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Falinda D, Malden N. Case series: Osteonecrosis of the jaw related to denosumab preceded by bisphosphonates in cancer and osteoporotic patients. ADVANCES IN ORAL AND MAXILLOFACIAL SURGERY 2022. [DOI: 10.1016/j.adoms.2022.100258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Effect of echinalkamide identified from Echinacea purpurea (L.) Moench on the inhibition of osteoclastogenesis and bone resorption. Sci Rep 2020; 10:10914. [PMID: 32616823 PMCID: PMC7331694 DOI: 10.1038/s41598-020-67890-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 06/08/2020] [Indexed: 11/15/2022] Open
Abstract
Plant cell cultures have been exploited to provide stable production and new secondary metabolites for better pharmacological activity. Fractionation of adventitious root cultures of Echinacea purpurea resulted in the isolation of eleven constituents, including three new compounds. The structures of the three new compounds were determined to be an alkylamide (1), a polyacetylene (2) and a lignan (3) on the basis of combined spectroscopic analysis. To discover new types of antiresorptive agents, we screened for new compounds that regulate osteoclast differentiation, and survival. Among three new compounds, echinalkamide (compound 1) had considerably inhibitory effects on RANKL-induced osteoclast differentiation, and on proliferation of osteoclasts and efficiently attenuated osteoclastic bone resorption without toxicity. In addition, echinalamide treatment inhibited the osteoclast—specific gene expression level. Echinalkamide achieved this inhibitory effect by disturbing phosphorylation of MAPK and activation of osteoclast transcription factors c-Fos and NFATc1. Conclusionally, our study investigated that echinalkamide remarkably inhibited osteoclast differentiation and osteoclast specific gene expression through repression of the MAPK–c-Fos–NFATC1 cascade.
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Awareness among patient at risk of developing Medication Related Osteonecrosis of the Jaw (MRONJ) - A primary prevention strategy. Saudi Pharm J 2020; 28:771-778. [PMID: 32550810 PMCID: PMC7292880 DOI: 10.1016/j.jsps.2020.05.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 05/06/2020] [Indexed: 12/26/2022] Open
Abstract
The quality of life, in itself, in cancer patients or in osteoporotic individuals, without even considering the side effects of the medication in the first place, has a considerable negative impact on the clinical outcome. The Medication Related Osteonecrosis of the Jaw (MRONJ), in the maxillofacial region, although rare, needs to be addressed with the prime importance. One of the key components of any given preventive treatment strategy is to, create awareness about the medication related unwanted effects, among health care professionals and patients. Objective This study is aimed to explore and assess the awareness level among dental patients about MRONJ, the risk factors, and the high-risk category (who are prone to develop MRONJ). Material and methods This is a prospective interviewer administered research electronic data capture (REDCap) survey. The sample included 68 patients, who are currently taking or will be taking Bisphosphonate (BP), and/or Denosumab, and anti-Angiogenic agent. Data have been analyzed using IBM SPSS software, Results Sixty-eight patients (18 males and 50 females), participated in this study. Only 23 subjects (33.82%) were aware about the MRONJ. Females were more aware about the complications than males. The awareness among the subjects with education at college level appears to be higher than the subjects having education less than high school level. Even though, a dental check- up, is mandatory, prior to starting these medications, to see if any dental treatment is required, only slightly more than half of the patients (54.72%) had a dental checkup. Conclusion This is a novel study in the Middle- East, used to assess awareness about the MRONJ including three type of related medications. Low awareness of MRONJ is alarming. The results of the study will help to initiate the process of providing the education materials, about the side effects and importance of oral hygiene maintenance, giving priority to improve the quality of life in such patients. Awareness of patients regarding the complications must be an important part of health care practice guidelines.
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Kuhlen M, Kunstreich M, Niinimäki R, Dunstheimer D, Lawitschka A, Bardi E, Willasch A, Bader P, Högler W, Peters C, Balduzzi A. Guidance to Bone Morbidity in Children and Adolescents Undergoing Allogeneic Hematopoietic Stem Cell Transplantation. Biol Blood Marrow Transplant 2020; 26:e27-e37. [DOI: 10.1016/j.bbmt.2019.10.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 09/12/2019] [Accepted: 10/08/2019] [Indexed: 12/13/2022]
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Ko KR, Lee S, Oh SY, Kim KD, Park SH, Lee S. Long-Term Oral Bisphosphonate Compliance Focusing on Switching of Prescription Pattern. Patient Prefer Adherence 2020; 14:2009-2016. [PMID: 33122894 PMCID: PMC7588837 DOI: 10.2147/ppa.s266697] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 09/21/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Factors determining bisphosphonate compliance are not fully understood. We examined fluctuations in oral bisphosphonate dosing intervals to gauge therapeutic compliance in patients with osteoporosis. MATERIALS AND METHODS Hospital data accruing between 2010 and 2017 were accessed to retrospectively study patients ≥50 years old (N=1873), each prescribed bisphosphonate at initial diagnosis of osteoporosis. The medication possession ratio (MPR), calculated as total days supplied divided by length of follow-up, served to measure therapeutic compliance. We compared MPRs of various prescription patterns (daily, weekly, monthly, and switch [ie, ≥1 change in pattern] groups). We also analyzed the impact of age, sex, fracture history, surgical history, and comorbidities. Multiple regression analysis was ultimately performed, using MPR as a dependent variable. RESULTS In our cohort (mean follow-up=5.7±2.4 years), once weekly dosing was the most common prescription pattern (1223/1873, 65.3%), as opposed to monthly (366/1873, 19.5%) or daily (164/1873, 8.8%) dosing. A total of 120 patients (6.4%) comprising the switch group changed dosing patterns during the study period. MPR was significantly higher in the switch group (32.8±22.7) than in the other three groups (daily, 21.9±25.9; weekly, 22.7±27.3; monthly, 23.2±27.7). In multiple regression analysis, younger age (P<0.001), female sex (P=0.004), and switching of prescription pattern (decrease or increase frequency) were factors significantly associated with higher MPR, signaling better compliance. CONCLUSION Better bisphosphonate compliance was associated with physician-modified dosing patterns. We therefore recommend adjustments of prescription intervals in poorly compliant patients requiring long-term treatment.
