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Gursu M, Aydin Z, Karadag S, Uzun S, Ogul S, Kiris A, Doventas Y, Koldas M, Ozturk S, Kazancioglu R, Mandreoli M, Bellasi A, Baldrati L, Corradini M, Rigotti A, Russo G, David S, Malmusi G, DiNicolo' P, Orsi C, Zambianchi L, Caruso F, Poisetti P, Fabbri A, Santoro A, Barton Pai A, Grabe D, Eisele G, Hutchison CA, Bevins A, Lukacik P, Hughes RG, Pratt G, Viana JL, Bishop NC, Kosmadakis G, Bevington A, Clapp EL, Feehally J, Smith AC, Joki N, Hase H, Tanaka Y, Iwasaki M, Yamaka T, Shigematsu T, Dou L, Gondouin B, Cerini C, Duval-Sabatier A, Poitevin S, Dignat-George F, Burtey S, Brunet P, Carrasco F, Salvador F, Origaca C, Nogueira E, Silva N, Silva A, Sikole A, Trajceska L, Selim G, Gelev S, Dzekova P, Amitov V, Arsov S, Dalboni M, Cruz E, Manfredi S, Mouro M, Quinto M, Grabulosa C, Batista M, Cendoroglo M, Hirayama A, Matsui H, Nagano Y, Ueda A, Aoyagi K, Owada S, Schepers E, Barreto D, Liabeuf S, Glorieux G, Eloot S, Barreto F, Massy Z, Vanholder R, Secara IF, Oleniuc M, Nistor I, Onofriescu M, Covic A, Aguerrevere S, Granada M, Bayes B, Pastor M, Sancho A, Bonal J, Canas L, Lauzurica R, Teixido J, Troya M, Romero R, Capitanini A, D'Alessandro C, Ferretti V, Petrone I, Pasquariello G, Cupisti A, Parastayeva MM, Berseneva ON, Kucher AG, Ivanova GT, Smirnov AV, Kayukov IG, Kayabasi H, Esmer S, Yilmaz Z, Kadiroglu AK, Yilmaz ME, Radic J, Kovacic V, Radic M, Ljutic D, Sain M, Karakan S, Sezer S, Tutal E, Ozdemir Acar FN, Bi G, Xing C, Chen R, Romero-Garcia A, Jacobo-Arias F, Martin del Campo F, Gonzalez-Espinoza L, Pazarin L, Cueto-Manzano AM, Panagoutsos S, Kriki P, Mourvati E, Tziakas D, Chalikias G, Stakos D, Apostolakis S, Tsigalou C, Gioka T, Konstantinides S, Vargemezis V, Nascimento M, Hayashi S, Seeberger A, Yamamoto T, Qureshi AR, Lind B, Riella M, Brodin LA, Lindholm B, Meier P, Menne J, Kruger K, Mooren FC, Weissmann N, Seimetz M, Haller H, Gusev E, Solomatina L, Zhuravleva J, Striker G, Uribarri J, Cai W, Goodman S, Pyzik R, Grosjean F, Vlassara H, So A, Gimona A, Kiechle T, Shpilsky A, Schlesinger N. Malnutrition & inflammation in CKD 1-5. Clin Kidney J 2011. [DOI: 10.1093/ndtplus/4.s2.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Tannenbaum H, Berenbaum F, Reginster JY, Zacher J, Robinson J, Poor G, Bliddal H, Uebelhart D, Adami S, Navarro F, Lee A, Moore A, Gimona A. Lumiracoxib is effective in the treatment of osteoarthritis of the knee: a 13 week, randomised, double blind study versus placebo and celecoxib. Ann Rheum Dis 2004; 63:1419-26. [PMID: 15020310 PMCID: PMC1754793 DOI: 10.1136/ard.2003.015974] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To compare the efficacy and safety of lumiracoxib with placebo and celecoxib for osteoarthritis OA in a 13 week, multicentre, randomised, double blind study. METHODS After a 37 day washout period for nonsteroidal antiinflammatory drugs, 1702 patients with knee OA were randomised to lumiracoxib 200 or 400 mg once daily od, celecoxib 200 mg od, or placebo 2221. A visual analogue scale VAS pain intensity > or =40 mm was required. Primary efficacy variables were OA pain intensity VAS mm in the target knee, patients global assessment of disease activity VAS mm, and WOMAC pain subscale and total scores at 13 weeks. OA pain intensity, patients and physicians global assessment of disease activity, and WOMAC total and all subscale scores were analysed by visit as secondary variables. RESULTS Lumiracoxib showed significant improvements in all primary and secondary variables