Archives of Osteoporosis最新文献

{"title":"Feasibility study of opportunistic osteoporosis screening on chest CT using a multi-feature fusion DCNN model","authors":"Jing Pan,&nbsp;Peng-cheng Lin,&nbsp;Shen-chu Gong,&nbsp;Ze Wang,&nbsp;Rui Cao,&nbsp;Yuan Lv,&nbsp;Kun Zhang,&nbsp;Lin Wang","doi":"10.1007/s11657-024-01455-7","DOIUrl":"10.1007/s11657-024-01455-7","url":null,"abstract":"<div><h3>\u0000 <i>Summary</i>\u0000 </h3><p>A multi-feature fusion DCNN model for automated evaluation of lumbar vertebrae L1 on chest combined with clinical information and radiomics permits estimation of volumetric bone mineral density for evaluation of osteoporosis.</p><h3>Purpose</h3><p>To develop a multi-feature deep learning model based on chest CT, combined with clinical information and radiomics to explore the feasibility in screening for osteoporosis based on estimation of volumetric bone mineral density.</p><h3>Methods</h3><p>The chest CT images of 1048 health check subjects were retrospectively collected as the master dataset, and the images of 637 subjects obtained from a different CT scanner were used for the external validation cohort. The subjects were divided into three categories according to the quantitative CT (QCT) examination, namely, normal group, osteopenia group, and osteoporosis group. Firstly, a deep learning–based segmentation model was constructed. Then, classification models were established and selected, and then, an optimal model to build bone density value prediction regression model was chosen.</p><h3>Results</h3><p>The DSC value was 0.951 ± 0.030 in the testing dataset and 0.947 ± 0.060 in the external validation cohort. The multi-feature fusion model based on the lumbar 1 vertebra had the best performance in the diagnosis. The area under the curve (AUC) of diagnosing normal, osteopenia, and osteoporosis was 0.992, 0.973, and 0.989. The mean absolute errors (MAEs) of the bone density prediction regression model in the test set and external testing dataset are 8.20 mg/cm³ and 9.23 mg/cm³, respectively, and the root mean square errors (RMSEs) are 10.25 mg/cm³ and 11.91 mg/cm³, respectively. The <i>R</i>-squared values are 0.942 and 0.923, respectively. The Pearson correlation coefficients are 0.972 and 0.965.</p><h3>Conclusion</h3><p>The multi-feature fusion DCNN model based on only the lumbar 1 vertebrae and clinical variables can perform bone density three-classification diagnosis and estimate volumetric bone mineral density. If confirmed in independent populations, this automated opportunistic chest CT evaluation can help clinical screening of large-sample populations to identify subjects at high risk of osteoporotic fracture.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"19 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s11657-024-01455-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142443328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel combined pharmacological strategy to alleviate acute phase response following zoledronic acid treatment","authors":"Chung-Hwan Chen,&nbsp;En Kee Yeap,&nbsp;Chia-Hao Hsu,&nbsp;Yen-Mou Lu,&nbsp;Tsung-Lin Cheng,&nbsp;Tien-Ching Lee,&nbsp;Cheng-Jung Ho,&nbsp;Jhong-You Li,&nbsp;Hsin-Yi Shen,&nbsp;Hsuan-Ti Huang,&nbsp;Cheng-Chang Lu,&nbsp;Sung-Yen Lin","doi":"10.1007/s11657-024-01452-w","DOIUrl":"10.1007/s11657-024-01452-w","url":null,"abstract":"<div><h3>\u0000 <i>Summary</i>\u0000 </h3><p><b>Brief rationale:</b> Zoledronic acid treatment against osteoporosis is limited by APR. <b>Main result:</b> Combination therapy (hydrocortisone plus non-steroidal anti-inflammatory drugs, acetaminophen, and prednisolone) reduced intolerable APR levels and provided complete symptom relief in most patients. <b>Significance of the paper:</b> Combination therapy can enhance patient outcomes in osteoporosis management.</p><h3>Purpose</h3><p>Osteoporosis is a common condition associated with high morbidity rates, often requiring treatment with bisphosphonates such as zoledronic acid. However, the persistence to zoledronic acid infusion is commonly limited by acute phase response (APR). This retrospective study aimed to evaluate the efficacy of a novel combination therapy in preventing APR symptoms.