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Affiliation(s)
- Kyung Rae Ko
- Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sangcheol Lee
- Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Seo Yoon Oh
- University of California, Berkeley, CA94720, USA
| | - Ki-duk Kim
- Department of Orthopaedic Surgery, Bucheon Hospital, Soonchunhyang University School of Medicine, Bucheon-si, Gyeonggi-do, Republic of Korea
| | - Sin Hyung Park
- Department of Orthopaedic Surgery, Bucheon Hospital, Soonchunhyang University School of Medicine, Bucheon-si, Gyeonggi-do, Republic of Korea
- Sin Hyung Park Department of Orthopaedic Surgery, Bucheon Hospital, Soonchunhyang University School of Medicine, 170 Jomaru-Ro, Bucheon-si, Gyeonggi-do, Republic of KoreaTel +82 32-621-5114Fax +82 32-708-3578 Email
| | - Soonchul Lee
- Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University, Seongnam-si, Gyeonggi-do, Republic of Korea
- Correspondence: Soonchul Lee Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University, 59 Yatap-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of KoreaTel +82 31-780-5289Fax +82 31-708-3578 Email
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Khalid AB, Slayden AV, Kumpati J, Perry CD, Berryhill SB, Crawford JA, Fatima I, Morselli M, Pellegrini M, Miranda-Carboni GA, Krum SA. GATA4 represses RANKL in osteoblasts via multiple long-range enhancers to regulate osteoclast differentiation. Bone 2018; 116:78-86. [PMID: 30031905 PMCID: PMC6158087 DOI: 10.1016/j.bone.2018.07.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 07/17/2018] [Accepted: 07/18/2018] [Indexed: 12/13/2022]
Abstract
GATA4 is a transcription factor that is responsible for tissue-specific gene regulation in many tissues, and more recent studies showed that it is necessary for osteoblast differentiation. Previously, we showed that in vivo deletion of Gata4 using Cre-recombinase under the control of the Col1a1 2.3 kb promoter, showed significantly reduced trabecular bone properties. To understand the role of GATA4 in more differentiated cells, GATA4fl/fl mice were crossed with mice expressing Cre-recombinase under the control of the osteocalcin promoter. MicroCT analysis of trabecular bone properties of the femur and tibia from 14-week-old female osteocalcin-Cre/GATA4fl/fl (OCN-cKO) mice showed a significant reduction in percentage bone volume, a decrease in trabecular number and an increase in trabecular spacing. In vivo, histomorphometric analysis revealed a decrease in the number of osteoblasts and an increase in the number of osteoclasts in the tibiae of OCN-cKO mice. In vivo and in vitro systems correlated a decrease in Gata4 mRNA with increased RANKL gene expression. To determine if RANKL is a direct target of GATA4, chromatin immunoprecipitation (ChIP)-sequencing was performed, and it demonstrated that GATA4 is recruited to seven enhancers near RANKL. Furthermore, when Gata4 is knocked down, the chromatin at the RANKL region is further opened, as detected by a reduction in histone 3 lysine 27 trimethylation (H3K27me3) and an increase in histone 3 lysine 4 dimethylation (H3K4me2) in the RANKL locus. In vitro, TRAP staining of cells from bone marrow cultures from Gata4 knockout cells show that the increased levels of RANKL are sufficient for osteoclast formation. Together, the data suggest that GATA4 directly represses RANKL expression via seven cis-regulatory regions and plays an important role in maintaining proper bone development and osteoclast formation.
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Affiliation(s)
- Aysha B Khalid
- Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Alexandria V Slayden
- Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Jerusha Kumpati
- Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Chanel D Perry
- Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Stuart B Berryhill
- Bone Histology and Imaging Core, Winthrop P. Rockefeller Cancer Institute, University of Arkansas Medical School, Little Rock, AR, United States
| | - Julie A Crawford
- Bone Histology and Imaging Core, Winthrop P. Rockefeller Cancer Institute, University of Arkansas Medical School, Little Rock, AR, United States
| | - Iram Fatima
- Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Marco Morselli
- Department of Molecular, Cellular and Developmental Biology, University of California at Los Angeles (UCLA), Los Angeles, CA, United States
| | - Matteo Pellegrini
- Department of Molecular, Cellular and Developmental Biology, University of California at Los Angeles (UCLA), Los Angeles, CA, United States
| | - Gustavo A Miranda-Carboni
- Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, United States; Center for Cancer Research, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Susan A Krum
- Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee Health Science Center, Memphis, TN, United States.
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Coskun Benlidayi I. Denosumab in the treatment of glucocorticoid-induced osteoporosis. Rheumatol Int 2018; 38:1975-1984. [PMID: 30019224 DOI: 10.1007/s00296-018-4106-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 07/13/2018] [Indexed: 12/16/2022]
Abstract
Glucocorticoid therapy is the number one cause of secondary osteoporosis particularly effecting young individuals. Possessing an increased risk for fractures, glucocorticoid-induced osteoporosis might interfere with patients' well-being and quality of life. Therefore, proper treatment of bone loss and prevention from fractures are of great importance. There are a limited number of therapeutic and preventative options for glucocorticoid-induced osteoporosis. Denosumab, with its high anti-resorptive potential, has been studied several times among patients on glucocorticoid therapy. However, a comprehensive look analysing the current data is lacking. Thus, the objective of the current article is to evaluate the current evidence on the efficacy, as well as the safety profile of denosumab in glucocorticoid-induced osteoporosis. Pubmed/MEDLINE, Scopus and Web of Science databases were searched for the terms denosumab, glucocorticoid-induced osteoporosis, steroid-induced osteoporosis, glucocorticoids and osteoporosis. Relevant data regarding the efficacy and safety of denosumab among patients with glucocorticoid-induced osteoporosis was analysed. Denosumab contributes to increased bone mineral density and decreased bone-turnover marker levels among glucocorticoid users. It is an effective therapeutic option with a favourable safety profile in glucocorticoid-induced osteoporosis.
