Endocrine Practice最新文献

{"title":"Prevalence of Diabetes-related Autoantibodies Among Individuals With Type 2 Diabetes From Primary Care and Endocrinology Community Practice Settings.","authors":"Laura D Lomeli, Michelle D Lundholm, Huijun Xiao, Keren Zhou, Kevin M Pantalone","doi":"10.1016/j.eprac.2025.05.748","DOIUrl":"10.1016/j.eprac.2025.05.748","url":null,"abstract":"<p><strong>Objective: </strong>The full implications of diabetes-related autoantibodies for classification and management of type 2 diabetes remain undetermined. To date, there are limited data on autoantibody positivity in community-based samples in the United States. This study assessed and compared the prevalence of diabetes-related autoantibodies in a community-based population of individuals with type 2 diabetes managed by endocrinology or primary care providers (PCPs).</p><p><strong>Methods: </strong>This single-center cross-sectional study enrolled 202 adults (102 in endocrinology and 100 in PCPs) with type 2 diabetes without a history of latent autoimmune diabetes of adulthood. Glutamic acid decarboyxlase-65, anti-islet cell, insulinoma-associated-2, zinc transporter 8, and anti-insulin antibodies were determined.</p><p><strong>Results: </strong>Among 199 participants with full antibody panel testing results, 13.6% tested positive for at least one diabetes-related autoantibody; prevalence trended higher, but nonsignificantly, among individuals managed by endocrinologists (16.0%) vs PCPs (11.1%). GAD-65 positivity was 4.5%. No participants displayed anti-islet cell autoantibodies. After excluding an additional 12 individuals positive for only anti-insulin antibodies, 8.0% of the remaining participants were autoantibody-positive (median age, 71 years; median body mass index, 31.8 kg/m²).</p><p><strong>Conclusions: </strong>The prevalence of diabetes-related autoantibodies in individuals with type 2 diabetes in a U.S. community-based care setting, most of whom did not display LADA phenotype characteristics, was notable and similar regardless of management by endocrinology or PCP practices. Although further studies are needed to assess the clinical implications of these findings, it is possible that proactive awareness of autoantibody status in individuals with type 2 diabetes could provide additional context to help guide treatment decisions.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis Frequency and Associated Factors of Nonalcoholic Fatty Liver Disease Among United States Hospitalized Adults in Urban vs Rural Populations From 2007 to 2019: An Emerging Public Health Crisis","authors":"Judy Huynh BS,&nbsp;Asef Raiyan Hoque MA,&nbsp;S. Sethu K. Reddy MD, MBA, FACP, MACE","doi":"10.1016/j.eprac.2025.05.740","DOIUrl":"10.1016/j.eprac.2025.05.740","url":null,"abstract":"<div><h3>Objective</h3><div>To describe and understand differences between United States rural and urban populations with respect to outcomes of hospitalization and related epidemiology of nonalcoholic fatty liver disease (NAFLD).</div></div><div><h3>Methods</h3><div>We analyzed data from the Healthcare Cost and Utilization Project National Inpatient Sample from 2007 to 2019, identifying 847 165 NAFLD cases, of which 370 131 met inclusion criteria. Statistical analyses included Pearson's chi-square, independent samples <em>t</em>-tests, Mann-Whitney <em>U</em> tests, and multivariate logistic regression models to examine factors associated with NAFLD.</div></div><div><h3>Results</h3><div>Hospitalizations due to NAFLD significantly increased over time from 2007 to 2019 with urban cases constituting 84.9% while rural cases represented 15.1%. Differences in demographics, hospital characteristics, insurance, income, and outcomes were significant between the 2 groups. Multivariate analysis showed higher odds of NAFLD diagnosis in fringe metro areas (adjusted odds ratio [aOR] = 1.074, 95% CI = 1.044-1.105), medium metro counties (aOR. = 1.146, 95% CI = 1.114-1.179), small metro counties (aOR = 1.182, 95% CI = 1.140-1.226), and rural regions (aO R = 1.279, 95% CI = 1.233-1.327) compared to central metro areas. NAFLD was more prevalent in females, those aged 35-49 or 50-64 years, and White patients, particularly among those with diabetes, metabolic syndrome, and obesity.</div></div><div><h3>Conclusion</h3><div>The increasing prevalence of NAFLD suggests a strong association with metabolic and cardiovascular diseases. With increasing closure of rural hospitals, we may see more rural patients with NAFLD admitted to urban centers. Early detection and diagnosis should help prevent long-term complications of NAFLD.