</p><h3>Methods</h3><p>A retrospective case–control study was conducted on 931 patients who received their first zoledronic acid infusion between 2011 and 2021. We evaluated the efficacy of combination therapy comprising a single dose of hydrocortisone prior to the infusion and a 3-d oral regimen of non-steroidal anti-inflammatory drugs, acetaminophen, and prednisolone following the infusion. Patients were divided into protocol (receiving combination therapy) and control groups (without treatment). Baseline characteristics, APR incidence, and the efficacy of symptom control were compared between groups using Fisher’s exact test and Student’s <i>t</i>-test.</p><h3>Results</h3><p>There was no difference in APR incidence between the protocol (<i>n</i> = 507) and control group (<i>n</i> = 407; <i>p</i> = 0.1442). However, the protocol group exhibited lower intolerable APR levels (3.72% vs. 16.71%; <i>p</i> &lt; 0.0001) and complete symptom relief in 96.28% of cases.</p><h3>Conclusion</h3><p>The combination therapy protocol effectively reduced intolerable APR and relieved symptoms in most patients following zoledronic acid infusion. This study highlights the importance of proactive management strategies for APR and emphasizes the potential of combination therapy in alleviating APR symptoms and reducing the occurrence of severe APR in patients undergoing osteoporosis management.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"19 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s11657-024-01452-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142434854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inpatient zoledronic acid in older hip fracture patients is well tolerated and safe","authors":"Frank Malgo,&nbsp;Floor J. A. van Deudekom,&nbsp;Roos Hup,&nbsp;Henk A. Formijne Jonkers,&nbsp;Diederik H. R. Kempen,&nbsp;Kerst de Vries,&nbsp;Hanna C. Willems,&nbsp;Annegreet G. Vlug","doi":"10.1007/s11657-024-01453-9","DOIUrl":"10.1007/s11657-024-01453-9","url":null,"abstract":"<div><h3>Summary</h3><p>Administering zoledronic acid (ZA) to older hip fracture patients during the hospital stay has faced safety concerns. However, in this study of 161 patients, no ZA-related side effects or readmissions were observed, demonstrating that ZA administration during hospitalization is safe and effective for secondary fracture prevention.</p><h3>Purpose</h3><p>According to the 2022 Dutch ‘Osteoporosis and fracture prevention’ guideline, zoledronic acid (ZA) is the preferred osteoporosis treatment for hip fracture patients. Less than 25% of hip fracture patients visit the outpatient fracture liaison service, therefore inpatient administration of ZA during the hip fracture hospitalization is now recommended in patients &gt; 75 years. In the OLVG Hospital, inpatient administration of ZA during hospitalization for hip fracture in older patients has been standard of care since 2020.</p><h3>Methods</h3><p>This single center retrospective observational follow-up study included hip fracture patients &gt; 75 years admitted to the orthogeriatric ward of the OLVG Hospital, and treated with 5 mg of ZA intravenously on the day of hospital discharge between June 2020 and December 2022. Life expectancy estimated &lt; 12 months, creatinine clearance &lt; 35 ml/min, hypocalcemia, and high risk of osteonecrosis of the jaw were contra-indications. During three months of follow-up (FU) adverse events, emergency room visits, hospital readmissions, and death were recorded.</p><h3>Results</h3><p>In 161 consecutive hospitalized hip fracture patients (mean age 86 ± 6 years, 65% female, 18% nursing home) ZA was administered and no adverse events were recorded. During 3 months of FU, 8 patients (5%) visited the emergency room, 19 patients (12%) were re-admitted to the hospital, 3 with a new fracture (2 contralateral hip, 1 radius), and 17 patients (11%) died of reasons unrelated to ZA.</p><h3>Conclusion</h3><p>This study shows that inpatient administration of zoledronic acid during hip fracture hospitalization is safe and feasible to prevent future fragility fractures in older hip fracture patients.