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Affiliation(s)
- Ilke Coskun Benlidayi
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Cukurova University, Adana, Turkey.
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Pharmacokinetics, pharmacodynamics, safety, and tolerability of single-dose denosumab in healthy Chinese volunteers: A randomized, single-blind, placebo-controlled study. PLoS One 2018; 13:e0197984. [PMID: 29933364 PMCID: PMC6014657 DOI: 10.1371/journal.pone.0197984] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 10/03/2017] [Indexed: 12/20/2022] Open
Abstract
Background Denosumab is a fully human monoclonal antibody against receptor activator of nuclear factor kappa-B ligand, a cytokine essential for the formation, function and survival of osteoclasts. This study assessed the pharmacokinetics, pharmacodynamics, safety and tolerability of single-dose denosumab (60 and 120 mg) in healthy Chinese volunteers. Methods This randomized (3:3:2), single-blind, placebo-controlled study enrolled healthy Chinese volunteers to receive single subcutaneous injection of denosumab 60 mg, 120 mg, or placebo. Study consisted of screening period (up to 21 days), treatment and assessment period (19 weeks), and an end-of-study visit (at week 26). Denosumab pharmacokinetics and pharmacodynamics parameters were estimated using non-compartmental analysis. Safety and tolerability were assessed throughout the study. Results A total of 63 volunteers received the study treatment and 62 (98.4%) completed the study. Denosumab serum concentrations peaked at around Day 10 with dose-proportional increase from 60 mg to 120 mg. The mean terminal half-life of denosumab 60 mg and 120 mg was 15 days and 26 days, respectively. The serum C-terminal cross-linking telopeptide of type I collagen concentration-time profiles were similar (>80% decrease within 5 days) between denosumab 60 mg and 120 mg groups. The most commonly reported adverse event (AE) was decreased blood calcium levels (denosumab 60 mg, n = 13; denosumab 120 mg, n = 13; placebo, n = 1); however only one volunteer had calcium level below the abnormality value of potential clinical importance and none of the volunteers developed symptoms of hypocalcemia. The majority of AEs were of mild to moderate intensity. There were no deaths, serious AEs, or withdrawal from study due to AEs. No clinically significant findings in vital signs or electrocardiogram were observed. Conclusions Both denosumab 60 mg and 120 mg were well tolerated with no new safety concerns identified in healthy Chinese volunteers with similar pharmacokinetics and pharmacodynamics profiles to that of Caucasians. Trial registration ClinicalTrial.gov NCT02135640
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Lizneva D, Yuen T, Sun L, Kim SM, Atabiekov I, Munshi LB, Epstein S, New M, Zaidi M. Emerging concepts in the epidemiology, pathophysiology, and clinical care of osteoporosis across the menopausal transition. Matrix Biol 2018; 71-72:70-81. [PMID: 29738833 DOI: 10.1016/j.matbio.2018.05.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 05/03/2018] [Accepted: 05/04/2018] [Indexed: 02/08/2023]
Abstract
Bone loss in women accelerates during perimenopause, and continues into old age. To-date, there has been little progress made in stratifying for fracture risk in premenopausal and early postmenopausal women. Epidemiologic data suggests that changes in serum FSH could predict decrements in bone mass during peri- and postmenopause. In bone, FSH stimulates osteoclast formation by releasing osteoclastogenic cytokines. Here, we address the evidence for bone loss across the menopausal transition, discuss strategies for detection and treatment of early postmenopausal osteoporosis, and describe the role FSH plays in physiology and likely in pathophysiology of early postmenopausal bone loss.
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Affiliation(s)
- Daria Lizneva
- The Mount Sinai Bone Program, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Reproductive Health Protection, Scientific Center of Family Health and Human Reproduction, Irkutsk, Russian Federation.
| | - Tony Yuen
- The Mount Sinai Bone Program, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Li Sun
- The Mount Sinai Bone Program, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Se-Min Kim
- The Mount Sinai Bone Program, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ihor Atabiekov
- Department of Reproductive Health Protection, Scientific Center of Family Health and Human Reproduction, Irkutsk, Russian Federation
| | - Lubna Bashir Munshi
- The Mount Sinai Bone Program, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sol Epstein
- The Mount Sinai Bone Program, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Maria New
- The Mount Sinai Bone Program, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Mone Zaidi
- The Mount Sinai Bone Program, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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Zhu S, Wei W, Liu Z, Yang Y, Jia H. Tanshinone‑IIA attenuates the deleterious effects of oxidative stress in osteoporosis through the NF‑κB signaling pathway. Mol Med Rep 2018; 17:6969-6976. [PMID: 29568934 PMCID: PMC5928650 DOI: 10.3892/mmr.2018.8741] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 05/16/2017] [Indexed: 02/04/2023] Open
Abstract
Osteoclasts are responsible for bone resorption caused by bone microstructural damage and bone-related disorders. Evidence shows that tanshinone IIA (Tan‑IIA), a traditional Chinese medicine, is used clinically as a drug for the treatment of cardiovascular and cerebrovascular diseases. However, the efficacy and mechanism underlying the effect of Tan‑IIA on the viability of osteoclasts remain to be fully elucidated. The present study investigated the therapeutic effects of Tan‑IIA on osteoblast differentiation and oxidative stress in vitro and in vivo. Cell viability was analyzed and oxidative stress was examined in the osteoblasts. Wnt1sw/sw mice were used to investigate the therapeutic effects of Tan‑IIA on spontaneous tibia fractures and severe osteopenia. The bone strength, collagen and mineral were examined in the tibia. Osteoblast activity was also analyzed in the experimental mice. The Tan‑IIA‑induced differentiation of osteoclasts and the mechanism of action were investigated in osteocytes. The data showed that Tan‑IIA treatment improved cell viability. The data also demonstrated that Tan‑IIA decreased the levels of H2O2, accumulation of reactive oxygen species and apoptosis of osteoblasts. Tan‑IIA inhibited the deleterious outcomes triggered by oxidative stress. In addition, Tan‑IIA inhibited the activation of nuclear factor (NF)‑κB and its target genes, tumor necrosis factor (TNF)‑α, inducible nitric oxide synthase and cyclooxygenase 2, and increased the levels of TNF receptor‑associated factor 1 and inhibitor of apoptosis protein‑1/2 in the osteocytes. Furthermore, it was shown that Tan‑IIA reduced the propensity to fractures and severe osteopenia in mice with osteoporosis. Tan‑IIA also exhibited improved bone strength, mineral and collagen in the bone matrix of the experimental mice. It was found that the Tan‑IIA‑mediated benefits on osteoblast activity and function were through the NF‑κB signaling pathway. Taken together, the data obtained in the present study suggested that Tan‑IIA had protective effects against oxidative stress in osteoblastic differentiation in mice with osteoporosis by regulating the NF‑κB signaling pathway.