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 8","pages":"Pages 1002-1010"},"PeriodicalIF":3.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuous Glucose Monitoring for Prediabetes: Roles, Evidence, and Gaps","authors":"Salwa J. Zahalka MD ,&nbsp;Halis K. Akturk MD ,&nbsp;Rodolfo J. Galindo MD, FACE ,&nbsp;Viral N. Shah MD ,&nbsp;Cecilia C. Low Wang MD, FACE, FACP","doi":"10.1016/j.eprac.2025.05.742","DOIUrl":"10.1016/j.eprac.2025.05.742","url":null,"abstract":"<div><div>Continuous glucose monitoring (CGM) has transformed the care of patients with diabetes, and there is great potential to extend these benefits to prediabetes. The recent US Food and Drug Administration approval of over-the-counter CGMs has increased interest for use in individuals with prediabetes. It is of particular interest to use CGM to guide early individualized lifestyle interventions to prevent the progression of prediabetes to diabetes and support reversion to normoglycemia. In this review, we discuss published evidence regarding CGM metrics in normoglycemia, briefly review the use of CGM to diagnose prediabetes, and review available evidence for CGM use during lifestyle interventions in individuals with prediabetes. Future studies are needed to validate CGM metrics for prediabetes and evaluate effects of early intervention with CGM in this population.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 8","pages":"Pages 1054-1060"},"PeriodicalIF":3.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuous Subcutaneous Hydrocortisone Infusion in Adrenal Insufficiency: Practical Experience in 33 Subjects","authors":"Jane Lee MD,&nbsp;Oksana Hamidi DO,&nbsp;Emily Simon APRN,&nbsp;Sasan Mirfakhraee MD","doi":"10.1016/j.eprac.2025.05.004","DOIUrl":"10.1016/j.eprac.2025.05.004","url":null,"abstract":"<div><h3>Objectives</h3><div>Diminished subjective health status and increased mortality have been reported in people with adrenal insufficiency (pwAI) receiving conventional glucocorticoid replacement therapy. Continuous subcutaneous hydrocortisone infusion (CSHI) permits individualized glucocorticoid delivery and mimics a more physiologic cortisol pattern compared with oral glucocorticoid therapy. However, data are limited regarding patient selection for CSHI, optimal dosing of CSHI, and CSHI impact on relevant clinical outcomes.</div></div><div><h3>Methods</h3><div>We performed a single-center, retrospective longitudinal cohort study in 33 consecutive pwAI offered a therapeutic trial of CSHI due to persistent AI symptoms.</div></div><div><h3>Results</h3><div>Our cohort comprised of 33 pwAI (82% women). Nine (27.3%) had primary adrenal insufficiency, 16 (48.5%) had secondary AI, and 8 (24.2%) had glucocorticoid-induced AI. The median total daily dose of glucocorticoid (in hydrocortisone equivalent) decreased from 30 mg/d (range, 15-180 mg) before CSHI to 26.7 mg/d (<em>P</em> = .013) at CSHI initiation and 26.6 mg/d (<em>P</em> = .023) at last encounter. The median number of ED visits/year due to adrenal crisis decreased from 0.5 (range, 0-3.4) to 0 (<em>P</em> = .002) and median number of hospitalization days/y decreased from 0.2 (range, 0-18) to 0 (<em>P</em> = .019) after switching to CSHI. There was a numerical increase in subjective health scores (SF-36 survey) following CSHI use. No significant differences were noted for change in weight, blood pressure, diabetes, cardiovascular/cerebrovascular events, total cholesterol, LDL, and/or triglyceride concentrations pre and post CSHI. At study conclusion, most patients (84.8%) remained on CSHI based on personal preference and tolerability.</div></div><div><h3>Conclusions</h3><div>CSHI is a safe and effective means of delivering individualized glucocorticoid therapy to pwAI.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 8","pages":"Pages 987-994"},"PeriodicalIF":3.7,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative Fine-Needle Aspiration in Goiter With Compressive Symptoms: A Systematic Review and Meta-analysis","authors":"Moeen Sbeit BSc ,&nbsp;Rania Faris BSc, MA ,&nbsp;Ohad Ronen MD","doi":"10.1016/j.eprac.2025.05.002","DOIUrl":"10.1016/j.eprac.2025.05.002","url":null,"abstract":"<div><h3>Objective</h3><div>There are currently no firm recommendations regarding the necessity of preoperative fine-needle aspiration (FNA) in patients with symptomatic goiter. FNA is an efficient and reliable method for determining the risk of malignancy of thyroid nodules; thus, it became the primary procedure for diagnosing neoplasms and guiding surgical treatment.