Journal of Bone and Mineral Research最新文献

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Association of vertebral fractures with worsening degenerative changes of the spine: a longitudinal study. 脊椎骨折与脊椎退行性病变恶化的关系:一项纵向研究。
IF 5.1 1区 医学
Journal of Bone and Mineral Research Pub Date : 2024-11-29 DOI: 10.1093/jbmr/zjae172
Carrie Ye, William D Leslie, Mary L Bouxsein, Alyssa B Dufour, Ali Guermazi, Daniel Habtemariam, Mohamed Jarraya, Douglas P Kiel, Pradeep Suri, Elizabeth J Samelson
{"title":"Association of vertebral fractures with worsening degenerative changes of the spine: a longitudinal study.","authors":"Carrie Ye, William D Leslie, Mary L Bouxsein, Alyssa B Dufour, Ali Guermazi, Daniel Habtemariam, Mohamed Jarraya, Douglas P Kiel, Pradeep Suri, Elizabeth J Samelson","doi":"10.1093/jbmr/zjae172","DOIUrl":"10.1093/jbmr/zjae172","url":null,"abstract":"<p><p>Vertebral compression fractures (VFs) and spinal degeneration are both common causes of back pain, particularly in older adults. Previous cross-sectional studies have shown a potential association between these entities, but there is limited evidence on the role of VFs in spinal degeneration. In this longitudinal study, we evaluated the association between prevalent VFs and the subsequent progression of facet joint osteoarthritis (FJOA) and intervertebral disc height narrowing (DHN), using data from the Framingham Heart Study Offspring and Third Generation Multi-Detector Computed Tomography study. Summary indices representing the total burden of each spinal parameter (VFs, DHN, and FJOA) were calculated for each individual. We hypothesized that prevalent VFs are associated with worsening spinal degeneration. Three hundred and seventy (31%) of 1197 participants had a baseline (prevalent) VF. The change in summary index of DHN over the follow-up period was significantly higher in those with vs without prevalent VF (difference in change in DHN 0.38, 95% CI 0.18 to 0.59, p<.001), but the change in summary index of FJOA was similar between those with and without prevalent VF. However, once adjusted for age, sex, cohort, smoking status, BMI, and baseline DHN, the change in summary index of DHN did not differ by prevalent VF status. There was a modestly higher change in the FJOA summary index in those with prevalent VFs compared to those without in the fully adjusted model (difference in change in FJOA 0.62, 95% CI -0.01 to 1.24, p = .054), driven primarily by those with severe (grade 3) VF (difference in change in FJOA 4.48, 95% CI 1.99-6.97). Moreover, there was greater change in the summary index of FJOA with increasing severity of prevalent VF (linear trend p = .005). Beyond the established morbidity and mortality associated with VFs, our study suggests that VFs may also lead to worsening spine osteoarthritis.</p>","PeriodicalId":185,"journal":{"name":"Journal of Bone and Mineral Research","volume":" ","pages":"1744-1751"},"PeriodicalIF":5.1,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11638720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142454262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Expression of Concern: CYP4A22 loss-of-function causes a new type of vitamin D-dependent rickets (VDDR1C). 表达关切:CYP4A22 功能缺失会导致一种新型维生素 D 依赖性佝偻病(VDDR1C)。
IF 5.1 1区 医学
Journal of Bone and Mineral Research Pub Date : 2024-11-29 DOI: 10.1093/jbmr/zjae168
{"title":"Expression of Concern: CYP4A22 loss-of-function causes a new type of vitamin D-dependent rickets (VDDR1C).","authors":"","doi":"10.1093/jbmr/zjae168","DOIUrl":"10.1093/jbmr/zjae168","url":null,"abstract":"","PeriodicalId":185,"journal":{"name":"Journal of Bone and Mineral Research","volume":" ","pages":"1839"},"PeriodicalIF":5.1,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Longitudinal changes in BMD in adults with cystic fibrosis. 囊性纤维化成人骨矿物质密度的纵向变化。
IF 5.1 1区 医学
Journal of Bone and Mineral Research Pub Date : 2024-11-29 DOI: 10.1093/jbmr/zjae139
Reem Jad, Xiayi Ma, Sanja Stanojevic, Abarnaa Illango, Elizabeth Tullis, Julie Gilmour, Christopher H Goss, Lisa J Strug, Anne L Stephenson
