Osteoporosis International最新文献

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Clinical experience with denosumab discontinuation. denosumab停药的临床经验。
IF 4.2 2区 医学
Osteoporosis International Pub Date : 2025-03-01 Epub Date: 2025-01-08 DOI: 10.1007/s00198-024-07351-7
Natasha Laursen, Anne Sophie Sølling, Torben Harsløf, Bente Langdahl
{"title":"Clinical experience with denosumab discontinuation.","authors":"Natasha Laursen, Anne Sophie Sølling, Torben Harsløf, Bente Langdahl","doi":"10.1007/s00198-024-07351-7","DOIUrl":"10.1007/s00198-024-07351-7","url":null,"abstract":"<p><p>In patients receiving long-term treatment with denosumab, denosumab discontinuation via sequential treatment with zoledronate, resulted in a minor decrease in bone mass density (BMD) of 0-2.5% within the first year and stabile BMD in the second year, thus showing that repeated treatments with zoledronate limit the loss of BMD, when discontinuing denosumab.</p><p><strong>Purpose: </strong>Discontinuing denosumab (DMAb) rapidly decreases bone mineral density (BMD) and increases the risk of multiple vertebral fractures. We wanted to examine if the recommendation stated in the ECTS position paper on DMAb discontinuation can prevent the bone loss in a clinical setting.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study based on medical records of patients referred for DMAb discontinuation. We administered zoledronate (ZOL) 6 months after the last DMAb injection and 3, 6, 12, and 24 months thereafter if p-C-terminal collagen crosslinks (CTX) increased above 0.5 μg/l or BMD decreased (≥ 5% at the hip, ≥ 3% at the spine) at months 12 and 24.</p><p><strong>Results: </strong>We included 66 women and men discontinuing DMAb after a mean treatment duration of 6.7 ± 2.7 (mean ± SD) years. BMD decreased 12 months after the initial ZOL treatment by 2.5 ± 4.2% and 1.9 ± 2.5% at the LS and TH, respectively (n = 44) (p ≤ 0.001 for all). There was no significant change in FNBMD (0.0 ± 5.1) (p > 0.05). No significant change in BMD was seen from month 12 to month 24 at any site (p > 0.05 for all). Thirty percent and twenty-two percent of patients experienced flu-like symptoms after the first and second ZOL infusion. No fractures occurred during the study period.</p><p><strong>Conclusion: </strong>Adhering to the recommendation in the ECTS position statement, a mean of 3 infusions of ZOL limited the bone loss 12 and 24 months after DMAb discontinuation, thereby preserving most of the BMD gained during DMAb treatment. The frequent occurrence of flu-like symptoms after ZOL proves to be a challenge, showing that routine prophylaxis against acute phase responses should be considered in patients treated with ZOL after discontinuing DMAb.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"435-446"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142952835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Hypoparathyroidism: Similarities and differences between Western and Eastern countries. 甲状旁腺功能减退症:东西方异同。
IF 4.2 2区 医学
Osteoporosis International Pub Date : 2025-03-01 Epub Date: 2025-01-08 DOI: 10.1007/s00198-024-07352-6
Yu-Ying Yang, Yan-Hua Deng, Li-Hao Sun, Lars Rejnmark, Ling Wang, Peter Pietschmann, Claus-Christian Glüer, Aliya A Khan, Salvatore Minisola, Jian-Min Liu
{"title":"Hypoparathyroidism: Similarities and differences between Western and Eastern countries.","authors":"Yu-Ying Yang, Yan-Hua Deng, Li-Hao Sun, Lars Rejnmark, Ling Wang, Peter Pietschmann, Claus-Christian Glüer, Aliya A Khan, Salvatore Minisola, Jian-Min Liu","doi":"10.1007/s00198-024-07352-6","DOIUrl":"10.1007/s00198-024-07352-6","url":null,"abstract":"<p><strong>Backgroud: </strong>Hypoparathyroidism (hypoPT) is characterized by acute and chronic complications due to insufficient parathyroid hormone (PTH) production or action. Several management guidelines have been developed, but mostly based on evidence from Western countries. Data from Eastern countries have not been systematically compared with those from Western countries.