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"19 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399215","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":"Percutaneous kyphoplasty combined with pediculoplasty (PKCPP) augments and internally fixates the severe osteoporotic vertebral fractures: a retrospective comparative study","authors":"Changming Xiao,&nbsp;Haozhong Wang,&nbsp;Yang Lei,&nbsp;Haoping Dai,&nbsp;Kaiquan Zhang,&nbsp;Mingzhong Xie,&nbsp;Sen Li","doi":"10.1007/s11657-024-01456-6","DOIUrl":"10.1007/s11657-024-01456-6","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;\u0000 &lt;i&gt;Summary&lt;/i&gt;\u0000 &lt;/h3&gt;&lt;p&gt;A retrospective comparative study revealed that percutaneous kyphoplasty combined with pediculoplasty (PKCPP) offers more benefits in terms of pain relief, spinal stability, and complications compared to simple percutaneous kyphoplasty. Moreover, PKCPP can augment and internally fixate the severe osteoporotic vertebral fractures.&lt;/p&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;p&gt;Vertebral augmentation (VA) has emerged as a satisfactory and minimally invasive surgical approach for severe osteoporotic vertebral fractures (OVFs). However, treating severe OVFs with advanced collapse, burst morphology with MC injury, posterior wall retropulsion, high degree of osseous fragmentation, pediculo-somatic junction fracture, and large vacuum cleft presents significant challenges. This study aimed to evaluate the effectiveness of percutaneous kyphoplasty combined with pediculoplasty (PKCPP) in reducing refracture, preventing further collapse and bone cement displacement, reconstructing vertebral body (VB) stability, and providing internal fixation of the anterior column (AC), middle column (MC), and the bilateral pedicles.&lt;/p&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;The current study was designed as a retrospective review of clinical and radiologic parameters. From July 2018 to September 2021, ninety-six patients with severe OVFs and without neurological deficit were treated either with simple percutaneous kyphoplasty (simple PKP group, &lt;i&gt;n&lt;/i&gt; = 54) or with percutaneous kyphoplasty combined with pediculoplasty (PKCPP group, &lt;i&gt;n&lt;/i&gt; = 42). All patients were followed up for at least 1 year, and clinical and radiological outcomes were assessed. Surgery duration and bone cement volume were compared between the two groups, as well as analgesic dosage and hospital stay. Anterior wall height (AWH), posterior wall height (PWH), and Cobb angle (CA) were measured and analyzed before and after surgery.&lt;/p&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;The simple PKP group had significantly shorter surgery duration and lower bone cement volume compared to the PKCPP group (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). Conversely, the simple PKP group had significantly higher analgesic dosage and longer hospital stay than the PKCPP group (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). Both groups showed significant improvements in AWH, PWH, and CA after surgery (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). At the final follow-up, the PWH in the simple PKP group was significantly lower than the preoperative measurement (&lt;i&gt;P&lt;/i&gt; &lt; 0.05), and the difference in PWH between the two groups was statistically significant (&lt;i&gt;P&lt;/i&gt; &gt; 0.05). Moreover, both groups demonstrated a significant reduction in CA after surgery, with the PKCPP group showing a greater reduction compared to the simple PKP group throughout the postoperative period to the final follow-up (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). VAS and ODI scores significantly decreased in both groups after surgery (&lt;i&gt;P&lt;/i&gt; &lt; 0.05), with no significant difference between the groups at the final follow","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"19 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387458","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":"Association between bone microarchitecture and sarcopenia in postmenopausal women with type 2 diabetes","authors":"Rimesh Pal,&nbsp;Trupti N. Prasad,&nbsp;Sanjay K. Bhadada,&nbsp;Veenu Singla,&nbsp;Urmila Yadav,&nbsp;Nipun Chawla","doi":"10.1007/s11657-024-01450-y","DOIUrl":"10.1007/s11657-024-01450-y","url":null,"abstract":"<div><h3>\u0000 <i>Summary</i>\u0000 </h3><p>Bone microarchitecture, as assessed using high-resolution peripheral quantitative computed tomography, is adversely affected in postmenopausal women with type 2 diabetes mellitus having sarcopenia/sarcopenic obesity while areal bone mineral density does not differ between those with and without sarcopenia.