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[Elastic sliding central medullary nailing with osteogenesis imperfecta. Fourteen cases at eight years follow-up].

PURPOSE OF THE STUDY: Elastic sliding centromedullary nailing (ESCN) proposed by Métaizeau in 1987 for the prevention and treatment of limb fractures in osteogenesis imperfecta has never been evaluated. A multicentric serie was studied in order to evaluate results of these procedure. MATERIAL AND METHODS: Thirty-six ESCN procedures were performed in fourteen patients. Percutaneous pinning was used for the femur and distal tibia and arthrotomy for the distal femur as needed and in all cases for the proximal tibia. The pins were bent in compliance with the principles of the ESCN system. The end

Novel therapeutic options for osteoporosis.

Osteoporosis remains a significant clinical problem despite effective therapies. Many patients cannot or will not take currently available therapies. For this reason, research continues in search of more effective and more tolerable agents. Arzoxifene and TSE-424 are investigational selective estrogen receptor modulators that have been shown to be effective in animal studies and are now in clinical studies. Tibolone is a tissue-specific steroid that is currently used in Europe for the prevention and treatment of osteoporosis. Multiple studies have shown efficacy in improving bone mineral densi

Therapeutic strategy in Paget's disease of bone.

Paget's disease of bone is a localized progressive disease, characterized by increased bone remodeling, bone hypertrophy, and abnormal bone structure, leading to pain and deformity. Disease complications involve the bones, joints, and central nervous system. Short-term treatment objectives are to alleviate or suppress bone pain; the long-term aim is for the prevention of complications caused by the slow disease progression in affected bones. The lifetime risk of complications depends on life expectancy, location, and activity index of Paget's disease. The use of potent and safe new bisphosphon

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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… Prevention by a diphosphonate of immobilisation ‘osteoporosis’ in rats. Nature. 1969;223:211–222. doi: 10.1038/223211a0. 29. Bassett C., Donath A., Macagno F., Preisig R., Fleisch H., Francis M. Diphosphonates in the treatment of myositis ossificans. … Diphosphonates and Paget’s disease of bone. Lancet. 1971;1:945–947. doi: 10.1016/S0140-6736(71)91447-4. 31. Russell R.G.G., Smith R., Preston C., Walton R.J., Woods C.F. Diphosphonates in Paget’s disease. Lancet. 1974;1:894–898. doi: 10.1016/S0140-6736(74)90347-X. 32. …

Multiple Myeloma (Part 2) - Update on The Approach to Bone Disease.

The increase in life expectancy of the world population has led to a concomitant increase in the prevalence of multiple myeloma (MM), a disease that usually affects the elderly population. Bone lesions are frequent in patients with this condition, demanding an early approach, from drug treatment, through radiotherapy to orthopedic surgery (prophylactic or therapeutic) with the objective of preventing or delaying the occurrence of fracture, or, when this event has already occurred, treat it through stabilization or replacement (lesions located in the appendicular skeleton) and/or promote stabil

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… Diphosphonates are pyrophosphate analogues that bind to exposed areas of hydroxyapatite crystals during the bone remodeling process. … Diphosphonates should be discontinued when osteonecrosis of the jaw is present, unless ongoing treatment is required (MMBD progression or recurrent hypercalcemia). …

Assessing Clinician Prescribing Practices for Prophylaxis and Treatment of Acute Phase Responses Following IV Bisphosphate Infusions for Osteoporosis: A Pilot Survey-Based Study.

OBJECTIVE: There appear to be no definitive guidelines on optimal prevention and management of acute phase responses (APRs) following intravenous bisphosphonates (IVBP) for osteoporosis. Our objective was to identify physician prescribing practices for supplementary therapy aimed at managing APRs and whether these were thought beneficial. METHODS: An online survey was distributed to members of key Australian societies for geriatrics, rheumatology and endocrinology (membership n ≈ 2900) with questions assessing if respondents prescribed IVBP, their experience managing APRs including medication

Prescribing of Medication to Prevent Glucocorticoid Harms in Patients With Polymyalgia Rheumatica: A Cross-Sectional Study and Two Emulated Target Trials in the Clinical Practice Research Datalink Aurum.