</p><p><strong>Methods: </strong>Literatures regarding to the epidemiology, genetics, risk factors, clinical manifestations and therapies for hypoPT in Easten and Western countries, including China, South Korea, Japan, India, and USA, Canada, Italy, and etc., were searched through PubMed and CNKI. This review was officially endorsed by European Calcified Tissue Society (ECTS) board.</p><p><strong>Results: </strong>Postoperative hypoPT is the major form of hypoPT in both Western and Eastern countries. The genetic profiles and clinical features of hypoPT are similar in Eastern and Western countries. The most commonly used medications in Eastern countries are calcium and native vitamin D or active vitamin D analogues, similar to their Western counterparts. While PTH replacement therapy is not available and approved to use in most Eastern countries.</p><p><strong>Conclusion: </strong>Physicians and surgeons should follow the guidelines on the management of thyroid nodules, taking more care of protecting parathyroid glands during surgery. The cross-talk between East and West in the management of hypoPT should be continued. Direct comparisons of the management strategies in patients with hypoPT between Eastern and Wester countries regarding to the morbidity, mortality, quality of life, optimal dosage, efficacies and side-effects of conventional therapies or newer medications, as well as pharmacogenetics and pharmacoeconomics, would be valuable.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"391-402"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142952842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
The association between blood cadmium levels and bone mineral density in U.S. adolescents aged 12-19 years. 美国12-19岁青少年血镉水平与骨密度的关系。
IF 4.2 2区 医学
Osteoporosis International Pub Date : 2025-03-01 Epub Date: 2025-01-08 DOI: 10.1007/s00198-024-07349-1
Fen Chen, Jiao Luo, Lin Li
{"title":"The association between blood cadmium levels and bone mineral density in U.S. adolescents aged 12-19 years.","authors":"Fen Chen, Jiao Luo, Lin Li","doi":"10.1007/s00198-024-07349-1","DOIUrl":"10.1007/s00198-024-07349-1","url":null,"abstract":"<p><p>According to the multivariable adjusted models, there was an inverse association between B-Cd levels and BMD, which was particularly evident in the subgroup analyses of other Hispanic and female individuals in the adolescent population. Clinicians and policy-makers should thoroughly consider the genetic implications of B-Cd levels in relation to BMD during the prevention and treatment of osteoporosis.</p><p><strong>Objective: </strong>To investigate the associations between blood cadmium (B-Cd) levels and bone mineral density (BMD) in adolescents.</p><p><strong>Methods: </strong>On the basis of the National Health and Nutrition Examination Survey (NHANES) database spanning from 2011 to 2018, we used weighted multiple regression, a generalized weighted model and smoothed curve methods to investigate the associations between B-Cd levels and BMD in adolescents. Subgroup analyses were also conducted to examine potential differences across age, sex, race, tobacco exposure status and other relevant variables.</p><p><strong>Results: </strong>Among the 2427 participants, 52% were males, and 48% were females. In this study, multistage sampling data from the NHANES database were analysed, and the positive association between B-Cd levels and BMD shifted to a negative association after adjustment for age, sex and race. Subgroup analyses revealed a more pronounced association among females (β =  - 0.07, 95% CI: - 0.09, - 0.04, P < 0.001), other Hispanic individuals (β =  - 0.08, 95% CI: - 0.14, - 0.02, P = 0.012) and individuals exposed to tobacco (β =  - 0.04, 95% CI: - 0.06, - 0.01, P = 0.016).</p><p><strong>Conclusion: </strong>The findings revealed a negative association between B-Cd levels and BMD in multivariable adjusted models.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":"485-500"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142952850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Long-term adherence to anti-osteoporosis medication and determinants of adherence in the population-based screening trial ROSE. 基于人群的筛查试验ROSE中抗骨质疏松药物的长期依从性和依从性的决定因素