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Affiliation(s)
- Shaowen Zhu
- Department of Orthopedics, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China
| | - Wanfu Wei
- Department of Orthopedics, Tianjin Hospital, Tianjin 300211, P.R. China
| | - Zhiwei Liu
- Basic Medicine Institution, Public Health Center, Peking University, Beijing 100871, P.R. China
| | - Yang Yang
- Department of Orthopedics, Tianjin Hospital, Tianjin 300211, P.R. China
| | - Haobo Jia
- Department of Orthopedics, Tianjin Hospital, Tianjin 300211, P.R. China
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Skripnikova IA, Kosmatova OV, Abirova ES, Novikov VE, Murashko LM. [Experience in using Prolia in patients with postmenopausal osteoporosis in clinical practice]. TERAPEVT ARKH 2018; 89:190-196. [PMID: 29488480 DOI: 10.17116/terarkh20178912190-196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM To evaluate the efficiency and safety of long-term Prolia therapy in patients with postmenopausal osteoporosis (OP). SUBJECTS AND METHODS The open prospective study enrolled 98 women (mean age, 68±9 years; mean menopause duration, 17±4 years) with postmenopausal OP, who were followed up in an outpatient setting at the National Medical Research Center for Preventive Medicine and who had been treated with denosumab 60 mg subcutaneously every 6 months for 12 months or more. The maximum follow-up period was 4 years: 48, 29, 11, and 10 patients were treated for 12, 24, 36, and 48 months, respectively. The patients were allocated into 2 groups: those who received and those who had not previously received antiosteoporotic therapy. Bone mineral density (BMD) was measured using dual-energy X-ray densitometry of the lumbar spine (LI-LIV) and proximal femur (PF). The ten-year probability of major osteoporotic fractures was estimated once in 72 patients not previously receiving antiosteoporotic therapy before the prescription of denosumab. RESULTS In the patients not previously receiving therapy, the median 10-year probability of major fractures using the FRAX algorithm was 14.9%; that of femoral neck (FN) fractures was 3.7%. During denosumab treatment, the BMD increase in the lumbar spine was 4.2% at 12 months, 7.5% at 24 months, was 8.8% at 36 months; that in FN was 3.1, 3.9, and 5.3%, that in PF was 2.8, 4.1, and 5%; and that in the 1/3 forearm was 0.9, 1.4, and 2.6%, respectively (p < 0.001). In the persons receiving and not previously receiving the therapy, the BMD increase was similar, i.e. there was an additional positive effect when switching to denosumab. The decrease in the serum concentration of C-terminal telopeptide of type I collagen (CTX-I) was 54% at 6 months after initiation of denosumab therapy (p < 0.001) and 72% at 12 months (p<0.001); and the achieved marker level remained unchanged at 48 months. Transition from the OP zone to osteopenia one was noted in 23 patients with low BMD (T-score -2.5 SD) in LI-LII and in 12 patients with that in FN at 12 months of denosumab therapy and this was in 25 patients at 24 months. Nine-eight patients receiving the first Prolia injection refused to continue treatment on their own; adverse events were not the reason for drug discontinuation. CONCLUSION Therapy with denosumab was effective in increasing BMD in routine outpatient practice and in allowing 25% of patients to achieve target values of this indicator. The marked decrease in the level of the bone resorption marker STX suggested that the drug had antiresorptive potency. The frequency of adverse reactions was low, confirming the good tolerability and safety profile of the drug. The convenience of the scheme and route of drug administration contributed to strict compliance with the doctor's recommendations. Denosumab was effective in increasing BMD not only in untreated patients, but also in those who had previously received antiosteoporotic therapy. The pharmacokinetic characteristics of denosumab, which contribute to its uniform distribution in trabecular and cortical bone tissue, regardless of active bone remodeling, and the fact that the clearance of the drug is independent of kidney function offer an advantage of administering the drug to patients with significant loss of FN and radius BMD and of reducing kidney function.
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Affiliation(s)
- I A Skripnikova
- National Medical Research Center for Preventive Medicine, Ministry of Health of Russia, Moscow, Russia
| | - O V Kosmatova
- National Medical Research Center for Preventive Medicine, Ministry of Health of Russia, Moscow, Russia
| | - E S Abirova
- National Medical Research Center for Preventive Medicine, Ministry of Health of Russia, Moscow, Russia
| | - V E Novikov
- National Medical Research Center for Preventive Medicine, Ministry of Health of Russia, Moscow, Russia
| | - L M Murashko
- National Medical Research Center for Preventive Medicine, Ministry of Health of Russia, Moscow, Russia
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Reduced bone resorption by intake of dietary vitamin D and K from tailor-made Atlantic salmon: A randomized intervention trial. Oncotarget 2018; 7:69200-69215. [PMID: 27542236 PMCID: PMC5342470 DOI: 10.18632/oncotarget.10171] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 06/09/2016] [Indexed: 11/25/2022] Open
Abstract
Suboptimal vitamin D status is common among humans, and might increase bone resorption with subsequent negative effects on bone health. Fatty fish, including Atlantic salmon, is an important dietary vitamin D source. However, due to a considerable change in fish feed composition, the contribution of vitamin D from salmon fillet has been reduced. The main objective was to investigate if intake of vitamin D3 enriched salmon or vitamin D3 tablets decreased bone biomarkers (urinary N-telopeptides, deoxypyridinoline, serum bone-specific alkaline phosphatase, and osteocalcin) compared to a low vitamin D3 intake. The 122 healthy postmenopausal women included in this 12 weeks intervention trial were randomized into four groups: three salmon groups (150 grams/two times/week) and one tablet group (800 IU vitamin D and 1000 mg calcium/day). The salmon groups also received calcium supplements. The salmon had three different vitamin D3/vitamin K1 combinations: high D3+high K1, low D3+high K1, or high D3+low K1. Increased intake of salmon containing high levels of vitamin D3 (0.35-0.38 mg/kg/fillet) and supplements with the same weekly contribution had a positive influence on bone health as measured by bone biomarkers in postmenopausal women. Consequently, an increased level of vitamin D3 at least to original level in feed for salmonids will contribute to an improved vitamin D3 status and may improve human bone health.