{"title":"Longitudinal changes in BMD in adults with cystic fibrosis.","authors":"Reem Jad, Xiayi Ma, Sanja Stanojevic, Abarnaa Illango, Elizabeth Tullis, Julie Gilmour, Christopher H Goss, Lisa J Strug, Anne L Stephenson","doi":"10.1093/jbmr/zjae139","DOIUrl":"10.1093/jbmr/zjae139","url":null,"abstract":"<p><p>Improved survival in people with cystic fibrosis (pwCF) presents new complexities of care, including CF-related bone disease, a common complication in older pwCF. The trajectory of bone loss with age in this population remains unclear. The objective of this study was to estimate the average rate of change in BMD in adults with CF. This retrospective study included adults with CF, aged 25-48 yr, followed between January 2000 and December 2021. Subjects with at least one DXA scan were included. Scans obtained posttransplantation, after the initiation of bisphosphonates or cystic fibrosis transmembrane conductance regulator modulator therapy was excluded. The primary outcome was BMD (g/cm2) at the LS and FN. A linear mixed-effects model with both random intercept and random slope terms was used to estimate the average annual change in BMD. A total of 1502 DXA scans in 500 adults (average age 28.4 y) were included. There was a statistically significant annual decline in BMD of -0.008 gm/cm2/yr (95% CI, -0.009 to -0.007) at the FN and -0.006 gm/cm2/yr (95% CI, -0.007 to -0.004) at the LS. Relative to BMD at age 25, there was a 18.8% decline at the FN by age 48 yr and a 11% decline at the LS. Pancreatic insufficient subjects had a faster rate of decline in BMD compared with pancreatic sufficient subjects. After adjusting for markers of disease severity, the annual rate of decline remained significant. Individuals with CF experience bone loss at an age when it is not anticipated, thereby entering early adulthood, where further bone loss is inevitable especially with the decrease in estrogen during menopause, with suboptimal BMD. As the CF population ages, it will become very important to consider interventions to maximize bone health.</p>","PeriodicalId":185,"journal":{"name":"Journal of Bone and Mineral Research","volume":" ","pages":"1716-1721"},"PeriodicalIF":5.1,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11637762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142102673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Maternal loss of 24-hydroxylase causes increased intestinal calcium absorption and hypercalcemia during pregnancy but reduced skeletal resorption during lactation in mice. 母体丧失 24- 羟化酶会导致小鼠妊娠期肠道钙吸收增加和高钙血症,但哺乳期骨骼吸收减少。
IF 5.1 1区 医学
Journal of Bone and Mineral Research Pub Date : 2024-11-29 DOI: 10.1093/jbmr/zjae166
Alexandre S Maekawa, David Bennin, Sarah A Hartery, Beth J Kirby, Ingrid J Poulton, René St-Arnaud, Natalie A Sims, Christopher S Kovacs
{"title":"Maternal loss of 24-hydroxylase causes increased intestinal calcium absorption and hypercalcemia during pregnancy but reduced skeletal resorption during lactation in mice.","authors":"Alexandre S Maekawa, David Bennin, Sarah A Hartery, Beth J Kirby, Ingrid J Poulton, René St-Arnaud, Natalie A Sims, Christopher S Kovacs","doi":"10.1093/jbmr/zjae166","DOIUrl":"10.1093/jbmr/zjae166","url":null,"abstract":"<p><p>Inactivation of 24-hydroxylase (CYP24A1) causes mild hypercalcemia in humans that becomes severe and life-threatening during pregnancy through unclear mechanisms. We studied Cyp24a1 null mice during pregnancy, lactation, and post-weaning. We hypothesized that Cyp24a1 nulls have a much greater increase in calcitriol during pregnancy and lactation, leading to markedly increased intestinal calcium absorption and reduced lactational bone loss. WT and Cyp24a1 null sisters were mated to Cyp24a1+/- males. Timepoints included baseline (BL), late pregnancy (LP), mid-lactation (ML), late lactation (LL), and weekly x4 weeks of post-weaning recovery (R1-4). Assessments included intestinal calcium absorption (IntCaAbs) by gavage of 45Ca, BMC by DXA, microCT of femurs, 3-point bending tests of tibias, serum hormones, serum and urine minerals, milk analysis, and intestinal gene expression. At LP, whole body BMC increased equally by ~12% in null and WT. Calcitriol was 2.5-fold higher in nulls vs WT, accompanied