IF 4.2 2区 医学
Osteoporosis International Pub Date : 2025-02-24 DOI: 10.1007/s00198-025-07436-x
Tanja Gram Petersen, Katrine Hass Rubin, Muhammad Kassim Javaid, Anne Pernille Hermann, Kristina E Åkesson, Bo Abrahamsen
{"title":"Long-term adherence to anti-osteoporosis medication and determinants of adherence in the population-based screening trial ROSE.","authors":"Tanja Gram Petersen, Katrine Hass Rubin, Muhammad Kassim Javaid, Anne Pernille Hermann, Kristina E Åkesson, Bo Abrahamsen","doi":"10.1007/s00198-025-07436-x","DOIUrl":"https://doi.org/10.1007/s00198-025-07436-x","url":null,"abstract":"<p><p>Screening initiatives for osteoporosis must facilitate treatment of those at elevated fracture risk. In a randomized controlled trial of 24,229 women, those in the screening group with FRAX ≥ 15% were invited for DXA with AOM treatment offered as per national guidelines. Treatment initiation in the following year was 9.5 times higher compared with controls.</p><p><strong>Purpose: </strong>To determine if screened individuals have lower adherence to anti-osteoporotic medication (AOM) than unscreened and to examine determinants for low treatment adherence.</p><p><strong>Method: </strong>In 2010/2011, women aged 65-80 (N = 34,229) in the Region of Southern Denmark were invited to the risk-stratified osteoporosis strategy evaluation (ROSE) randomized study. Women in the screening group with moderate to high 10-year fracture risk (FRAX® ≥ 15%) were invited for dual-energy x-ray absorptiometry with AOM treatment as per national guidelines. Screened, controls, and an age-matched general population sample were compared for adherence to AOM using 10-year follow-up data on prescription and hospital records.</p><p><strong>Results: </strong>Among ROSE participants with FRAX ≥ 15%, 5864 screened and 5790 controls were eligible for analysis, along with an equal number from the general population. AOM initiation in the first year was 9.5 times higher in screened compared to controls (HR 9.50, 7.16; 12.61). There was no difference in implementation assessed as medication possession ratio. The 5-year persistence rates were similar in screened and controls (51-52%), but lower in the general population (44%). FRAX risk factors partly influenced AOM initiation in the screened, with different patterns in other groups. Immobilization, comorbidities, and co-medications were key determinants of discontinuation in both the short and long term.</p><p><strong>Conclusion: </strong>The ROSE screening programme significantly increased treatment initiation in postmenopausal women. Screened women showed similar treatment adherence levels to non-screened once they started medication. However, frail women were more prone to treatment discontinuation, highlighting the need for targeted support in this subgroup.</p><p><strong>Trial registration: </strong>The original ROSE trial is registered at ClinicalTrials.gov (NCT01388244). The study protocol has been published in Rubin et al. The risk-stratified osteoporosis strategy evaluation study (ROSE): a randomized prospective population-based study. Design and baseline characteristics. Calcif Tissue Int. 2015;96(2):167-79.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
TBS as a complementary tool for assessing vertebral fractures and spinal deformity in children and adolescents with osteogenesis imperfecta. TBS作为评估儿童和青少年成骨不全症椎体骨折和脊柱畸形的补充工具。
IF 4.2 2区 医学
Osteoporosis International Pub Date : 2025-02-24 DOI: 10.1007/s00198-025-07423-2
Jiayi Liu, Yi Zhang, Wei Yu, Lei Sun, Jing Hu, Yan Jiang, Ou Wang, Xiaoping Xing, Weibo Xia, Mei Li
