishment and growth. The bone marrow is replete with myeloid and lymphoid linage cells that provide a fertile niche for metastatic cancer cells promoting their survival and growth. Here, we discuss the role of macrophages and T cells in pro- and anti-tumoral mechanisms, their interaction to support cancer cell growth, and their contribution to the development of skeletal metastases. Importantly, immunotherapeutic strategies targeting macrophages and T cells in cancer are also discussed in

Molecular-Based Treatment Strategies for Osteoporosis: A Literature Review.

Osteoporosis is an unavoidable public health problem in an aging or aged society. Anti-resorptive agents (calcitonin, estrogen, and selective estrogen-receptor modulators, bisphosphonates, anti-receptor activator of nuclear factor κB ligand antibody along with calcium and vitamin D supplementations) and anabolic agents (parathyroid hormone and related peptide analogs, sclerostin inhibitors) have major roles in current treatment regimens and are used alone or in combination based on the pathological condition. Recent advancements in the molecular understanding of bone metabolism and in bioengin

[Pertrochanterian fracture revealing multiple myeloma: how is it treated?]

Skeletal involvement is the major clinical complication of multiple myelomas, resulting in pathological fractures. Proximal femoral fractures are very frequent during multiple myeloma evolution and they seriously compromise survival and quality of life of patients with cancer. Early surgical treatment allows mortality and morbidity improvement. Cervicomedullary Gamma locking nail osteosynthesis allows efficient, sustainable and stable fixation associated with early patient mobilization and survival improvement. However, prolonged survival imposes regular monitoring of the osteosynthesis in ord

Safety and tolerability of zoledronic acid and other bisphosphonates in osteoporosis management.

Bisphosphonates (BPs) are widely used in the treatment of postmenopausal osteoporosis and other metabolic bone diseases. They bind strongly to bone matrix and reduce bone loss through inhibition of osteoclast activity. They are classified as nitrogen- and non-nitrogen-containing bisphosphonates (NBPs and NNBPs, respectively). The former inhibit farnesyl diphosphate synthase while the latter induce the production of toxic analogs of adenosine triphosphate. These mechanisms of action are associated with different antifracture efficacy, and NBPs show the most powerful action. Moreover, recent evi

Calcium Phosphate Bone Substitutes in the Prevention of Bisphosphonate-Related Osteonecrosis of the Jaw: A Review.

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is characterized by exposed necrotic bone that often progresses with increasing pain and impaired quality of life. Zoledronate, the most potent and widely used bisphosphonate, has been strongly associated with BRONJ development following invasive dental procedures. Given the rising incidence of BRONJ, understanding and implementing effective preventive strategies have become imperative. Biomaterials based on synthetic hydroxyapatite and beta-tricalcium phosphate have been investigated as potential preventive agents. Their therapeutic rati

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

Identified Medications Causing Medication-Related Osteonecrosis of the Jaw: A Literature Review.

Medication-related osteonecrosis of the jaw (MRONJ) is a serious adverse event that occurs in patients treated with certain medications, leading to a major side effect that can result in substantial morbidity. MRONJ is known to be associated with antiresorptive (AR) and antiangiogenic (AA) medicines, but recent evidence suggests that other medications may also be involved. Recognizing a broad range of drug-induced risk factors is important, notably in light of the increasing number of drugs associated with MRONJ. The primary objective of this review is to update and synthesize findings from th

Bone complications in patients with multiple myeloma in five European countries: a retrospective patient chart review.

BackgroundBone complications (pathologic fracture, spinal cord compression, surgery to bone and radiation to bone) are a common problem in patients with multiple myeloma (MM). We set out to provide insights into the real-world burden of bone complications in patients with newly diagnosed MM (NDMM).MethodsWe conducted a retrospective review of medical charts of patients with NDMM whose disease had progressed following first-line treatment in the 3 months before data collection in 2016 in five European countries (France, Germany, Italy, Spain and the United Kingdom).ResultsThe aggregated study p

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… Effects of zoledronic acid versus clodronic acid on skeletal morbidity in patients with newly diagnosed multiple myeloma (MRC myeloma IX): secondary outcomes from a randomised controlled trial. Lancet Oncol. 2011;12(8):743–752. doi: 10.1016/S1470-2045(11)70157-7. 10. …

Comprehensive Study of the Risk Factors for Medication-Related Osteonecrosis of the Jaw Based on the Japanese Adverse Drug Event Report Database.

Medication-related osteonecrosis of the jaw (MRONJ) is associated with many drugs, including bisphosphonates (BPs). BPs are associated with atypical femoral fractures and osteonecrosis of the external auditory canal. Thus, many drugs are reported to cause adverse effects on bone. This study aimed to investigate the effects of drugs and patient backgrounds regarding osteonecrosis-related side effects, including MRONJ. This study used a large voluntary reporting database, namely, the Japanese Adverse Drug Event Report database. First, we searched for risk factors related to MRONJ using volcano p

Genetic Background of Medication-Related Osteonecrosis of the Jaw: Current Evidence and Future Perspectives.

Medication-related osteonecrosis of the jaw (MRONJ) is a rare side effect of antiresorptive drugs that significantly hinders the quality of life of affected patients. The disease develops in the presence of a combination of factors. Important pathogenetic factors include inflammation, inhibition of bone remodeling, or genetic predisposition. Since the first description of this rare side effect in 2003, a growing body of data has suggested a possible role for genetic factors in the disease. Several genes have been suggested to play an important role in the pathogenesis of MRONJ such as SIRT1, V

Efficacy of percutaneous vertebroplasty for the relief of osteoblastic spinal metastasis pain.