by 3-fold increased IntCaAbs, hypercalcemia, hypercalciuria, and 6.5-fold higher FGF23. PTH was suppressed in both. Twenty percent of null dams died during delivery but their serum calcium at LP did not differ from Cyp24a1 nulls that survived. At ML, calcitriol, IntCaAbs, and FGF23 declined in both genotypes but remained higher than BL values in Cyp24a1 nulls. By LL, nulls were still hypercalcemic vs WT, and had lost less mean whole body BMC (11% vs. 21%, p<0.02), but by micro-CT there were no differences from WT in cortical or trabecular bone mass. Lactational losses in BMC, cortical thickness, and trabecular number were restored by R4 in both genotypes. In summary, ablation of Cyp24a1 increased IntCaAbs and caused hypercalcemia during pregnancy and lactation, late gestational mortality in some nulls, and reduced lactational BMC loss. Treating women with gestational hypercalcemia from CYP24A1 mutations should focus on reducing calcitriol or IntCaAbs, since increased bone resorption is not the cause.</p>","PeriodicalId":185,"journal":{"name":"Journal of Bone and Mineral Research","volume":" ","pages":"1793-1808"},"PeriodicalIF":5.1,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11638558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142386744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Deciphering the spatial distribution of Gli1-lineage cells in dental, oral, and craniofacial regions. 解密 Gli1 系细胞在牙齿、口腔和颅面区域的空间分布。
IF 5.1 1区 医学
Journal of Bone and Mineral Research Pub Date : 2024-11-29 DOI: 10.1093/jbmr/zjae152
Bo Li, Zhangfan Ding, Takehito Ouchi, Yueqi Liao, Bingzhi Li, Jiajing Gong, Yuhang Xie, Zhihe Zhao, Longjiang Li
{"title":"Deciphering the spatial distribution of Gli1-lineage cells in dental, oral, and craniofacial regions.","authors":"Bo Li, Zhangfan Ding, Takehito Ouchi, Yueqi Liao, Bingzhi Li, Jiajing Gong, Yuhang Xie, Zhihe Zhao, Longjiang Li","doi":"10.1093/jbmr/zjae152","DOIUrl":"10.1093/jbmr/zjae152","url":null,"abstract":"<p><p>The craniofacial bone, crucial for protecting brain tissue and supporting facial structure, undergoes continuous remodeling through mesenchymal (MSCs) or skeletal stem cells in their niches. Gli1 is an ideal marker for labeling MSCs and osteoprogenitors in this region, and Gli1-lineage cells are identified as pivotal for bone growth, development, repair, and regeneration. Despite its significance, the distribution of Gli1-lineage cells across the dental, oral, and craniofacial (DOC) regions remains to be systematically explored. Utilizing tissue-clearing and light sheet fluorescence microscopy with a Gli1CreER; tdTomatoAi14 mouse model, we mapped the spatial distribution of Gli1-lineage cells throughout the skull, focusing on calvarial bones, sutures, bone marrow, teeth, periodontium, jaw bones, and the temporomandibular joint. We found Gli1-lineage cells widespread in these areas, underscoring their significance in DOC regions. Additionally, we observed their role in repairing calvarial bone defects, providing novel insights into craniofacial biology and stem cell niches and enhancing our understanding of stem cells and their progeny's behavior in vivo.</p>","PeriodicalId":185,"journal":{"name":"Journal of Bone and Mineral Research","volume":" ","pages":"1809-1820"},"PeriodicalIF":5.1,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142277663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Defining the key clinician skills and attributes for competency managing patients with osteoporosis and fragility fractures. 确定临床医生管理骨质疏松症和脆性骨折患者的关键技能和特质。
IF 5.1 1区 医学
Journal of Bone and Mineral Research Pub Date : 2024-11-29 DOI: 10.1093/jbmr/zjae146
Kirtan Ganda, Michael Bennett, Jacqueline R Center, Robin M Daly, Markus J Seibel, Jason Talevski, Tania Winzenberg