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Durden E, Pinto L, Lopez-Gonzalez L, Juneau P, Barron R. Two-year persistence and compliance with osteoporosis therapies among postmenopausal women in a commercially insured population in the United States. Arch Osteoporos 2017; 12:22. [PMID: 28243883 PMCID: PMC5329075 DOI: 10.1007/s11657-017-0316-5] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 02/13/2017] [Indexed: 02/03/2023]
Abstract
This retrospective, observational study assessed 2-year persistence and compliance by treatment, route of administration, and dosing frequency in postmenopausal women initiating a new osteoporosis therapy. Two-year persistence and compliance rates were higher in women receiving injectables compared with oral agents. PURPOSE This study extends previous studies limited to 1-year follow-up by examining persistence with osteoporosis therapies over a 2-year period and compares short- and long-term trends in persistence and compliance among postmenopausal women with commercial or Medicare supplemental insurance in the USA. METHODS This retrospective, observational cohort study enrolled women ≥50 years newly initiating osteoporosis therapy between January 1 and December 31, 2012 (i.e., the index date), with continuous enrollment ≥14 months before and ≥24 months after their index date. Persistence (continuous therapy without a >60-day gap) and compliance with the index therapy were evaluated at 2 years of follow-up. Multivariable logistic regression was used to compare the odds of persistence and compliance across treatment and dosing regimens. RESULTS This study included 43,543 patients with mean (standard deviation) age 65 (10) years. At 2 years of follow-up, persistence and compliance were higher for patients treated with injectable agents (ranging from 34 to 41%, excluding an every-3-month injection) than those treated with oral agents (ranging from 20 to 31%). Additionally, patients initiating oral bisphosphonates (except risedronate once daily), raloxifene (daily), or zoledronic acid (annually) had significantly lower odds of persistence compared with denosumab (every 6 months). CONCLUSIONS Patients initiating injectable therapies had greater persistence and compliance at 2 years than those initiating oral therapies. Patients initiating an every-6-month injection had significantly higher persistence compared with those initiating more frequently dosed (e.g., daily and weekly) oral or injectable agents.
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Affiliation(s)
- Emily Durden
- Life Sciences, Truven Health Analytics, 7700 Old Georgetown Road, Bethesda, MD, 20814, USA.
| | - Lionel Pinto
- Global Health Economics, Amgen Inc., 1 Amgen Center Drive, Thousand Oaks, CA, 91320, USA
| | - Lorena Lopez-Gonzalez
- Custom Data Analytics, Life Sciences, Truven Health Analytics, 7700 Old Georgetown Road, Bethesda, MD, 20814, USA
| | - Paul Juneau
- Statistical Services Group, Truven Health Analytics, 7700 Old Georgetown Road, Bethesda, MD, 20814, USA
| | - Richard Barron
- Global Health Economics, Amgen Inc., 1 Amgen Center Drive, Thousand Oaks, CA, 91320, USA
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14
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Sone T, Kon N, Gaither KW, Okubo N, Osakabe T, Nakayama Y, Fukunaga M, Ito M, Nakamura T. Effects of 3-year denosumab treatment on hip structure in Japanese postmenopausal women and men with osteoporosis. Bone Rep 2017; 7:164-171. [PMID: 29188222 PMCID: PMC5701790 DOI: 10.1016/j.bonr.2017.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 11/07/2017] [Accepted: 11/13/2017] [Indexed: 12/31/2022] Open
Abstract
Denosumab, a human monoclonal antibody against RANK ligand, is shown to have strong anti-fracture effects in Japanese osteoporosis patients. However, there have been no data showing actions on Japanese bone architecture. Here we show that denosumab continuously improves several geometrical parameters calculated by hip structural analysis for 3 years. Compared to placebo, denosumab significantly increased bone mineral density, cortical thickness and cross sectional area in all of the three analyzed areas: the narrow neck, intertrochanter and femoral shaft. The subsequent derived mechanical parameters, cross-sectional moment of inertia, section modulus and buckling ratio, were also improved by denosumab. In addition, the improvement of these parameters was also observed in the patients that had switched from placebo to denosumab treatment. The present study suggests the structural evidence explaining the strong anti-fracture efficacy of denosumab and its significant effects on cortical bone in Japanese.