{"title":"TBS as a complementary tool for assessing vertebral fractures and spinal deformity in children and adolescents with osteogenesis imperfecta.","authors":"Jiayi Liu, Yi Zhang, Wei Yu, Lei Sun, Jing Hu, Yan Jiang, Ou Wang, Xiaoping Xing, Weibo Xia, Mei Li","doi":"10.1007/s00198-025-07423-2","DOIUrl":"https://doi.org/10.1007/s00198-025-07423-2","url":null,"abstract":"<p><p>This study evaluated trabecular bone score (TBS) for assessing vertebral fractures and spinal deformity in children and adolescents with osteogenesis imperfecta (OI). TBS showed superior performance in identifying vertebral fractures compared to areal bone mineral density (aBMD), especially in patients without densitometric osteoporosis, suggesting its potential for monitoring vertebral fractures and spinal deformity risk.</p><p><strong>Background: </strong>TBS, derived from a textural greyscale analysis of lumbar spine dual-energy X-ray absorptiometry (DXA) images, offers a non-invasive and indirect evaluation of bone microarchitecture. This method potentially enhances the assessment of skeletal phenotypes beyond the scope of aBMD. We aim to explore the utility of TBS in assessing vertebral fractures and spinal deformity in children and adolescents with OI.</p><p><strong>Methods: </strong>In this cross-sectional study, 153 children and adolescents with OI were enrolled. DXA was used to measure TBS and aBMD, and their Z-scores were calculated based on reference values for BMD and TBS in normal children and adolescents with the same age and sex. Lateral thoracolumbar films were used to evaluate vertebral fractures and calculate the spine deformity index (SDI). The accuracy of TBS and aBMD for identifying vertebral compression fractures (VCFs) was assessed using area under the curve (AUC).</p><p><strong>Results: </strong>TBS Z-score was negatively correlated with the age of children with OI (r =  - 0.435, P < 0.001) and was positively correlated to aBMD Z-score at the lumbar spine and femoral neck (both P < 0.01), even after adjusting for confounding factors. TBS Z-score was as effective as lumbar spine aBMD Z-score in discriminating VCFs (AUC, 0.667 vs 0.666, P > 0.05). Notably, in patients without densitometric osteoporosis, TBS Z-score demonstrated superior discriminative power for VCFs compared to lumbar spine aBMD Z-score (AUC, 0.719 vs 0.545, P < 0.05). In this population, only the TBS Z-score (r =  - 0.358, P < 0.05), rather than the lumbar spine aBMD Z-score, was negatively correlated with the SDI.</p><p><strong>Conclusion: </strong>TBS has a close correlation with bone mineral density in children and adolescents with OI. In patients without densitometric osteoporosis, the Z-score of TBS is more effective than that of bone mineral density in assessing VCFs and spinal deformity, highlighting the potential of TBS in evaluating the risk of VCFs and monitoring the progression of spinal deformity.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
The effect of hypersensitive C-reactive protein to albumin ratio on the risk of fragility fracture in the Chinese male population. 超敏c反应蛋白/白蛋白比对中国男性脆性骨折风险的影响。
IF 4.2 2区 医学
Osteoporosis International Pub Date : 2025-02-21 DOI: 10.1007/s00198-025-07428-x
Lu Guo, Nan Zhang, Xinhao Fan, Xiaoli Hou, Man Li, Wenqi Xu, Peipei Liu, Lei Xing, Jingyao Wang, Shuohua Chen, Shouling Wu, Faming Tian
{"title":"The effect of hypersensitive C-reactive protein to albumin ratio on the risk of fragility fracture in the Chinese male population.","authors":"Lu Guo, Nan Zhang, Xinhao Fan, Xiaoli Hou, Man Li, Wenqi Xu, Peipei Liu, Lei Xing, Jingyao Wang, Shuohua Chen, Shouling Wu, Faming Tian","doi":"10.1007/s00198-025-07428-x","DOIUrl":"https://doi.org/10.1007/s00198-025-07428-x","url":null,"abstract":"<p><p>This study explored the association between the hypersensitive C-reactive protein to albumin ratio (CAR) and fragility fractures in Chinese males. Results show that elevated levels of CAR were associated with an increased risk of fragility fractures and that this association was robust to adjustment for multiple potential confounders.</p><p><strong>Purpose: </strong>This study investigates the relationship between the hypersensitive C-reactive protein to albumin ratio (CAR) and fragility fractures in a Chinese male population.