compared with placebo. Lumiracoxib 200 mg od and celecoxib 200 mg od achieved similar improvements in OA pain intensity and functional status. Lumiracoxib 400 mg od demonstrated better efficacy for OA pain intensity and patients global assessment of disease activity at weeks 2, 4, and 8 and similar efficacy at week 13 compared with celecoxib 200 mg od. The incidence of adverse events AEs, serious AEs, and discontinuations due to AEs was similar in each group. CONCLUSION Lumiracoxib demonstrated significant improvement in OA pain intensity, patients global assessment of disease activity, and the WOMAC pain subscale and total scores compared with placebo. Lumiracoxib was well tolerated in this study, with overall tolerability similar to that of placebo and celecoxib.
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Affiliation(s)
- H Tannenbaum
- Rheumatic Disease Centre of Montreal, 4060 SteCatherine St West, Suite 740, Montreal H3Z 2Z3 QC, Canada.
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Chesnut CH, Silverman S, Andriano K, Genant H, Gimona A, Harris S, Kiel D, LeBoff M, Maricic M, Miller P, Moniz C, Peacock M, Richardson P, Watts N, Baylink D. A randomized trial of nasal spray salmon calcitonin in postmenopausal women with established osteoporosis: the prevent recurrence of osteoporotic fractures study. PROOF Study Group. Am J Med 2000; 109:267-76. [PMID: 10996576 DOI: 10.1016/s0002-9343(00)00490-3] [Citation(s) in RCA: 796] [Impact Index Per Article: 33.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE We conducted a 5-year, double-blind, randomized, placebo-controlled study to determine whether salmon calcitonin nasal spray reduced the risk of new vertebral fractures in postmenopausal women with osteoporosis. SUBJECTS AND METHODS A total of 1,255 postmenopausal women with established osteoporosis were randomly assigned to receive salmon calcitonin nasal spray (100, 200, or 400 IU) or placebo daily. All participants received elemental calcium (1,000 mg) and vitamin D (400 IU) daily. Vertebral fractures were assessed with lateral radiographs of the spine. The primary efficacy endpoint was the risk of new vertebral fractures in the salmon calcitonin nasal spray 200-IU group compared with the placebo group. RESULTS During 5 years, 1,108 participants had at least one follow-up radiograph. A total of 783 women completed 3 years of treatment, and 511 completed 5 years. The 200-IU dose of salmon calcitonin nasal spray significantly reduced the risk of new vertebral fractures by 33% compared with placebo [200 IU: 51 of 287, placebo: 70 of 270, relative risk (RR) = 0.67, 95% confidence interval (CI): 0.47- to 0.97, P = 0.03]. In the 817 women with one to five prevalent vertebral fractures at enrollment, the risk was reduced by 36% (RR = 0.64, 95% CI: 0.43- to 0.96, P = 0.03). The reductions in vertebral fractures in the 100-IU (RR = 0.85, 95% CI: 0.60- to 1.21) and the 400-IU (RR = 0.84, 95% CI: 0.59- to 1.18) groups were not significantly different from placebo. Lumbar spine bone mineral density increased significantly from baseline (1% to 1. 5%, P<0.01) in all active treatment groups. Bone turnover was inhibited, as shown by suppression of serum type-I collagen cross-linked telopeptide (C-telopeptide) by 12% in the 200-IU group (P <0.01) and by 14% in the 400-IU group (P<0.01) as compared with placebo. CONCLUSION Salmon calcitonin nasal spray at a dose of 200 IU daily significantly reduces the risk of new vertebral fractures in postmenopausal women with osteoporosis.