The aim of the present manuscript was to retrospectively evaluate the efficacy of fluoroscopy-guided percutaneous vertebroplasty (PVP) for the relief of osteoblastic spinal metastases pain. PVP was performed in 39 consecutive patients with 82 osteoblastic metastatic spinal vertebras. 19 vertebras had pathologic compressive fracture and the other 63 vertebras had no compressive fracture with obvious imaging abnormalities. The ages of the patients ranged from 40 to 77 years with a mean age of 58.5±9.0 years. Visual analog scale (VAS) and QLQ-BM22 score were used to evaluate pain and quality of l

Zoledronic Acid may reduce intraoperative bleeding in spinal tumors: a prospective cohort study.

Between June 2010 and June 2011, 176 patients were divided into 2 groups: a group with spinal metastasis of solid tumors (n = 157) and a group with multiple myeloma (n = 19). Both groups were further divided into 2 subgroups: a group receiving zoledronic acid before surgery and a control group. The zoledronic acid subgroup of the solid tumors group was group A (n = 81), the control subgroup of the solid tumors group was group B (n = 76), the zoledronic acid subgroup of the multiple myeloma group was group C (n = 10), and the control subgroup of the multiple myeloma group was group D (n = 9). T

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… Effects of zoledronic acid versus clodronic acid on skeletal morbidity in patients with newly diagnosed multiple myeloma (MRC Myeloma IX): secondary outcomes from a randomised controlled trial The Lancet Oncology 2011 12 8 743 752 10.1016/S1470-2045(11)70157-7 2-s2.0-79960891058 21771568 PMC3148431 …

Medication-Related Osteonecrosis of the Jaws in Patients on Antiresorptive Medication With Dental Implants. A Scoping Review.

OBJECTIVES: Patients receiving antiresorptive medication (AR) for osteoporosis or cancer are at risk of medication-related osteonecrosis of the jaws (MRONJ), especially after surgical procedures. Dental implant (DI) placement in high-dose AR (HDAR) patients is widely discouraged, and thorough counseling is recommended for low-dose AR (LDAR) patients. However, data on the role of AR type, dose, and duration remain limited. This review evaluates MRONJ associated with DIs, focusing on AR type and accumulated dose, and identifies local and systemic risk factors. MATERIALS AND METHODS: This review

The Impact of Immune System in Regulating Bone Metastasis Formation by Osteotropic Tumors.

Bone metastases are frequent and debilitating consequence for many tumors, such as breast, lung, prostate, and kidney cancer. Many studies report the importance of the immune system in the pathogenesis of bone metastasis. Indeed, bone and immune system are strictly linked to each other because bone regulates the hematopoietic stem cells from which all cells of the immune system derive, and many immunoregulatory cytokines influence the fate of bone cells. Furthermore, both cytokines and factors produced by immune and bone cells promote the growth of tumor cells in bone, contributing to supporti

Unexpected massive bleeding caused by extensive maxillary osteonecrosis in a breast cancer patient: a case report.

Diphosphonate application is routinely recommended to treat bone metastasis (BM) in cancer patients. However, the severe side effects of diphosphonate, especially after long-term use, are often overlooked by clinicians. In this article, we describe a case in which a heavily-treated breast cancer patient, suffered from massive bleeding as a result of maxillary osteonecrosis by zoledronic acid (ZA) and apatinib. In October 2018, a 48-year-old Chinese female with breast cancer presented at our department with brain metastases. The patient had experienced progression multiple times and had receive

A systematic review of dosing frequency with bone-targeted agents for patients with bone metastases from breast cancer.

BackgroundBone-targeted agents are usually administered to breast cancer patients with bone metastases every 3-4 weeks. Less frequent ('de-escalated') treatment may provide similar benefits with improved safety and reduced cost.MethodsTo systematically review randomised trials comparing de-escalated treatment with bone-targeted agents (i.e. every 12-16 weeks) to standard treatment (i.e. every 3-4 weeks), a formal systematic review of the literature was performed. Two individuals independently screened citations and full text articles. Random effects meta-analyses of clinically important outcom

Synthesis and biological evaluation of a new polymeric conjugate and nanocarrier with osteotropic properties.

Bone-seeking (osteotropic) drug delivery systems (ODDS) represent an interesting solution for targeting different types of drugs to the bones. In particular, anticancer and antibacterial agents could take advantage of such therapeutic strategy. We have recently developed an innovative approach to this aim: a new osteotropic biomaterial was prepared, based on the conjugation of a poly(lactide-co-glycolide) (PLGA) with the bisphosphonate drug alendronate (PLGA-ALE); its hemo- and cytocompatibility were verified. Starting with this copolymer, an osteotropic nanoparticle system (NP) was produced f

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… Bisphosphonate prodrugs: Synthesis and in vitro evaluation of novel acyloxyalkyl esters of clodronic acid J Med Chem 1999 2 5053 5058 10585214 10.1021/jm991109o 24. …

Multiple myeloma in the very elderly patient: challenges and solutions.

Diagnosis and management of myeloma in the very elderly patient is challenging. Treatment options have vastly improved for elderly myeloma patients but still require the clinician to personalize therapy. In this paper, we offer evidence-based, pragmatic advice on how to overcome six of the main challenges likely to arise: 1) diagnosis of myeloma in this age group, 2) assessment of the need for treatment, and the fitness for combination chemotherapy, 3) provision of the best quality of supportive care, 4) choice of combination chemotherapy in those fit enough for it, 5) treatment of relapsed my

Совпадение в полном тексте источника
… First-line treatment with zoledronic acid as compared with clodronic acid in multiple myeloma (MRC Myeloma IX): a randomised controlled trial. Lancet. 2010;376(9757):1989–1999. doi: 10.1016/S0140-6736(10)62051-X. 31. Knudsen LM, Hippe E, Hjorth M, Holmberg E, Westin J. …