</p><p><strong>Methods: </strong>A total of 48,186 male participants (age range 18-98 years old, average age 53.92 years) at baseline were recruited from the Kailuan Study and followed up for outcomes until 2022. The Cox proportional hazards model was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for incident fragility fractures. The dose response between CAR and fracture risk was analyzed using restricted cubic splines. Additionally, the concordance index (C-index), net reclassification index (NRI), and integrated discrimination improvement (IDI) were utilized to assess the incremental predictive value of various indicators for the discrimination of fragility fractures.</p><p><strong>Results: </strong>During an average follow-up of 11.17 years, 728 incident fragility fractures occurred among the 48,186 participants. Compared to participants in the second quartile of CAR, those in the highest quartile had a 49% increased risk of fragility fractures (HR = 1.49, 95% CI = 1.21-1.84) after adjusting for risk factors. Restricted cubic spline analysis showed a nonlinear relationship between CAR and the risk of fragility fractures. The C-index, continuous NRI, and IDI for predicting the risk of fragility fractures were 61.142%, 0.089 (p < 0.05), and 0.00009 (p < 0.05), respectively, which were higher than those of hs-CRP (C-index 0.6137, NRI 0.086, IDI 0.000074) and albumin (C- index 0.6116, NRI 0.068, IDI - 0.000004).</p><p><strong>Conclusion: </strong>Elevated levels of CAR were associated with an increased risk of fragility fractures and that this association was robust to adjustment for multiple potential confounders.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Author response to the letter to the editor "Comment on: The risk of fragility fractures in men with prostate cancer treated with androgen deprivation therapy" (OSIN-D-24-01632). 作者回复了给编辑的信“评论:接受雄激素剥夺治疗的前列腺癌患者脆性骨折的风险”(OSIN-D-24-01632)。
IF 4.2 2区 医学
Osteoporosis International Pub Date : 2025-02-16 DOI: 10.1007/s00198-024-07331-x
M M van Oostwaard, J P van den Bergh, C E Wyers
{"title":"Author response to the letter to the editor \"Comment on: The risk of fragility fractures in men with prostate cancer treated with androgen deprivation therapy\" (OSIN-D-24-01632).","authors":"M M van Oostwaard, J P van den Bergh, C E Wyers","doi":"10.1007/s00198-024-07331-x","DOIUrl":"https://doi.org/10.1007/s00198-024-07331-x","url":null,"abstract":"","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Rheumatoid arthritis and subsequent fracture risk: an individual person meta-analysis to update FRAX. 类风湿关节炎和随后的骨折风险:更新FRAX的个人荟萃分析
IF 4.2 2区 医学
Osteoporosis International Pub Date : 2025-02-16 DOI: 10.1007/s00198-025-07397-1
John A Kanis, Helena Johansson, Eugene V McCloskey, Enwu Liu, Marian Schini, Liesbeth Vandenput, Kristina E Åkesson, Fred A Anderson, Rafael Azagra, Cecilie L Bager, Charlotte Beaudart, Heike A Bischoff-Ferrari, Emmanuel Biver, Olivier Bruyère, Jane A Cauley, Jacqueline R Center, Roland Chapurlat, Claus Christiansen, Cyrus Cooper, Carolyn J Crandall, Steven R Cummings, José A P da Silva, Bess Dawson-Hughes, Adolfo Diez-Perez, Alyssa B Dufour, John A Eisman, Petra J M Elders, Serge Ferrari, Yuki Fujita, Saeko Fujiwara, Claus-Christian Glüer, Inbal Goldshtein, David Goltzman, Vilmundur Gudnason, Jill Hall, Didier Hans, Mari Hoff, Rosemary J Hollick, Martijn Huisman, Masayuki Iki, Sophia Ish-Shalom, Graeme Jones, Magnus K Karlsson, Sundeep Khosla, Douglas P Kiel, Woon-Puay Koh, Fjorda Koromani, Mark A Kotowicz, Heikki Kröger, Timothy Kwok, Olivier Lamy, Arnulf Langhammer, Bagher Larijani, Kurt Lippuner, Fiona E A McGuigan, Dan Mellström, Thomas Merlijn, Tuan V Nguyen, Anna Nordström, Peter Nordström, Terence W O Neill, Barbara Obermayer-Pietsch, Claes Ohlsson, Eric S Orwoll, Julie A Pasco, Fernando Rivadeneira, Anne-Marie Schott, Eric J Shiroma, Kristin Siggeirsdottir, Eleanor M Simonsick, Elisabeth Sornay-Rendu, Reijo Sund, Karin Swart, Pawel Szulc, Junko Tamaki, David J Torgerson, Natasja M van Schoor, Tjeerd P van Staa, Joan Vila, Nicole C Wright, Noriko Yoshimura, M Carola Zillikens, Marta Zwart, Nicholas C Harvey, Mattias Lorentzon, William D Leslie