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Key Words
- BMD, bone mineral density
- BR, buckling ratio
- Bone quality
- CSA, cross sectional area
- CSMI, cross sectional moment of inertia
- CoTh, cortical thickness
- DIRECT, Denosumab fracture Intervention Randomized placebo Controlled Trial
- DMAb/DMAb, denosumab/denosumab
- DXA, dual-energy X-ray absorptiometry
- Denosumab
- ED, endocortical diameter
- FREEDOM, Fracture Reduction Evaluation of Denosumab in Osteoporosis every 6 Months
- HSA, hip structural analysis
- Hip structural analysis
- Japanese
- OD, outer diameter
- Osteoporosis
- PBO/DMAb, placebo/denosumab
- RANK ligand
- RANK, receptor activator of nuclear factor kappa-B
- SM, section modulus
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Affiliation(s)
- Teruki Sone
- Department of Nuclear Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama 701-0192, Japan
| | - Naohiro Kon
- Medical Science Department, Daiichi Sankyo Co. Ltd., Tokyo, Japan
| | - Kenneth W. Gaither
- Bioclinica, Inc., 11731 Northeast Glenn Widing Drive Portland, Oregon 97220, United States
| | - Naoki Okubo
- Biostatistics and Data Management Department, Daiichi Sankyo Co. Ltd., Tokyo, Japan
| | - Taisuke Osakabe
- Clinical Development Department, Daiichi Sankyo Co. Ltd., Tokyo, Japan
| | - Yutaka Nakayama
- Post-Marketing Regulatory Affairs Department, Daiichi Sankyo Co. Ltd., Tokyo, Japan
| | - Masao Fukunaga
- Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama 701-0192, Japan
| | - Masako Ito
- Center for Diversity and Inclusion, Nagasaki University, 1-14 Bunkyo-machi, Nagasaki 852-8521, Japan
| | - Toshitaka Nakamura
- Touto Sangenjaya Rehabilitation Hospital, 1-24-3 Sangenjaya, Setagaya-ku, Tokyo 154-0024, Japan
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15
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Liu Y, Zuo G, Meng X, Gao X, Zhang L, Tang P. Adrenomedullin inhibits osteoclast differentiation through the suppression of receptor activator of nuclear factor-κB ligand-induced nuclear factor-κB activation in glucocorticoid-induced osteoporosis. Exp Ther Med 2017; 14:4009-4016. [PMID: 29067096 PMCID: PMC5647721 DOI: 10.3892/etm.2017.5025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 04/21/2017] [Indexed: 12/22/2022] Open
Abstract
The current study aimed to improve the understanding on the association between adrenomedullin and osteoporosis in mice with glucocorticoid-induced osteoporosis. Bone resorption and osteoporosis-associated indexes, including maximum load, stiffness, energy to failure, ultimate strength, elastic modulus, post-yield displacement and post-yield displacement, in mice with osteoporosis were analyzed in order to evaluate the effect of adrenomedullin. The receptor activator of nuclear factor-κB ligand (RANKL)-induced osteoclast differentiation was investigated subsequent to treatment with adrenomedullin in vitro. The results demonstrated that adrenomedullin significantly improved bone mass loss, density, bone strength and osteoporosis disease in the mice with glucocorticoid-induced osteoporosis. In addition, adrenomedullin markedly improved the osteoporosis-associated NFATc1, TRAP, OSCAR and c-Fos expression levels. Furthermore, the current findings indicated that RANKL-mediated osteoclast differentiation was suppressed in vitro and in vivo. Notably, the data revealed that adrenomedullin significantly improved the osteoporotic symptoms through inhibition of RANKL-induced NF-κB activation in glucocorticoid-induced osteoporosis. In conclusion, adrenomedullin serves an essential role in the progression of glucocorticoid-induced osteoporosis, regulating the bone mass loss, density and strength through the NF-κB signaling pathway.
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Affiliation(s)
- Yuanxin Liu
- Department of Orthopaedics, Chinese PLA General Hospital, Beijing 100853, P.R. China
| | - Guilai Zuo
- Department of Orthopaedics, Pingyin People Hospital, Jinan, Shandong 250400, P.R. China
| | - Xin Meng
- Department of Orthopaedics, Pingyin People Hospital, Jinan, Shandong 250400, P.R. China
| | - Xingxiao Gao
- Department of Orthopaedics, Pingyin People Hospital, Jinan, Shandong 250400, P.R. China
| | - Lihai Zhang
- Department of Orthopaedics, Chinese PLA General Hospital, Beijing 100853, P.R. China
| | - Peifu Tang
- Department of Orthopaedics, Chinese PLA General Hospital, Beijing 100853, P.R. China
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Lipton A, Chapman JAW, Leitzel K, Garg A, Pritchard KI, Ingle JN, Budd GT, Ellis MJ, Sledge GW, Rabaglio M, Han L, Elliott CR, Shepherd LE, Goss PE, Ali SM. Osteoporosis therapy and outcomes for postmenopausal patients with hormone receptor-positive breast cancer: NCIC CTG MA.27. Cancer 2017; 123:2444-2451. [DOI: 10.1002/cncr.30682] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Revised: 11/08/2016] [Accepted: 12/01/2016] [Indexed: 02/02/2023]
Affiliation(s)
- Allan Lipton
- Penn State Hershey Cancer Institute; Penn State Hershey Medical Center; Hershey Pennsylvania
| | | | - Kim Leitzel
- Penn State Hershey Cancer Institute; Penn State Hershey Medical Center; Hershey Pennsylvania
| | - Ashwani Garg
- Penn State Hershey Cancer Institute; Penn State Hershey Medical Center; Hershey Pennsylvania
| | - Kathleen I. Pritchard
- Sunnybrook Odette Cancer Centre; Toronto Sunnybrook Regional Cancer Centre; Toronto Ontario Canada
| | | | | | - Matthew J. Ellis
- Lester and Sue Smith Breast Center, Baylor College of Medicine; Houston Texas
| | | | - Manuela Rabaglio
- International Breast Cancer Study Group Coordinating Center and Inselspital; Bern Switzerland
| | - Lei Han
- Canadian Cancer Trials Group; Queen's University; Kingston Ontario Canada
| | | | - Lois E. Shepherd
- Canadian Cancer Trials Group; Queen's University; Kingston Ontario Canada
| | - Paul E. Goss
- Massachusetts General Hospital Cancer Center; Boston Massachusetts
| | - Suhail M. Ali
- Penn State Hershey Cancer Institute; Penn State Hershey Medical Center; Hershey Pennsylvania
- Lebanon VA Medical Center; Lebanon Pennsylvania
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Abstract
PURPOSE OF THE REVIEW The purposes of this study are to examine the literature within the past 5 years regarding osteoporosis and offer a discussion on new topics and controversies. RECENT FINDINGS Patient compliance with therapy remains an issue. The effectiveness of Vitamin D and calcium are being called into question Atypical femur fractures have been associated with bisphosphonate and denosumab use. Treatment is both surgical and pharmaceutical. A multidisciplinary approach to osteoporotic fractures is important and having some form of fracture liaison service (FLS) improves the efficacy of osteoporotic care and decreases secondary fractures. Screening for osteoporosis remains low. Ultrasound may be cost-effective for diagnosis. Understanding of osteoporosis has come a long way in the medical community, but the translation to the lay community has lagged behind. Patients often take a laissez-faire attitude toward osteoporosis that can affect compliance. Information read by patients often focuses on complications, such as atypical femur fractures and myocardial infarctions. It is essential for providers to be able to discuss these issues with patients. Newer medications and more cost-effective diagnostic tests exist, but availability may be limited. FLS are effective, but the most cost-effective model for therapy still eludes us. Areas for further investigation include FLS models, the effectiveness of vitamin supplementation, and more ubiquitous and cost-effective diagnostic tools.
