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Stanoyevitch A, Zhang L, Sanz J, Follett RW, Bell DS. Association of Antiosteoporotic Medication Bisphosphonates and Denosumab with Primary Breast Cancer: An Electronic Health Record Cohort Study. ACTA ACUST UNITED AC 2021; 2:316-324. [PMID: 34476414 PMCID: PMC8409235 DOI: 10.1089/whr.2020.0120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2021] [Indexed: 11/22/2022]
Abstract
Background: The risks of osteoporosis and breast cancer are increasing in elderly women. Bisphosphonates and denosumab are recommended for treatment of osteoporosis. They have different and overlapping pharmacodynamics and previous studies have shown conflicting results regarding their risk association with breast cancer. We intend to further look into this issue through a comparative study. Methods: Electronic health records of 91,626 women older than 50 years with no previous history of malignancy and no nonbreast cancer during follow-up were retrieved from southern California and retrospectively analyzed using univariate, bivariate, and log-rank tests. Medication use, breast cancer risk, and associated demographic and clinical history were assessed. Results: Over an average of 3.6 years follow-up, the breast cancer relative risks (RRs) counted after 365 days of latency are 1.12 (95% confidence interval [CI]: 0.64–1.97) for denosumab ever users and 0.37 (95% CI: 0.21–0.66) for bisphosphonates ever users, when covariates are comparable. The significant difference is supported by the Log-rank test (p = 0.0004). Excluding statins coprescribers, the breast cancer RR is 1.31 (0.71, 2.43) in denosumab group and 0.26 (0.11, 0.62) in bisphosphonates group. There is a reduced RR in statins ever users (0.47, 95% CI: 0.38–0.58), and the breast cancer risk difference is not significant between concomitant denosumab/statins and bisphosphonates/statins ever users with RR 0.65 (0.16, 2.58) versus 0.55 (0.26, 1.16), p = 0.692. Conclusions: Our data support an association of lower breast cancer risk with bisphosphonates use in elderly women. We did not observe a lower breast cancer risk in denosumab group; however, our data revealed a potential lower breast cancer risk in denosumab users with concurrent statins use and this requires further study.
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Affiliation(s)
- Alexander Stanoyevitch
- Department of Mathematics, California State University-Dominguez Hills, Carson, California, USA
| | - Lei Zhang
- Pathology Associates of Anaheim, Anaheim Regional Medical Center, Anaheim, California, USA
| | - Javier Sanz
- University of California at Los Angeles, Clinical and Translational Science Institute, Los Angeles, California, USA
| | - Robert W Follett
- University of California at Los Angeles, Clinical and Translational Science Institute, Los Angeles, California, USA
| | - Douglas S Bell
- University of California at Los Angeles, Clinical and Translational Science Institute, Los Angeles, California, USA
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Müller WEG, Wang X, Schröder HC. New Target Sites for Treatment of Osteoporosis. PROGRESS IN MOLECULAR AND SUBCELLULAR BIOLOGY 2017; 55:187-219. [PMID: 28238039 DOI: 10.1007/978-3-319-51284-6_6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
In the last few years, much progress has been achieved in the discovery of new drug target sites for treatment of osteoporotic disorders, one of the main challenging diseases with a large burden for the public health systems. Among these new agents promoting bone formation, shifting the impaired equilibrium between bone anabolism and bone catabolism in the direction of bone synthesis are inorganic polymers, in particular inorganic polyphosphates that show strong stimulatory effects on the expression of bone anabolic marker proteins and hydroxyapatite formation. The bone-forming activity of these polymers can even be enhanced by combination with certain small molecules like quercetin, or if given as functionally active particles with certain divalent cations like strontium ions even showing by itself biological activity. This chapter summarizes recent developments in the search and development of novel anti-osteoporotic agents, with a particular focus on therapeutic approaches based on the potential application of inorganic polymers and combinations.
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Affiliation(s)
- Werner E G Müller
- ERC Advanced Investigator Group, Institute for Physiological Chemistry, University Medical Center of the Johannes Gutenberg University, Duesbergweg 6, 55128, Mainz, Germany. .,NanotecMARIN GmbH, Duesbergweg 6, 55128, Mainz, Germany.