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Affiliation(s)
- C H Chesnut
- University of Washington (CHC), Seattle, Washington, USA
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Abstract
OBJECTIVES Oestrogens are widely believed to be effective against postmenopausal osteoporosis. However there are some outstanding questions which still need an answer. For example, the minimal effective dose regimen of oestradiol needs to be established and the relationship between oestradiol levels and efficacy on bone turnover and bone mass needs to be further clarified. METHODS Menorest is being tested in the prevention of postmenopausal bone loss. A phase II/III clinical program, that includes two double blind, dose-ranging, placebo-controlled, parallel group, 2-year studies, has started in 58 centers in Europe and South Africa. Four-hundred eighty women will be enrolled in the two studies (201 and 305). The objective of the studies is to evaluate the efficacy of Menorest at different doses and regimens, in the prevention of bone loss in early postmenopausal women. In study 201, the treatment regimen is 'cyclic sequential' (24 days of transdermal oestradiol during a 28-day cycle with progestin taken during the last 14 days of oestrogen administration). In study 305 the treatment regimen is "continuous sequential' (28 days of transdermal oestradiol during, a 28-day cycle with progestin taken during the last 14 days of oestrogen administration). The doses studied are 50, 75, 100 micrograms/day in study 201, and 25, 50, 75 micrograms/day in study 305, (the two studies are otherwise identical). All 'active-dose' treated groups receive dydrogesterone 20 mg/day during the last 14 days of Menorest administration and placebo tablets are given to the placebo patch group. The main entry criteria are natural or surgical menopause, (with hormonal confirmation) from 1 to 6 years, with no contra-indication to HRT and with a bone mineral density (BMD) at the lumbar spine with a T-score between 0 and -3. Women with severe vasomotor symptoms are excluded from the studies. The primary efficacy variable is the mean change from baseline, measured with dual energy X-ray absorptiometry (DXA) at 2 years, in the lumbar spine BMD (L1-L4). Whole body and hip BMD are also evaluated. Markers of bone turnover (bone-specific alkaline phosphatase, osteocalcin and CrossLaps) are monitored throughout the study. Blood samples are drawn on the third day of patch application at certain visits in order to monitor oestradiol levels and establish any potential correlation with activity on bone (BMD, bone markers). Besides routine safety analysis, lipid profile and coagulation factors are also monitored. Special attention is drawn to endometrial safety with endometrial aspiration or trans vaginal sonography (TVS) performed before study start, after 1 year and at 2 years of treatment. RESULTS Data presented here refer to 146 patients for whom demographics and clinical data are already available, and to 370 patients for whom baseline DXA data have already been validated. The mean (+/-S.D.) age of the women included in the two studies is 53.4 (+/-3.2) with a menopausal age of 38.3 (+/-19.6) months. None of the women who entered the study had severe postmenopausal symptoms as shown by a mean number of hot flushes of 2.2 (+/-2.6) per day, during the last 14 days before inclusion. The mean (+/-S.D.) lumbar spine (L1-L4) BMD is 0.914 (+/-0.122) g/cm2 which corresponds to a Z-score of -0.26 and a T-score of -1.17. Femoral neck, trochanter and Wards triangle have a BMD which is below the mean of age-matched controls but still within the normal range (Z-scores between 0 and -1). Only the whole body BMD is over the mean of age-matched controls, with a Z-score of 0.32. The in-vivo precision mean (+/-S.D.), was calculated and showed a value of 0.868 (+/-0.872), which can be considered a good performance. CONCLUSIONS In summary, the use of one of the most recent techniques to assess the bone mineral content/density together with an accurate quality control program on all the densitometers used in the studies will help to improve the in-vivo BMD precision and therefore mak
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Affiliation(s)
- P Delmas
- Service de Rhumatologie et de Pathologie Osseuse, Hôpital E. Herriot, Lyon, France
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