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Affiliation(s)
- Kyle M Schweser
- Department of Orthopaedic Surgery, University of Missouri, N116, One Hospital Dr, Columbia, MO, 65212, USA
| | - Brett D Crist
- Department of Orthopaedic Surgery, University of Missouri, N116, One Hospital Dr, Columbia, MO, 65212, USA.
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18
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Ge JR, Xie LH, Chen J, Li SQ, Xu HJ, Lai YL, Qiu LL, Ni CB. Liuwei Dihuang Pill () Treats Postmenopausal Osteoporosis with Shen (Kidney) Yin Deficiency via Janus Kinase/Signal Transducer and Activator of Transcription Signal Pathway by Up-regulating Cardiotrophin-Like Cytokine Factor 1 Expression. Chin J Integr Med 2016; 24:415-422. [PMID: 28028720 DOI: 10.1007/s11655-016-2744-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To investigate the mechanism of Liuwei Dihuang Pill (, LDP) in treating postmenopausal osteoporosis (PMOP) with Shen (Kidney) yin deficiency. METHODS In this study, 205 cases of PMOP were divided into the PMOP Shen-yin deficiency group (Group A), PMOP Shen-yang deficiency group (Group B), PMOP without Shen deficiency group (Group C), and control group (Group N). Real-time polymerase chain reaction (RT-PCR) and Western blot techniques were used to observe the effects of LDP treatment on the cardiotrophin-like cytokine factor 1 (CLCF1), ankyrin repeat and SOCS box containing 1 (ASB1), and prokineticin 2 (PROK2) genes and the Janus kinase/signal transducer and activator of transcription (JAK/STAT) signaling pathway. RESULTS The mRNA (P<0.05) and protein (P<0.01) expression levels of the CLCF1 gene in Group A were significantly lower than the corresponding levels in Group N. After LDP treatment for 3 months, the mRNA expression levels of the CLCF1 gene were obviously up-regulated (P<0.01). After 6-month treatment, the expression levels of CLCF1 mRNA and protein were significantly up-regulated (both P<0.01), and the average bone density of the top femur had significantly increased (P<0.05). In vitro, CLCF1 overexpression resulted in a significant increase in the total protein and phosphorylated protein levels of JAK2 and STAT3. CONCLUSIONS The CLCF1 gene is an important gene associated with PMOP Shen-yin deficiency and the therapeutic effects of LDP may be mediated by up-regulation of CLCF1 gene expression and activation of the JAK/STAT signaling pathway.
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Affiliation(s)
- Ji-Rong Ge
- Key Research Laboratory of Osteoporosis Syndrome Genomics, Fujian Academy of Traditional Chinese Medicine, Fuzhou, 350003, China.
| | - Li-Hua Xie
- Key Research Laboratory of Osteoporosis Syndrome Genomics, Fujian Academy of Traditional Chinese Medicine, Fuzhou, 350003, China
| | - Juan Chen
- Key Research Laboratory of Osteoporosis Syndrome Genomics, Fujian Academy of Traditional Chinese Medicine, Fuzhou, 350003, China
| | - Sheng-Qiang Li
- Key Research Laboratory of Osteoporosis Syndrome Genomics, Fujian Academy of Traditional Chinese Medicine, Fuzhou, 350003, China
| | - Hui-Juan Xu
- Key Research Laboratory of Osteoporosis Syndrome Genomics, Fujian Academy of Traditional Chinese Medicine, Fuzhou, 350003, China
| | - Yu-Lian Lai
- Key Research Laboratory of Osteoporosis Syndrome Genomics, Fujian Academy of Traditional Chinese Medicine, Fuzhou, 350003, China
| | - Long-Long Qiu
- Key Research Laboratory of Osteoporosis Syndrome Genomics, Fujian Academy of Traditional Chinese Medicine, Fuzhou, 350003, China
| | - Chen-Bo Ni
- Key Research Laboratory of Osteoporosis Syndrome Genomics, Fujian Academy of Traditional Chinese Medicine, Fuzhou, 350003, China
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19
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Russell RGG. Pharmacological diversity among drugs that inhibit bone resorption. Curr Opin Pharmacol 2015; 22:115-30. [DOI: 10.1016/j.coph.2015.05.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Accepted: 05/07/2015] [Indexed: 02/08/2023]
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21
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Sarkar M, Bhardwaj R, Madabhavi I, Khatana J. Osteoporosis in chronic obstructive pulmonary disease. CLINICAL MEDICINE INSIGHTS-CIRCULATORY RESPIRATORY AND PULMONARY MEDICINE 2015; 9:5-21. [PMID: 25788838 PMCID: PMC4358421 DOI: 10.4137/ccrpm.s22803] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 01/28/2015] [Accepted: 02/11/2015] [Indexed: 12/21/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) is a lifestyle-related chronic inflammatory pulmonary disease associated with significant morbidity and mortality worldwide. COPD is associated with various comorbidities found in all stages of COPD. The comorbidities have significant impact in terms of morbidity, mortality, and economic burden in COPD. Management of comorbidities should be incorporated into the comprehensive management of COPD as this will also have an effect on the outcome in COPD patients. Various comorbidities reported in COPD include cardiovascular disease, skeletal muscle dysfunction, anemia, metabolic syndrome, and osteoporosis. Osteoporosis is a significant comorbidity in COPD patients. Various risk factors, such as tobacco smoking, systemic inflammation, vitamin D deficiency, and the use of oral or inhaled corticosteroids (ICSs) are responsible for its occurrence in patients with COPD. This review will focus on the prevalence, pathogenesis, risk factors, diagnosis, and treatment of osteoporosis in COPD patients.