| | - Xiaohong Wang
- ERC Advanced Investigator Group, Institute for Physiological Chemistry, University Medical Center of the Johannes Gutenberg University, Duesbergweg 6, 55128, Mainz, Germany.,NanotecMARIN GmbH, Duesbergweg 6, 55128, Mainz, Germany
| | - Heinz C Schröder
- ERC Advanced Investigator Group, Institute for Physiological Chemistry, University Medical Center of the Johannes Gutenberg University, Duesbergweg 6, 55128, Mainz, Germany.,NanotecMARIN GmbH, Duesbergweg 6, 55128, Mainz, Germany
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Xu Z, Hao D, He L, Guo H, He B, Liu T, Zheng Y, Wang D. An assessment system for evaluating the severity of thoracolumbar osteoporotic fracture and its clinical application: A retrospective study of 381 cases. Clin Neurol Neurosurg 2015; 139:70-5. [PMID: 26383865 DOI: 10.1016/j.clineuro.2015.09.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 09/07/2015] [Accepted: 09/08/2015] [Indexed: 11/25/2022]
Abstract
OBJECTIVE We put forward an assessment system of thoracolumbar osteoporotic fracture (ASTLOF) evaluating the severity of thoracolumbar osteoporotic fracture. This study was to investigate its efficacy in guiding clinical practice. METHODS Three hundred and eighty-one patients with thoracolumbar vertebral osteoporosis fracture admitted to the hospital from January 2010 to December 2011 were enrolled in the study. All cases were evaluated by ASTLOF including evaluation of morphological changes, MRI, bone mineral density and pain. The patients were treated with different methods according to ASTLOF score. All patients were followed up on a regular basis. The treatment results were assessed by VAS and ODI. RESULTS All patients were followed up with an average of 20.1 (range: 6-30) months. There were 91 cases of ASTLOF score<4 points. Their average VAS score decreased from 8.0 ± 1.7 points to 2.0 ± 1.3 with statistical significance (P<0.05) and the average ODI score decreased from 69.5 ± 2.8 to 38.1 ± 1.5 (P<0.05). One hundred and thirty-two cases were with ASTLOF score=4, with the average VAS score decreased from 8.2 ± 1.4 to 1.9 ± 1.2 (P<0.05) and the average ODI score decreased from 71.5 ± 3.7 to 36.2 ± 2.5 (P<0.05). There were 158 cases of ASTLOF score ≥ 5, with the VAS score decreased from 8.0 ± 1.7 to 2.0 ± 1.3 and the ODI score decreased from 69.5 ± 2.8 to 38.1 ± 1.5. CONCLUSIONS ASTLOF based on the severity of thoracolumbar osteoporotic fracture was suggested to be helpful in guiding clinical practice.
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Affiliation(s)
- Zhengwei Xu
- Department of Spinal Surgery, Xi'an Jiaotong University Medical College Hong Hui Hospital, No. 76 Nanguo Road, Xi'an, Shaanxi Province 710054, China
| | - Dingjun Hao
- Department of Spinal Surgery, Xi'an Jiaotong University Medical College Hong Hui Hospital, No. 76 Nanguo Road, Xi'an, Shaanxi Province 710054, China.
| | - Limin He
- Department of Spinal Surgery, Xi'an Jiaotong University Medical College Hong Hui Hospital, No. 76 Nanguo Road, Xi'an, Shaanxi Province 710054, China
| | - Hua Guo
- Department of Spinal Surgery, Xi'an Jiaotong University Medical College Hong Hui Hospital, No. 76 Nanguo Road, Xi'an, Shaanxi Province 710054, China
| | - Baorong He
- Department of Spinal Surgery, Xi'an Jiaotong University Medical College Hong Hui Hospital, No. 76 Nanguo Road, Xi'an, Shaanxi Province 710054, China
| | - Tuanjiang Liu
- Department of Spinal Surgery, Xi'an Jiaotong University Medical College Hong Hui Hospital, No. 76 Nanguo Road, Xi'an, Shaanxi Province 710054, China
| | - Yonghong Zheng
- Department of Spinal Surgery, Xi'an Jiaotong University Medical College Hong Hui Hospital, No. 76 Nanguo Road, Xi'an, Shaanxi Province 710054, China
| | - Dongqi Wang
- Department of Spinal Surgery, Xi'an Jiaotong University Medical College Hong Hui Hospital, No. 76 Nanguo Road, Xi'an, Shaanxi Province 710054, China
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Hubert PA, Lee SG, Lee SK, Chun OK. Dietary Polyphenols, Berries, and Age-Related Bone Loss: A Review Based on Human, Animal, and Cell Studies. Antioxidants (Basel) 2014; 3:144-58. [PMID: 26784669 PMCID: PMC4665444 DOI: 10.3390/antiox3010144] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2013] [Revised: 02/23/2014] [Accepted: 02/24/2014] [Indexed: 12/27/2022] Open
Abstract
Bone loss during aging has become an increasing public health concern as average life expectancy has increased. One of the most prevalent forms of age-related bone disease today is osteoporosis in which the body slows down bone formation and existing bone is increasingly being resorbed by the body to maintain the calcium balance. Some causes of this bone loss can be attributed to dysregulation of osteoblast and osteoclast activity mediated by increased oxidative stress through the aging process. Due to certain serious adverse effects of the currently available therapeutic agents that limit their efficacy, complementary and alternative medicine (CAM) has garnered interest as a natural means for the prevention of this debilitating disease. Natural antioxidant supplementation, a type of CAM, has been researched to aid in reducing bone loss caused by oxidative stress. Naturally occurring polyphenols, such as anthocyanins rich in berries, are known to have anti-oxidative properties. Several studies have been reviewed to determine the impact polyphenol intake-particularly that of berries-has on bone health. Studies reveal a positive association of high berry intake and higher bone mass, implicating berries as possible inexpensive alternatives in reducing the risk of age related bone loss.