{"title":"Rheumatoid arthritis and subsequent fracture risk: an individual person meta-analysis to update FRAX.","authors":"John A Kanis, Helena Johansson, Eugene V McCloskey, Enwu Liu, Marian Schini, Liesbeth Vandenput, Kristina E Åkesson, Fred A Anderson, Rafael Azagra, Cecilie L Bager, Charlotte Beaudart, Heike A Bischoff-Ferrari, Emmanuel Biver, Olivier Bruyère, Jane A Cauley, Jacqueline R Center, Roland Chapurlat, Claus Christiansen, Cyrus Cooper, Carolyn J Crandall, Steven R Cummings, José A P da Silva, Bess Dawson-Hughes, Adolfo Diez-Perez, Alyssa B Dufour, John A Eisman, Petra J M Elders, Serge Ferrari, Yuki Fujita, Saeko Fujiwara, Claus-Christian Glüer, Inbal Goldshtein, David Goltzman, Vilmundur Gudnason, Jill Hall, Didier Hans, Mari Hoff, Rosemary J Hollick, Martijn Huisman, Masayuki Iki, Sophia Ish-Shalom, Graeme Jones, Magnus K Karlsson, Sundeep Khosla, Douglas P Kiel, Woon-Puay Koh, Fjorda Koromani, Mark A Kotowicz, Heikki Kröger, Timothy Kwok, Olivier Lamy, Arnulf Langhammer, Bagher Larijani, Kurt Lippuner, Fiona E A McGuigan, Dan Mellström, Thomas Merlijn, Tuan V Nguyen, Anna Nordström, Peter Nordström, Terence W O Neill, Barbara Obermayer-Pietsch, Claes Ohlsson, Eric S Orwoll, Julie A Pasco, Fernando Rivadeneira, Anne-Marie Schott, Eric J Shiroma, Kristin Siggeirsdottir, Eleanor M Simonsick, Elisabeth Sornay-Rendu, Reijo Sund, Karin Swart, Pawel Szulc, Junko Tamaki, David J Torgerson, Natasja M van Schoor, Tjeerd P van Staa, Joan Vila, Nicole C Wright, Noriko Yoshimura, M Carola Zillikens, Marta Zwart, Nicholas C Harvey, Mattias Lorentzon, William D Leslie","doi":"10.1007/s00198-025-07397-1","DOIUrl":"https://doi.org/10.1007/s00198-025-07397-1","url":null,"abstract":"<p><p>The relationship between rheumatoid arthritis (RA) and fracture risk was estimated in an international meta-analysis of individual-level data from 29 prospective cohorts. RA was associated with an increased fracture risk in men and women, and these data will be used to update FRAX®.</p><p><strong>Introduction: </strong>RA is a well-documented risk factor for subsequent fracture that is incorporated into the FRAX algorithm. The aim of this study was to evaluate, in an international meta-analysis, the association between rheumatoid arthritis and subsequent fracture risk and its relation to sex, age, duration of follow-up, and bone mineral density (BMD) with a view to updating FRAX.</p><p><strong>Methods: </strong>The resource comprised 1,909,896 men and women, aged 20-116 years, from 29 prospective cohorts in which the prevalence of RA was 3% or less (primary analysis) and an additional 17 cohorts with a prevalence greater than 3% (supplementary analysis). The association between RA and fracture risk (any clinical fracture, osteoporotic fracture, major osteoporotic fracture (MOF), and hip fracture) was examined using an extension of the Poisson regression model in each cohort and each sex, followed by random-effects meta-analyses of the weighted beta coefficients.</p><p><strong>Results: </strong>In the primary analysis, RA was reported in 1.3% of individuals. During 15,683,133 person-years of follow-up, 139,002 fractures occurred, of which 27,518 were hip fractures. RA was associated with an increased risk of any clinical fracture (hazard ratio [HR] 1.49, 95% confidence interval [CI] 1.35-1.65). The HRs were of similar magnitude for osteoporotic fracture and MOF but higher for hip fracture (HR = 2.23; 95% CI 1.85-2.69). For hip fracture, there was a significant interaction with age with higher HRs at younger ages. HRs did not differ between men and women and were independent of exposure to glucocorticoids and femoral neck BMD. Lower HRs were observed in the supplementary analysis cohorts, particularly in those with a high apparent prevalence of RA, possibly from conflation of RA with osteoarthritis.</p><p><strong>Conclusions: </strong>A diagnosis of RA confers an increased risk of fracture that is largely independent of BMD, sex, and corticosteroids. RA should be retained as a risk factor in future iterations of FRAX with updated risk functions to improve fracture risk prediction.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Skeletal health status among patients with chronic hypoparathyroidism: results from the Canadian National Hypoparathyroidism Registry (CNHR). 慢性甲状旁腺功能减退患者的骨骼健康状况:来自加拿大国家甲状旁腺功能减退登记处(CNHR)的结果
IF 4.2 2区 医学