</div><div>We performed this systematic review of articles to establish the necessity of FNA in patients with compressive goiter.</div></div><div><h3>Methods</h3><div>Following PRISMA guidelines, a systematic literature search was conducted using electronic databases. Included were studies dealing with euthyroid goiter and compressive symptoms in adult patients designated to undergo therapeutic surgery. Two reviewers independently extracted the data and assessed the risk of bias using the risk of bias visualization (<em>ROBVIS</em>; visualization tool). Our main outcome measure was final histology compared with preoperative FNA.</div></div><div><h3>Results</h3><div>The initial search identified 3304 relevant studies. After screening and quality assessment, 14 studies were included in the systematic review. The FNA accuracy of malignant and nonmalignant nodules diagnosed correctly preoperatively was 88.4%. In a meta-analysis that included both benign and malignant preoperative FNA results with subsequent postoperative histology, we observed a relative risk of 0.79.</div></div><div><h3>Conclusion</h3><div>Our data underscore the significant value of preoperative FNA when planning a thyroidectomy for patients with a goiter. The FNA results enable both the physician and the patient to make informed decisions, consider a staged surgical approach if necessary, determine an appropriate follow-up strategy, and discuss potential complications based on the preoperative findings.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 8","pages":"Pages 1038-1045"},"PeriodicalIF":3.7,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Life-Saving Drug or Potential Threat? The Role of Mineralocorticoid Receptor Antagonists in Myocardial Infarction: A Meta-Analysis","authors":"Xiangfeng Guan MMed ,&nbsp;Ju Zhang MMed ,&nbsp;Yang Yu MD,&nbsp;Chunxiang Zhang MD, PhD","doi":"10.1016/j.eprac.2025.05.001","DOIUrl":"10.1016/j.eprac.2025.05.001","url":null,"abstract":"<div><div>Mineralocorticoid receptor antagonists (MRAs) have been studied as a potential therapeutic option to improve outcomes in patients with myocardial infarction (MI). Although several randomized controlled trials have evaluated the effectiveness of MRAs in post-MI patients, the specific effects remain debated. We systematically searched databases including Web of Science, PubMed, Embase, and Cochrane Library. The primary efficacy outcome was death from any cause. Secondary efficacy outcomes included death from cardiovascular causes, death from MI, and others. Subgroup analyses were performed based on the presence of heart failure and the type of MRA used. Safety outcomes included hyperkalemia, hypokalemia, breast tenderness, and gynecomastia. A total of 13 randomized controlled trials involving 17 851 patients were included. The results demonstrated that MRAs significantly reduced the risk of death from any cause (relative risk [RR] 0.87; 95% CI 0.79-0.95; <em>P</em> = .004). Subgroup analysis indicated that the effectiveness of MRAs varied based on the presence of heart failure. MRAs significantly reduced the risk of death from cardiovascular causes in heart failure patients (RR 0.87; 95% CI 0.78-0.97), but had no significant effect in patients without heart failure (RR 0.69; 95% CI 0.34-1.38). Furthermore, subgroup analysis based on different MRA drugs showed varying effects on outcomes. While some adverse events, such as hyperkalemia (RR 1.95; 95% CI 1.55-2.46; <em>P</em> &lt; .01), were significantly more frequent, other safety events did not show significant differences. MRAs improve cardiovascular outcomes in MI patients, especially in those with heart failure. When choosing a specific MRA drug, eplerenone or spironolactone is recommended.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 8","pages":"Pages 1061-1070"},"PeriodicalIF":3.7,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Performance of Noninvasive Tests for Identifying Advanced Fibrosis in Metabolic Dysfunction-Associated Fatty Liver Disease With Mixed Etiologies","authors":"He Yi MD ,&nbsp;Yan Zhang MD ,&nbsp;Ziwei Zhou MD ,&nbsp;Weixia Sun MD ,&nbsp;Yifan Wang MD ,&nbsp;Wenxuan Tao MD ,&nbsp;Hekai Yu MD ,&nbsp;Liqin Yao MD, PhD ,&nbsp;Jia Li MD, PhD ,&nbsp;Ling Li MD, PhD","doi":"10.1016/j.eprac.2025.04.021","DOIUrl":"10.1016/j.eprac.2025.04.021","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess the performance of fibrosis-4 index (FIB-4), nonalcoholic fatty liver disease fibrosis score (NFS) and aspartate aminotransferase to platelet ratio index (APRI) for advanced fibrosis in metabolic dysfunction-associated fatty liver disease (MAFLD) subgroups categorized by concomitant liver conditions.