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Affiliation(s)
- Malay Sarkar
- Department of Pulmonary Medicine, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
| | - Rajeev Bhardwaj
- Department of Cardiology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
| | - Irappa Madabhavi
- Department of Medical and Pediatric Oncology, GCRI, Ahmedabad, Gujarat, India
| | - Jasmin Khatana
- Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
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22
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Sakai A, Ito M, Tomomitsu T, Tsurukami H, Ikeda S, Fukuda F, Mizunuma H, Inoue T, Saito H, Nakamura T. Efficacy of combined treatment with alendronate (ALN) and eldecalcitol, a new active vitamin D analog, compared to that of concomitant ALN, vitamin D plus calcium treatment in Japanese patients with primary osteoporosis. Osteoporos Int 2015; 26:1193-202. [PMID: 25592133 PMCID: PMC4331603 DOI: 10.1007/s00198-014-2991-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 12/05/2014] [Indexed: 01/22/2023]
Abstract
UNLABELLED Combined treatment with alendronate and eldecalcitol was found to be more effective in reducing the bone turnover markers and increasing bone mineral density than alendronate treatment with vitamin D3 and calcium supplementation in the osteoporotic patients. INTRODUCTION We compared the clinical efficacy and safety of combined treatment with alendronate plus eldecalcitol (ALN + ELD) with those of treatment with ALN plus vitamin D and calcium (ALN + VitD). METHODS Osteoporotic 219 patients were randomly assigned to the ALN + ELD, or the ALN + VitD group. Primary endpoint was the inter-group differences in lumbar spine BMD (L-BMD) at patient's last visit. Secondary endpoints included the differences in BMD at other sites and the bone turnover marker (BTM) levels. RESULTS L-BMD, total hip BMD and femoral neck (FN-BMD) increased from baseline by 7.30, 2.41, and 2.70 % in the ALN + ELD group, and by 6.52, 2.27, and 1.18% in the ALN + VitD group, respectively. Inter-group differences of the L-BMD and total hip BMD values were not significant. The increase of the FN-BMD was larger in the ALN + ELD group than the ALN + VitD group. Reductions of the BTMs were greater in the ALN + ELD group than the ALN + VitD group. Interaction of the percent increase of the L-BMD with the baseline values of the BTMs was observed in the ALN + VitD group only. The increases of the FN-BMD in patients with lower baseline values of type-I-collagen C-telopeptide (sCTX) and serum 25(OH) D levels <20 ng/mL were significantly larger in the ALN + ELD group than the other group. CONCLUSION Combination treatment of ALN plus ELD was more effective in reducing the BTMs and increasing the FN-BMD than ALN treatment with vitamin D3 and calcium.
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Affiliation(s)
- A. Sakai
- Department of Orthopaedic Surgery, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - M. Ito
- Medical Work-Life Balance Center, Nagasaki University Hospital, Nagasaki, Japan
| | - T. Tomomitsu
- Department of Radiological Technology, Kawasaki College of Allied Health Professions, Kurashiki, Japan
| | - H. Tsurukami
- Tsurukami Clinic of Orthopaedic and Rheumatology Hospital, Kumamoto, Japan
| | - S. Ikeda
- Ken-Ai Memorial Hospital, Onga, Japan
| | - F. Fukuda
- Kitakyushu General Hospital, Kitakyushu, Japan
| | - H. Mizunuma
- Department of Obstetrics and Gynecology, Hirosaki University School of Medicine, Hirosaki, Japan
| | - T. Inoue
- Taisho Pharmaceutical Co. Ltd, Tokyo, Japan
| | - H. Saito
- Chugai Pharmaceutical Co. Ltd, Tokyo, Japan
| | - T. Nakamura
- National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjyuku-ku, Tokyo, 162-8655 Japan
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Passeri E, Benedini S, Costa E, Corbetta S. A Single 60 mg Dose of Denosumab Might Improve Hepatic Insulin Sensitivity in Postmenopausal Nondiabetic Severe Osteoporotic Women. Int J Endocrinol 2015; 2015:352858. [PMID: 25873952 PMCID: PMC4383275 DOI: 10.1155/2015/352858] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Revised: 03/09/2015] [Accepted: 03/11/2015] [Indexed: 02/06/2023] Open
Abstract
Background. The RANKL/RANK/OPG signaling pathway is crucial for the regulation of osteoclast activity and bone resorption being activated in osteoporosis. The pathway has been also suggested to influence glucose metabolism as observed in chronic low inflammation. Aim. To test whether systemic blockage of RANKL by the monoclonal antibody denosumab influences glucose metabolism in osteoporotic women. Study Design. This is a prospective study on the effect of a subcutaneously injected single 60 mg dose of denosumab in 14 postmenopausal severe osteoporotic nondiabetic women evaluated at baseline and 4 and 12 weeks after their first injection by an oral glucose tolerance test. Results. A single 60 mg dose of denosumab efficiently inhibited serum alkaline phosphatase while it did not exert any significant variation in fasting glucose, insulin, or HOMA-IR at both 4 and 12 weeks. No changes could be detected in glucose response to the glucose load, Matsuda Index, or insulinogenic index. Nonetheless, 60 mg denosumab induced a significant reduction in the hepatic insulin resistance index at 4 weeks and in HbA1c levels at 12 weeks. Conclusions. A single 60 mg dose of denosumab might positively affect hepatic insulin sensitivity though it does not induce clinical evident glucose metabolic disruption in nondiabetic patients.
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Affiliation(s)
- Elena Passeri
- Endocrinology and Diabetology Unit, IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy
| | - Stefano Benedini
- Endocrinology and Diabetology Unit, Department of Biomedical Sciences for Health, University of Milan, IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy
| | - Elena Costa
- Clinical Laboratory, IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy
| | - Sabrina Corbetta
- Endocrinology and Diabetology Unit, Department of Biomedical Sciences for Health, University of Milan, IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy
- *Sabrina Corbetta:
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