{"title":"Defining the key clinician skills and attributes for competency managing patients with osteoporosis and fragility fractures.","authors":"Kirtan Ganda, Michael Bennett, Jacqueline R Center, Robin M Daly, Markus J Seibel, Jason Talevski, Tania Winzenberg","doi":"10.1093/jbmr/zjae146","DOIUrl":"10.1093/jbmr/zjae146","url":null,"abstract":"","PeriodicalId":185,"journal":{"name":"Journal of Bone and Mineral Research","volume":" ","pages":"1835-1836"},"PeriodicalIF":5.1,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142277664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Weight change, variability, and trajectories and risk of hip fracture among older adults with dysglycemia: the cardiovascular health study. 患有糖耐量异常症的老年人的体重变化、可变性和轨迹与髋部骨折风险:心血管健康研究。
IF 5.1 1区 医学
Journal of Bone and Mineral Research Pub Date : 2024-11-29 DOI: 10.1093/jbmr/zjae142
Shohinee Sarma, Petra Bůžková, Rachel E Elam, Howard A Fink, Jane A Cauley, Luc Djoussé, Joshua Barzilay, Kenneth J Mukamal
{"title":"Weight change, variability, and trajectories and risk of hip fracture among older adults with dysglycemia: the cardiovascular health study.","authors":"Shohinee Sarma, Petra Bůžková, Rachel E Elam, Howard A Fink, Jane A Cauley, Luc Djoussé, Joshua Barzilay, Kenneth J Mukamal","doi":"10.1093/jbmr/zjae142","DOIUrl":"10.1093/jbmr/zjae142","url":null,"abstract":"<p><p>Type 2 diabetes mellitus and lower weight are both associated with osteoporotic fractures, but the roles of variability and trajectory are less clear. The associations of these factors among older adults with dysglycemia, who are at highest risk of fracture, with fracture risk and BMD remain uncertain. We followed 775 men and 1080 women from the Cardiovascular Health Study (mean age 77.4 years) with abnormal oral glucose tolerance testing in 1989-1990. We measured their weights yearly through 1994-1995 and derived intra-individual mean weight, weight slope, and weight variability. We also used growth mixture modeling to derive 4 latent BMI trajectories over time. We used Cox proportional hazards models to calculate hazard ratios (HRs) and 95% CI for subsequent hip fracture through 2015 and linear regression models to estimate cross-sectional associations with BMD of the hip. Each 10 kg higher mean weight was associated with a lower risk of subsequent hip fracture overall (HR 0.81; CI, 0.70-0.94) and among women (HR 0.76; CI, 0.64-0.91) and with higher BMD (p <.001). Higher weight variability was directly associated with incident hip fracture among women (HR 1.18; CI, 1.03-1.35). Compared with a stable trajectory, a \"progressive overweight\" trajectory was associated with lower risk of hip fracture (HR 0.66; CI, 0.44-0.99). An uncommon trajectory of \"accelerating obesity\" was associated with higher BMD. Among older adults with dysglycemia at high risk for fracture, lower mean weight is associated with higher fracture risk, but variability and trajectory may also contribute. These results highlight the complex effects of weight in older age.</p>","PeriodicalId":185,"journal":{"name":"Journal of Bone and Mineral Research","volume":" ","pages":"1735-1743"},"PeriodicalIF":5.1,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11637761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142131393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Standardization of bone morphometry and mineral density assessments in zebrafish and other small laboratory fishes using X-ray radiography and micro-computed tomography. 利用 X 射线射线照相术和微型计算机断层扫描技术对斑马鱼和其他实验室小型鱼类的骨骼形态和矿物质密度进行标准化评估。
IF 5.1 1区 医学
Journal of Bone and Mineral Research Pub Date : 2024-11-29 DOI: 10.1093/jbmr/zjae171
Erika Kague, Ronald Young Kwon, Björn Busse, Paul Eckhard Witten, David Karasik
{"title":"Standardization of bone morphometry and mineral density assessments in zebrafish and other small laboratory fishes using X-ray radiography and micro-computed tomography.","authors":"Erika Kague, Ronald Young Kwon, Björn Busse, Paul Eckhard Witten, David Karasik","doi":"10.1093/jbmr/zjae171","DOIUrl":"10.1093/jbmr/zjae171","url":null,"abstract":"<p><p>Zebrafish and other small laboratory fishes are emerging as important animal models for investigating human skeletal development and diseases. In recent years, there has been a notable increase in research publications employing X-ray radiography and micro-computed tomography to analyze the skeletal structures of these animals. However, evaluating bone morphology and mineral density in small laboratory fish poses unique challenges compared