</div></div><div><h3>Methods</h3><div>We conducted a multicentered study comprising inpatients with type 2 diabetes mellitus and MAFLD. Participants were categorized into 2 groups: MAFLD with pure metabolic etiologies (MAFLD-P) and MAFLD with mixed etiologies (MAFLD-M). Diagnostic performance of FIB-4, NFS, and APRI was assessed by area under the curve (AUC), sensitivity, and specificity.</div></div><div><h3>Results</h3><div>This study comprised a total of 1475 participants, with a mean (SD) age of 58.4 (13) years and 835 (56.6%) males. FIB-4 and APRI had higher AUCs for advanced fibrosis in the MAFLD-M group than in the MAFLD-P group (MAFLD-M vs MAFLD-P: FIB-4 0.680 vs 0.591, <em>P</em> = .0442; APRI 0.723 vs 0.631, <em>P</em> = .0363). No significant difference was observed in the AUC of NFS between the 2 subgroups (MAFLD-M 0.572 vs MAFLD-P 0.617; <em>P</em> = .3237). Besides, the sensitivity of FIB-4 (69.6% vs 54.0%; <em>P</em> = .019) and APRI (43.5% vs 26.1%; <em>P</em> = .005) was higher in the MAFLD-M group. However, no significant difference in sensitivity of NFS and specificity of FIB-4, NFS, and APRI was observed between subgroups.</div></div><div><h3>Conclusions</h3><div>In this diagnostic study of the type 2 diabetes mellitus population, FIB-4 and APRI showed better performance for identifying advanced fibrosis in MAFLD with mixed etiologies.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 8","pages":"Pages 995-1001"},"PeriodicalIF":3.7,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Teprotumumab in Thyroid Eye Disease: A Systematic Review and Meta-Analysis","authors":"Wenxin Huang MM ,&nbsp;Xiaodan Ou MD ,&nbsp;Shuzhen Lin MM ,&nbsp;Wei Lin MD ,&nbsp;Gang Chen MD, PhD ,&nbsp;Huibin Huang MD ,&nbsp;Junping Wen MD, PhD","doi":"10.1016/j.eprac.2025.01.012","DOIUrl":"10.1016/j.eprac.2025.01.012","url":null,"abstract":"<div><h3>Objective</h3><div>Teprotumumab was approved by the US Food and Drug Administration (FDA) for treating Graves' orbitopathy in adults on January 21, 2020. This study evaluates its efficacy and safety in treating thyroid eye disease (TED).</div></div><div><h3>Methods</h3><div>We reviewed studies on teprotumumab for TED treatment from PubMed, Web of Science, EMBASE, Cochrane library, and Clinical trials. gov up to January 1, 2024. Outcomes included proptosis response, diplopia, Clinical Activity Score (CAS) score, and adverse events (AEs).</div></div><div><h3>Results</h3><div>Our analysis included 10 studies, 4 randomized controlled trials, and 6 observational studies. The randomized controlled trials involved 210 teprotumumab patients and 193 controls. Teprotumumab significantly improved proptosis response (relative risk [RR] 4.18, 2.72-6.43), diplopia regression (RR 2.29, 1.54-3.41), and CAS score (RR 3.09, 1.98-4.80) compared to placebo. A significant reduction in proptosis was observed (standardized mean difference −8.38, −9.25 - −7.52). The risk of AEs and serious AEs was higher with teprotumumab. The 6 observational studies included 211 patients, showing an 82% proptosis response rate, a −3.31 mm change in proptosis, a 0.58 diplopia improvement rate, and a 0.66 pooled effect size for CAS score. AE incidence was 0.78, and serious AEs were 0.31.</div></div><div><h3>Conclusion</h3><div>Teprotumumab effectively reduces proptosis, improves diplopia, and lowers disease activity in TED, regardless of previous treatments, severity, or dosage, albeit with increased AEs. It has the potential to become a vital first-line treatment for TED, enhancing patient quality of life.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 5","pages":"Pages 640-649"},"PeriodicalIF":3.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Link Between Thyroid Disorders and Obesity: Mechanisms, Impacts, and Clinical Implications","authors":"Ashni Dharia MD ,&nbsp;Dimpi Desai MD ,&nbsp;Kaniksha Desai MD","doi":"10.1016/j.eprac.2025.02.005","DOIUrl":"10.1016/j.eprac.2025.02.005","url":null,"abstract":"<div><h3>Objective</h3><div>Obesity and thyroid dysfunction are among the most significant challenges in endocrinology, frequently overlapping to create complexities in weight management. Even after achieving euthyroidism, weight variations persist, significantly affecting patients' quality of life. This review explores the mechanisms linking hypothyroidism and hyperthyroidism to weight fluctuations, emphasizing their impact on basal metabolic rate, appetite regulation, glucose and lipid metabolism, and thermogenesis.