</p><h3>Purpose</h3><p>Type 2 diabetes (T2D) increases the risk of sarcopenia, which independently contributes to bone fragility. We aimed to explore the association between sarcopenia/sarcopenic obesity and bone quality using second-generation high-resolution peripheral quantitative computed tomography (HR-pQCT) in T2D.</p><h3>Methods</h3><p>We analyzed the baseline participant characteristics of an ongoing randomized clinical pilot trial (CTRI/2022/02/039978). Postmenopausal women (≥ 50 years) with T2D and high risk of fragility fractures were included. Areal BMD (aBMD), trabecular bone score (TBS), and body composition were measured using DXA. Bone microarchitecture was assessed at distal radius/distal tibia using HR-pQCT. Muscle strength was estimated using dominant handgrip strength (HGS). <i>Sarcopenia</i> was defined as low HGS (&lt; 18.0 kg) and low appendicular skeletal muscle index (ASMI) (&lt; 4.61 kg/m²). <i>Probable sarcopenia</i> was defined as low HGS with normal ASMI. <i>Sarcopenic obesity</i> was classified as co-existence of sarcopenia and obesity (BMI ≥ 25.0 kg/m²).</p><h3>Results</h3><p>We recruited 129 postmenopausal women (mean age 64.2 ± 6.7 years). Participants were categorized into four mutually exclusive groups: group A (normal HGS and ASMI, <i>n</i> = 17), group B (probable sarcopenia, <i>n</i> = 77), group C (non-obese sarcopenia, <i>n</i> = 18), and group D (obese sarcopenia, <i>n</i> = 18). The four groups did not differ significantly with regard to baseline characteristics, fracture prevalence, HbA1c, aBMD, and TBS. However, HR-pQCT-derived volumetric BMD and cortical/trabecular microarchitecture were significantly poorer in group C/group D than in group A/group B.</p><h3>Conclusions</h3><p>Bone quality rather than bone density (quantity) is adversely affected in T2D postmenopausal women with sarcopenia/sarcopenic obesity, which could increase the fracture risk in this patient sub-population.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"19 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142370838","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":"Individuals with a fragility fracture and a prescription for bone active medication have a positive perception of the medication but do not associate it with fracture risk reduction","authors":"Joanna E. M. Sale,&nbsp;Suvabna Theivendrampillai,&nbsp;Denise Linton,&nbsp;Judy Porteous","doi":"10.1007/s11657-024-01449-5","DOIUrl":"10.1007/s11657-024-01449-5","url":null,"abstract":"<div><h3>Summary</h3><p>Most participants reported a positive perception of bone active medication despite sustaining a fracture while taking the medication, reporting medication side effects, or having a healthcare provider stop the prescription. Participants did not appear to connect the medication to fracture risk, suggesting this connection should be emphasized by healthcare providers.</p><h3>Objective</h3><p>Our purpose was to examine perceptions about bone active medication from individuals with a fragility fracture and a prescription for bone active medication.</p><h3>Methods</h3><p>In this qualitative description study, eligible participants were those who attended an Osteoporosis Canada education session, and reported sustaining a previous fragility fracture and receiving a prescription for bone active medication. We conducted one-on-one interviews and analyzed the data using the analytic hierarchy approach.</p><h3>Results</h3><p>We interviewed 32 female participants (age range 58–89 years). Based on our analysis, two themes were developed: (1) most participants spoke positively about bone active medication, indicating they were willing to start, or continue to take, their medication. Positive perceptions were held by participants who sustained a fracture while taking bone active medication, participants whose healthcare provider had stopped the prescription, and participants who reported side effects from the medication; (2) most participants did not discuss bone active medication in relation to their fracture and did not appear to connect the medication to the concept of fracture risk. Instead, participants talked about the medication in relation to bone health in general, or to bone density.</p><h3>Conclusion</h3><p>Participants appeared to have positive perceptions of bone active medication, despite sustaining a fracture while taking the medication, reporting medication side effects, or having a healthcare provider stop the prescription. Participants did not connect bone active medication to the concept of fracture risk, illustrating the need for healthcare providers to emphasize the connection between fracture risk and bone active medication.