to well-established small rodent models. The varied approaches to image acquisition, analysis, and reporting across studies have led to substantial obstacles in interpreting and comparing research findings. This article addresses the urgent need for standardized reporting of parameters and methodologies related to image acquisition and analysis, as well as the adoption of harmonized nomenclature. Furthermore, it offers guidance on anatomical terminology, units of measurement, and the establishment of minimal parameters for reporting, along with comprehensive documentation of methods and algorithms used for acquisition and analysis. We anticipate that adherence to these guidelines will enhance the consistency, reproducibility, and interpretability of reported measurements of bone density and morphometry in small fish models. These advancements are vital for accurately interpreting phenotypes and gene functions, particularly in the context of multi-center studies.</p>","PeriodicalId":185,"journal":{"name":"Journal of Bone and Mineral Research","volume":" ","pages":"1695-1710"},"PeriodicalIF":5.1,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11642618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142542361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Advancing our understanding of cystic fibrosis-related bone disease. 增进我们对囊性纤维化相关骨病的了解。
IF 5.1 1区 医学
Journal of Bone and Mineral Research Pub Date : 2024-11-29 DOI: 10.1093/jbmr/zjae154
Melissa S Putman
{"title":"Advancing our understanding of cystic fibrosis-related bone disease.","authors":"Melissa S Putman","doi":"10.1093/jbmr/zjae154","DOIUrl":"10.1093/jbmr/zjae154","url":null,"abstract":"","PeriodicalId":185,"journal":{"name":"Journal of Bone and Mineral Research","volume":" ","pages":"1693-1694"},"PeriodicalIF":5.1,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142337960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Treating osteoporosis in patients with atypical femoral fracture. 治疗非典型股骨骨折患者的骨质疏松症。
IF 5.1 1区 医学
Journal of Bone and Mineral Research Pub Date : 2024-11-29 DOI: 10.1093/jbmr/zjae150
Robert A Adler
{"title":"Treating osteoporosis in patients with atypical femoral fracture.","authors":"Robert A Adler","doi":"10.1093/jbmr/zjae150","DOIUrl":"10.1093/jbmr/zjae150","url":null,"abstract":"<p><p>Patients who have suffered an atypical femoral fracture while on bisphosphonates or denosumab may continue to be at risk for typical osteoporotic fractures. There are no studies to provide guidance on safe treatment for such patients. Instead, using an illustrative case, 5 principles of management are provided that may lead to decreased osteoporotic fracture risk. The first principle is to discontinue the anti-resorptive medications, which may be challenging for the patient on denosumab because of rebound vertebral fractures reported in patients stopping denosumab. The second principle is to maximize non-pharmacologic management to reduce falls and fractures. Home safety, other methods of fall risk reduction, adequate nutrition, and an exercise prescription should help reduce fracture risk. Investigating potential secondary causes of osteoporosis, particularly if the original workup was not comprehensive, is the third principle because treatment of some specific causes may lower fracture risk. Reviewing the medication list is the fourth principle, with the goal of eliminating drugs that may increase fracture risk, and considering thiazides for some patients, which may lower fracture risk. Finally, some patients may benefit from anabolic therapy. One potential (but not FDA-approved) method is to use long-term cyclic teriparatide or abaloparatide on a 3-mo on, 3-mo off schedule. Tailoring the approach to each patient is important, based on the 5 clinical principles, in the absence of evidence-based management recommendations.</p>","PeriodicalId":185,"journal":{"name":"Journal of Bone and Mineral Research","volume":" ","pages":"1711-1715"},"PeriodicalIF":5.1,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142306797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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