</div></div><div><h3>Methods</h3><div>We conducted a comprehensive review using PubMed and Google Scholar, applying the search criteria: (obesity OR overweight) AND (Hashimoto's thyroiditis OR hyperthyroidism OR hypothyroidism OR Thyroid Cancer). From this search, we reviewed 500 publications and finally included 71 publications, focusing on broad clinical questions regarding the role of thyroid hormones in weight regulation and metabolism, the impact of thyroid disorders and their treatments on obesity, and approaches for managing obesity in the context of thyroid dysfunction.</div></div><div><h3>Results</h3><div>In hypothyroidism, the impact of levothyroxine therapy on weight changes is discussed, along with the potential role of T3 supplementation. For hyperthyroid patients, the effects of antithyroid medications, radioactive iodine therapy, and thyroidectomy on weight regulation are explored. Pharmacological and nonpharmacological strategies for managing obesity in thyroid disorders are reviewed. Lifestyle interventions and pharmacotherapies are evaluated for their efficacy and potential effects on thyroid function. Lastly, the implications of bariatric surgery are explored, including its effects on thyroid function, medication absorption, and postsurgical management of thyroid disorders.</div></div><div><h3>Conclusion</h3><div>This review underscores the importance of an integrated, multidisciplinary approach to managing obesity in the context of thyroid dysfunction to optimize patient outcomes.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 5","pages":"Pages 660-667"},"PeriodicalIF":3.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antiresorptive Therapy to Reduce Fracture Risk and Effects on Dental Implant Outcomes in Patients With Osteoporosis: A Systematic Review and Osteonecrosis of the Jaw Taskforce Consensus Statement","authors":"Dalal S. Ali MD, MSc, FRCPI ,&nbsp;Aliya A. Khan MD, FRCPC, FACP, FACE, FASBMR ,&nbsp;Archibald Morrison DDS, PhD ,&nbsp;Sotirios Tetradis DDS, PhD ,&nbsp;Reza D. Mirza MD, MSc, FRCPC ,&nbsp;Mohamed El Rabbany DDS, MSc, PhD, FRCDC ,&nbsp;Bo Abrahamsen MD, PhD ,&nbsp;Tara L. Aghaloo DDS, MD, PhD ,&nbsp;Hatim Al-Alwani MD ,&nbsp;Rana Al-Dabagh DDS ,&nbsp;Athanasios D. Anastasilakis MD ,&nbsp;Mohit Bhandari O.Ont, MD, PhD, FRCSC ,&nbsp;Jean-Jacques Body MD ,&nbsp;Maria Luisa Brandi MD, PhD ,&nbsp;Romina Brignardello-Petersen PhD ,&nbsp;Jacques P. Brown MD ,&nbsp;Angela M. Cheung MD ,&nbsp;Juliet Compston MD ,&nbsp;Cyrus Cooper MD ,&nbsp;Adolfo Diez-Perez MD, PhD ,&nbsp;Salvatore L. Ruggiero DMD, MD, FACS","doi":"10.1016/j.eprac.2025.02.016","DOIUrl":"10.1016/j.eprac.2025.02.016","url":null,"abstract":"<div><h3>Objective</h3><div>Placement of a dental implant in a patient on antiresorptive therapy has been hypothesized to increase the risk of medication-related osteonecrosis of the jaw (MRONJ) and/or impact implant survival. In patients with osteoporosis, the risk of MRONJ with antiresorptive therapy is only marginally higher than observed in the general population.</div></div><div><h3>Methods</h3><div>The International ONJ Taskforce conducted a systematic review of the literature and evaluated the outcomes of implant placement in individuals with osteoporosis receiving antiresorptive therapy.</div></div><div><h3>Results</h3><div>The data were reviewed by the International Taskforce, and consensus was achieved on the following GRADEd recommendation. In patients with osteoporosis on antiresorptive therapy, the Taskforce suggests that antiresorptive therapy does not need to be stopped prior to proceeding with dental implant (weak recommendation, very low-quality evidence). Long-term bisphosphonate use maybe associated with a small increase in the risk of MRONJ (3 cases per 1000 patients; adjusted hazard ratio: 4.09, 95% CI: 2.75-6.09, <em>P</em> &lt; .001, moderate certainty).</div></div><div><h3>Conclusion</h3><div>Current evidence does not suggest an association between antiresorptive therapy in patients with osteoporosis and dental implant failure. Implants may be safely placed in the presence of concomitant use of bisphosphonates or denosumab in patients with osteoporosis with no evidence of an increased risk of implant failure/compromise.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 5","pages":"Pages 686-698"},"PeriodicalIF":3.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143906535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}