Osteoporosis International Pub Date : 2025-02-16 DOI: 10.1007/s00198-025-07410-7
Aliya A Khan, Hajar AbuAlrob, Dalal S Ali, Zayd Al Kassem, Abdulrahman Almoulia, Habiba Afifi, Manoela Braga, Alice Cheng, Jouma Malhem, Adam Millar, Emmett Morgante, Parwana Muhammad, Terri L Paul, Ally Prebtani, Zubin Punthakee, Tayyab Khan, Sarah Khan, Muhammad Shrayyef, Stan Van Uum, James Edward Massey Young, Maria Luisa Brandi, Michel Ovize, Blandine Weiss
{"title":"Skeletal health status among patients with chronic hypoparathyroidism: results from the Canadian National Hypoparathyroidism Registry (CNHR).","authors":"Aliya A Khan, Hajar AbuAlrob, Dalal S Ali, Zayd Al Kassem, Abdulrahman Almoulia, Habiba Afifi, Manoela Braga, Alice Cheng, Jouma Malhem, Adam Millar, Emmett Morgante, Parwana Muhammad, Terri L Paul, Ally Prebtani, Zubin Punthakee, Tayyab Khan, Sarah Khan, Muhammad Shrayyef, Stan Van Uum, James Edward Massey Young, Maria Luisa Brandi, Michel Ovize, Blandine Weiss","doi":"10.1007/s00198-025-07410-7","DOIUrl":"https://doi.org/10.1007/s00198-025-07410-7","url":null,"abstract":"<p><p>In the CNHR study, 35% of postmenopausal women had osteoporosis by BMD or fragility fracture, and 4% had both. Three men ≥ 50 had osteoporosis by BMD or fragility fracture (33.3%; n = 3/9). This suggests that close follow-up of skeletal health is necessary in postmenopausal women, and men ≥ 50 with chronic HypoPT.</p><p><strong>Purpose: </strong>Chronic hypoparathyroidism (HypoPT) has been associated with decreased bone turnover and abnormalities in bone mineral density (BMD), microarchitecture, and strength. Current guidelines do not recommend systematic evaluation of skeletal health in patients with chronic HypoPT. Our study assessed skeletal health in pre- and postmenopausal women with chronic HypoPT and adult men.</p><p><strong>Methods: </strong>This prospective study enrolled adults with chronic HypoPT from the Canadian National Hypoparathyroidism Registry. Clinical characteristics, bone fractures, biochemistry, and serum bone biomarkers were assessed at baseline. Skeletal health evaluation included assessments of fragility fractures, BMD at lumbar spine (LS), femoral neck (FN), total hip (TH), 1/3 radial sites, trabecular bone score (TBS), and bone biomarkers.</p><p><strong>Results: </strong>We present the baseline data of the patients enrolled in the registry. We analyzed a total of 101 patients: 18 men, 35 premenopausal, and 48 postmenopausal women. The mean (SD) age at the onset of HypoPT was 40.7 (16.8) years, and the average disease duration was 11.2 (8.6) years. The most common etiology was postsurgical (74.3% vs. 25.7% non-surgical). Most patients received calcium supplements (89%) and active vitamin D (80%) at baseline. No fragility fractures or low BMD were reported in premenopausal women. However, BMD at LS, FN, TH, and TBS were significantly lower in postmenopausal compared to premenopausal women.</p><p><strong>Conclusions: </strong>Overall, 35% of postmenopausal women had osteoporosis by BMD or prior fragility fracture, and 4% had both. Three men ≥ 50 years had osteoporosis by BMD or fragility fracture (33.3%; n = 3/9). This study suggests that close follow-up of skeletal health is necessary in postmenopausal women with chronic HypoPT and men ≥ 50 years.</p>","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Comment on: The risk of fragility fractures in men with prostate cancer treated with androgen deprivation therapy. 评论:男性前列腺癌患者接受雄激素剥夺治疗发生脆性骨折的风险。
IF 4.2 2区 医学
Osteoporosis International Pub Date : 2025-02-16 DOI: 10.1007/s00198-024-07329-5
Shangxian Pan, Kuangyang Yang, Kexin Wang
{"title":"Comment on: The risk of fragility fractures in men with prostate cancer treated with androgen deprivation therapy.","authors":"Shangxian Pan, Kuangyang Yang, Kexin Wang","doi":"10.1007/s00198-024-07329-5","DOIUrl":"https://doi.org/10.1007/s00198-024-07329-5","url":null,"abstract":"","PeriodicalId":19638,"journal":{"name":"Osteoporosis International","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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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