OBJECTIVE: Polymyalgia rheumatica (PMR) is a common indication for long-term glucocorticoid (GC) treatment. Bone-protective and gastroprotective medications are recommended for those at high risk of adverse events from GCs, but no trials have evaluated their effectiveness in PMR. We describe bone-protective and gastroprotective medicine prescribing in people with PMR and evaluate its impact on adverse GC outcomes using a target trial approach. METHODS: A sample of >40,000 individuals aged ≥50 years with a coded PMR diagnosis from January 2010 to March 2022 who were prescribed GCs within 21 da

Baseline Bone Mineral Density Predicts Treatment Switch in Pediatric Chronic Nonbacterial Osteomyelitis: A Real-World Cohort Study.

OBJECTIVES: To assess whether baseline bone mineral density (BMD) influences treatment response and predicts the need for treatment switching in patients with chronic nonbacterial osteomyelitis (CNO). METHODS: Demographics and clinical characteristics of patients, 25-OH vitamin D levels, radiologic findings (dual-energy X-ray absorptiometry, magnetic resonance imaging), and treatment switching were evaluated. First, patients were divided into 2 groups based on their treatment options: group 1 (NSAIDs/cDMARDs) and group 2 (TNFi/bisphosphonates). In addition, predictive factors for treatment sw

The effects of teriparatide and bisphosphonates on new fractures in postmenopausal women with osteoporosis: A protocol for systematic review and meta-analysis.

BACKGROUND: To systematically evaluate the efficacy of teriparatide and bisphosphonates in preventing fractures in postmenopausal women with osteoporosis. MATERIALS AND METHODS: We performed a systematic search of PubMed, Embase, and the Cochrane Library for randomized controlled trials (RCTs) that compared teriparatide and bisphosphonates for osteoporosis treatment. Searches were performed without language restrictions and included studies from beginning of time to March 2019. Two authors independently screened and extracted the selected article. The quality of the included studies was evalu

DPD Quantification in Cardiac Amyloidosis: A Novel Imaging Biomarker.

OBJECTIVES: To assess whether single-photon emission computed tomography (SPECT/CT) quantification of bone scintigraphy would improve diagnostic accuracy and offer a means of quantifying amyloid burden. BACKGROUND: Transthyretin-related cardiac amyloidosis is common and can be diagnosed noninvasively using bone scintigraphy; interpretation, however, relies on planar images. SPECT/CT imaging offers 3-dimensional visualization. METHODS: This was a single-center, retrospective analysis of 99mTc-3,3-diphosphono-1,2-propanodicarboxylic acid (DPD) scans reported using the Perugini grading system (

Pharmacological evaluation of imidazole-derived bisphosphonates on receptor activator of nuclear factor-κB ligand-induced osteoclast differentiation and function.

Bisphosphonates (BPs) have been commonly used in the treatment of osteolytic bone lesions, such as osteoporosis and osteogenesis imperfecta. However, serious side-effects can occur during the therapy. To search for novel potent BPs with lower side-effects, a series of imidazole-containing BPs (zoledronic acid [ZOL]; ZOL derivatives by substitution of the hydrogen at the 2-position on the imidazole ring with a methyl [MIDP], ethyl [EIDP], n-propyl [PIDP], or n-butyl group [BIDP]) were developed and the effects on receptor activator of nuclear factor-κB ligand (RANKL)-induced osteoclast differen

Bisphosphonate use and incident cardiovascular events among older breast cancer survivors.

BACKGROUND: Cardiovascular disease (CVD) is a leading cause of mortality in early-stage breast cancer survivors. Recent studies suggest that bisphosphonates may decrease CVD risk in older patients. OBJECTIVE: This study sought to assess whether bisphosphonate use is associated with lower rates of incident CVD events among early-stage breast cancer survivors. METHODS: Longitudinal, population-based cohort study was conducted by using data from the Surveillance, Epidemiology and End Results registry linked to Medicare claims. We identified women >65 years with no history of CVD who were diagno

[Osteoporosis and chronic kidney disease: review and new therapeutic strategies].

Osteoporosis affects a segment of the population in which Chronic Kidney Disease is also greatly represented. Nephropathic patients may present peculiar biochemical abnormalities related to Chronic Kidney Disease, defining the Mineral and Bone Disorder. This kind of anomalies, in the worst scenarios, configure the typical histomorphology patterns of Renal Osteodystrophy. Scientific Societies of Endocrinology have established therapy guidelines for patients with osteoporosis only based on the glomerular filtration rate and recommend avoiding the use of some drugs for the more advanced classes o

Oral bisphosphonate use and age-related macular degeneration: retrospective cohort and nested case-control study.