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"19 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142340033","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":"Prevalence of fractures in adults over 50 years of age with osteoporosis in Colombia","authors":"Néstor Correa-Gonzalez,&nbsp;Daniel G. Fernández-Ávila,&nbsp;Diego Rosselli","doi":"10.1007/s11657-024-01412-4","DOIUrl":"10.1007/s11657-024-01412-4","url":null,"abstract":"<div><h3>\u0000 <i>Summary</i>\u0000 </h3><p>What are the fractures associated with osteoporosis in Colombian persons over 50 years of age? Through the analysis of the Ministry of Health databases, Colombians over 50 years of age with osteoporosis fracture the forearm the most, followed by the thoracolumbar vertebrae and then the hip. We describe the differences between men and women.</p><h3>Purpose</h3><p>The aim of this study was to determine the frequency of all bone fractures among adults aged 50 and above, both with and without osteoporosis, using data from SISPRO (Integrated Information System for Social Protection), the administrative database of the Colombian Ministry of Health.</p><h3>Methods</h3><p>Information was collected for the years 2017 to 2021 for all bone fractures (except cranial or face fractures), and how many of them occurred in patients who had the diagnosis of osteoporosis. Prevalence ratios (PR) were estimated separately for males and females by dividing the prevalence in those with by the prevalence of those without osteoporosis.</p><h3>Results</h3><p>For the period from 2017 to 2021, 303,037 adults over 50 years of age (females 279,057, 92.1%) were diagnosed with osteoporosis in Colombia, for a prevalence of 39.4 per thousand women and 4.14 in men; 40,823 of these women (14.6%) presented a fracture in the period, as well as 4020 of men (16.7%). Osteoporosis was present in 7.5% of the 596.618 (females 369.795; 62.0%) who suffered any fracture (1.8% of males and 11.0% of females). Overall PR was 3.4 (males 4.3; females 3.3). In men with osteoporosis, the most frequent fractures were hip (902), followed by lumbar vertebrae (842), ribs (648), and forearm (538), while in women, forearm (11,001), followed by hip (6885), lumbar vertebra (4813), and thoracic vertebra (2701) were the most common. PR in men was 21.9 for dorsal vertebrae fracture, 21.3 for lumbar vertebrae, 11.8 for ribs, and 7.7 for hip fracture. In women, PR was 15.7 for thoracic vertebrae, 13.3 for lumbar vertebrae, 3.3 for hip fracture, and 2.2 for forearm fracture.</p><h3>Conclusion</h3><p>Osteoporosis is a highly prevalent disease in Colombia where women are more affected. Although fractures were more common in women, men with osteoporosis have a higher PR of associated fractures.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"19 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142340034","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":"Correction to: Incidence and excess mortality of hip fractures in a predominantly Caucasian population in the South of Brazil","authors":"Dalisbor Marcelo Weber Silva,&nbsp;Marise Lazaretti-Castro,&nbsp;Cristiano Augusto de Freitas Zerbini,&nbsp;Vera Lúcia Szejnfeld,&nbsp;Sergio Ragi Eis,&nbsp;Victoria Zeghbi Cochenski Borba","doi":"10.1007/s11657-024-01416-0","DOIUrl":"10.1007/s11657-024-01416-0","url":null,"abstract":"","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"19 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307045","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":"Perspectives of healthcare providers on osteoporosis, falls and fracture risk: a systematic review and thematic synthesis of qualitative studies","authors":"Catherine Cho,&nbsp;Grace Bak,&nbsp;Daniel Sumpton,&nbsp;Bethan Richards,&nbsp;Catherine Sherrington","doi":"10.1007/s11657-024-01446-8","DOIUrl":"10.1007/s11657-024-01446-8","url":null,"abstract":"<div><h3>Objective</h3><p>Osteoporosis and falls are major risk factors for osteoporotic fractures, with significant detriment to patients’ quality of life. We aimed to describe healthcare provider (HCP) perspectives and experiences in the diagnosis, management and prevention of osteoporosis, falls and fractures obtained through primary qualitative research.