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Affiliation(s)
- Patrice A Hubert
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269-4017, USA.
| | - Sang Gil Lee
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269-4017, USA.
| | - Sun-Kyeong Lee
- Center on Aging, University of Connecticut Health Center, Farmington, CT 06030-5215, USA.
| | - Ock K Chun
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269-4017, USA.
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Abstract
BACKGROUND According to the 2010 Osteoporosis Canada Clinical Practice Guidelines, denosumab is a first-line option for the pharmacological management of postmenopausal osteoporosis (PMO), along with several therapeutics that may be more familiar to family practice doctors: bisphosphonates, raloxifene, teriparatide, and hormone therapy. Denosumab is indicated for postmenopausal patients at high risk for fracture or others who have failed, or are intolerant to, other osteoporosis therapies. SCOPE We undertook a review of the efficacy and safety of denosumab in PMO, searching the English-language literature on this drug via PubMed queries as of July 2012. FINDINGS Although established treatments reduce fracture risk among osteoporotic postmenopausal women in trials, their effectiveness in clinical practice is limited by patient adherence. Twice-yearly denosumab treatment is associated with markedly improved bone mineral density (BMD) and cortical and trabecular bone strength, and significantly reduced osteoporotic fracture. Inhibition of bone resorption is fully reversible following discontinuation. Placebo-controlled and open-label extension studies showed similar adverse event (AE) and serious AE rates, relative to placebo, over up to 5 years. Data indicate a potential advantage of denosumab over the bisphosphonate alendronate for BMD and patient adherence and preference. CONCLUSION Owing to its efficacy, safety, and potential to improve adherence rates, denosumab is an appropriate first-line pharmacologic option for PMO management.
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Affiliation(s)
- Robert Josse
- St Michael's Hospital, University of Toronto, Toronto, ON, Canada.
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Bibliography. Parathyroids, bone and mineral metabolism. Current world literature. Curr Opin Endocrinol Diabetes Obes 2011; 18:418-22. [PMID: 22024994 DOI: 10.1097/med.0b013e32834decbe] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Current World Literature. Curr Opin Support Palliat Care 2011; 5:297-305. [DOI: 10.1097/spc.0b013e32834a76ed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Schröder HC, Wiens M, Wang X, Schloßmacher U, Müller WEG. Biosilica-based strategies for treatment of osteoporosis and other bone diseases. PROGRESS IN MOLECULAR AND SUBCELLULAR BIOLOGY 2011; 52:283-312. [PMID: 21877270 DOI: 10.1007/978-3-642-21230-7_10] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Osteoporosis is a common disease in later life, which has become a growing public health problem. This degenerative bone disease primarily affects postmenopausal women, but also men may suffer from reduced bone mineral density. The development of prophylactic treatments and medications of osteoporosis has become an urgent issue due to the increasing proportion of the elderly in the population. Apart from medical/hormonal treatments, current strategies for prophylaxis of osteoporosis are primarily based on calcium supplementation as a main constituent of bone hydroxyapatite mineral. Despite previous reports suggesting an essential role in skeletal growth and development, the significance of the trace element silicon in human bone formation has attracted major scientific interest only rather recently. The interest in silicon has been further increased by the latest discoveries in the field of biosilicification, the formation of the inorganic silica skeleton of the oldest still extant animals on Earth, the sponges, which revealed new insights in the biological function of this element. Sponges make use of silicon to build up their inorganic skeleton which consists of biogenously formed polymeric silica (biosilica). The formation of biosilica is mediated by specific enzymes, silicateins, which have been isolated, characterized, and expressed in a recombinant way. Epidemiological studies revealed that dietary silicon reduces the risk of osteoporosis and other bone diseases. Recent results allowed for the first time to understand the molecular mechanism underlying the protective effect of silicic acid/biosilica against osteoporosis. Biosilica was shown to modulate the ratio of expression of two cytokines involved in bone formation-RANKL and osteoprotegerin. Hence, biosilica has been proposed to have a potential in prophylaxis and therapy of osteoporosis and related bone diseases.
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Affiliation(s)
- Heinz C Schröder
- ERC Advanced Grant Research Group, Institute for Physiological Chemistry, University Medical Center of the Johannes Gutenberg University Mainz, Duesbergweg 6, D-55128, Mainz, Germany,
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