Our objective here was to determine whether oral bisphosphonate (BP) use is associated with the incidence of age-related macular degeneration (AMD). We performed a population-based study using electronic health records from UK primary care (Clinical Practice Research Datalink). A cohort of 13,974 hip fracture patients (1999-2013) was used to conduct (1) a propensity score-matched cohort analysis and (2) a nested case-control analysis. Hip fracture patients were aged ≥50 years without AMD diagnosis before hip fracture date or in the first year of follow-up. Among 6208 matched patients and durin

The Efficacy of Minodronate in the Treatment of Glucocorticoid-induced Osteoporosis.

Objective To investigate the efficacy of minodronate in the treatment of glucocorticoid-induced osteoporosis (GIO). Methods The study population included patients in whom the administration of minodronate (50 mg, once every 4 weeks) had been newly started for the treatment of GIO in Niigata Rheumatic Center from 2012 to 2015. Patients who were bisphosphonate-naïve and those who switched from other bisphosphonates were classified into the naïve and switch groups, respectively. The changes in the bone mineral density (BMD) and bone metabolic markers after one year of minodronate treatment were r

Effect of a single intravenous zoledronic acid administration on biomarkers of acute kidney injury (AKI) in patients with osteoporosis: a pilot study.

AIMS: The pilot study was designed to evaluate the early effect of intravenous (i.v.) zoledronic acid (ZA) on renal function. METHODS: Five mg i.v. ZA was administered to 23 patients with osteoporosis (17 women and 6 men, mean age 73 ± 7 SD years). Urinary NGAL, KIM-1, and MCP-1, plasma (p) MCP-1 and serum (s) IL-18, serum calcium (sCa), Creatinine clearance (CrCl), parathyroid hormone (PTH), plasma C-terminal FGF23 (pFGF23), serum (s) Klotho, calcium excretion (CaEx) and renal threshold phosphate concentration/GFR (TmPO4 /GFR) were assessed at baseline, 24 h and Day 30 after administration.

Intravenous Zoledronic Acid 5 mg on Bone Turnover Markers and Bone Mineral Density in East China Subjects with Newly Diagnosed Osteoporosis: A 24-month Clinical Study.

OBJECTIVE: This randomized, double-blind, placebo-controlled study assessed the necessity of early intervention, safety and efficacy of intravenous zoledronic acid 5 mg/year in East China women with newly diagnosed osteoporosis at high risk of fracture during a 24-month treatment period. METHODS: Subjects (57 [52-62] years old) were randomized 3:2 to zoledronic acid versus placebo (randomized at baseline, zoledronic acid [175 cases], placebo-zoledronic acid [110 cases]). The bone mineral density of the lumbar spine and total hip was measured every 6 months with the use of dual-energy X-ray ab

Time to onset of bisphosphonate-related osteonecrosis of the jaws: a multicentre retrospective cohort study.

OBJECTIVES: Osteonecrosis of the jaw (ONJ) is a potentially severe adverse effect of bisphosphonates (BP). Although the risk of ONJ increases with increasing duration of BP treatment, there are currently no reliable estimates of the ONJ time to onset (TTO). The objective of this study was to estimate the TTO and associated risk factors in BP-treated patients. SUBJECTS AND METHODS: Retrospective analysis of data from 22 secondary care centres in seven countries relevant to 349 patients who developed BP-related ONJ between 2004 and 2012. RESULTS: The median (95%CI) TTO was 6.0 years in patient

Effect of anti-angiogenesis induced by chemotherapeutic monotherapy, chemotherapeutic/bisphosphonate combination therapy and anti-VEGFA mAb therapy on tooth extraction socket healing in mice.

Osteonecrosis of the jaw (ONJ), which is a rare but severe adverse effect, mainly occurs in oncology patients receiving chemotherapeutic agents and bisphosphonates. However, the combined impact of chemotherapy and bisphosphonates on wound healing after tooth extraction remains unknown. The aim of this study was to determine the precise etiology of ONJ induced by chemotherapy and bisphosphonate combination therapy. Mice received zoledronate (ZA) monotherapy, cyclophosphamide (CY) monotherapy or CY/ZA combination therapy. The maxillary first molars were extracted 3 weeks after the initiation of

[Focus: Drug-related osteonecrosis of the jaw].

Antiresorptives and antiangiogenics are treatments that have proven effective in oncology and the treatment of osteoporosis and they are increasingly prescribed. The care of these patients requires collaboration between the prescriber and the oral health professional to establish an optimized treatment plan. Therapeutic education of the patient is essential for him to understand the issues of good oral health and the adverse effects that can be caused by these treatments. The management is essentially based on the individual benefit/risk balance resulting from the general, local and inherent o