</p><h3>Methods</h3><p>Thematic synthesis was performed on articles identified through a search of electronic databases (MEDLINE, Embase, PsychINFO and CINAHL), which were searched from inception to May 2023.</p><h3>Results</h3><p>Twenty-seven studies including 1662 HCPs, including general practitioners (GPs), physicians, surgeons, physiotherapists (PTs), occupational therapists (OTs), pharmacists and nurses, were included, with identification of six themes: overshadowed as a disease entity, uncertainty in decision making, frustration with interdisciplinary and systemic tension, avoiding medical paternalism, desire for improved care and embracing the responsibility.</p><h3>Conclusion</h3><p>Osteoporotic fracture and fall prevention in routine clinical care is hampered by inadequate priority and lack of perceived connection with morbidity and mortality, deficits in interdisciplinary collaboration, lack of clinical confidence and health resourcing. However, HCPs acknowledge their role in promoting healthy ageing, thus providing support through appropriate continuing education, resourcing and public health campaigns that are significant future directions, which may improve osteoporotic fracture prevention.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"19 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11420259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of teriparatide vs. bisphosphonates and denosumab vs. bisphosphonates in osteoporosis not previously treated with bisphosphonates: a systematic review and meta-analysis of randomized controlled trials","authors":"Mingnian Li,&nbsp;Zhuoqi Ge,&nbsp;Benqi Zhang,&nbsp;Li Sun,&nbsp;Zhongyuan Wang,&nbsp;Tao Zou,&nbsp;Qi Chen","doi":"10.1007/s11657-024-01447-7","DOIUrl":"10.1007/s11657-024-01447-7","url":null,"abstract":"<div><h3>\u0000 <i>Summary</i>\u0000 </h3><p>The study found that in osteoporosis patients who had not previously received bisphosphonate treatment and were in a treatment cycle of over 12 months, both teriparatide and denosumab significantly increased bone mineral density compared to bisphosphonates. Additionally, teriparatide was also shown to significantly decrease the risk of fractures.</p><h3>Objective</h3><p>The systematic review and meta-analysis aimed to assess and compare the safety and efficacy of teriparatide vs. bisphosphonates and denosumab vs. bisphosphonates in patients with osteoporosis who had not previously received bisphosphonates.</p><h3>Methods</h3><p>We conducted a search of published literature from inception to May 31, 2023, including databases such as PubMed, Embase, Cochrane Library, CNKI, SinoMed, VIP, and WanFang. The study only included head-to-head randomized controlled trials (RCTs) that compared teriparatide and denosumab with bisphosphonates to treat patients with osteoporosis. Fixed-effect model and random-effect model were used due to clinical heterogeneity. Meta-analysis was performed via Stata 17.0.</p><h3>Results</h3><p>A total of 6680 patients were enrolled across 23 eligible trials. The results of the meta-analysis showed that teriparatide was superior to bisphosphonates in decreasing the risk of fracture (risk ratio (RR) = 0.61, 95% confidence interval (CI) (0.51, 0.74), <i>P</i> &lt; 0.001). Denosumab showed no benefit compared to bisphosphonates in reducing the risk of fracture in treating osteoporosis (RR 0.99, 95% CI (0.62, 1.57), <i>P</i> = 0.96). Compared with bisphosphonates, teriparatide and denosumab could significantly improve femoral neck, total hip, and lumbar spine bone mineral density (BMD) (<i>P</i> &lt; 0.05). Furthermore, teriparatide and denosumab did not increase the incidence of adverse events (teriparatide vs. bisphosphonates, RR 0.92, 95% CI (0.79, 1.08), <i>P</i> = 0.32; denosumab vs. bisphosphonates, RR 0.98, 95% CI (0.95, 1.02), <i>P</i> = 0.37).</p><h3>Conclusions</h3><p>Teriparatide is superior to bisphosphonates in decreasing the risk of fracture in patients with osteoporosis. In addition, teriparatide and denosumab were more efficacious than bisphosphonates in increasing the percentage change in BMD at the femoral neck, total hip, and lumbar spine.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"19 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11420281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}