Temporal change in the diagnosis and treatment rates of osteoporosis: results from the Korea National Health and Nutrition Examination Survey
ConclusionOsteoporosis management in South Korea is improving but is insufficient compared with diabetes management. More extensive efforts are needed to improve the diagnosis and treatment rates of osteoporosis. (Source: Osteoporosis International)
Source: Osteoporosis International - February 25, 2021 Category: Orthopaedics Source Type: research

Correction to: Over half of seniors who start oral bisphosphonate therapy are exposed for 3 or more years: novel rolling window approach and patterns of use
A Correction to this paper has been published:https://doi.org/10.1007/s00198-021-05883-w (Source: Osteoporosis International)
Source: Osteoporosis International - February 24, 2021 Category: Orthopaedics Source Type: research

Using 3D image registration to maximize the reproducibility of longitudinal bone strength assessment by HR-pQCT and finite element analysis
AbstractSummaryWe developed and validated a finite element (FE) approach for longitudinal high-resolution peripheral quantitative computed tomography (HR-pQCT) studies using 3D image registration to account for misalignment between images. This reduced variability in longitudinal FE estimates and improved our ability to measure in vivo changes in HR-pQCT studies of bone strength.IntroductionWe developed and validated a finite element (FE) approach for longitudinal high-resolution peripheral quantitative computed tomography (HR-pQCT) studies using 3D rigid-body registration (3DR) to maximize reproducibility by accounting fo...
Source: Osteoporosis International - February 24, 2021 Category: Orthopaedics Source Type: research

Novel homozygous variant in BMP1 associated with a rare osteogenesis imperfecta phenotype
We report the clinical presentation and diagnostic evaluation of a patient found to have a novel homozygous variant inBMP1. We also provide an overview of reportedBMP1 variants to date, with discussion focusing on the use of bisphosphonate therapy in these patients. A 7-year-old male with speech and motor delay sustained five bilateral tibial fractures with minimal trauma since age 2.5  years. At age 6, he developed severe back pain after a fall. Diffuse spinal osteopenia and multiple vertebral compression fractures (VCF) at T9, L1, L3, and L5 were identified. Total hip BMD was generous (adjusted Z-score* =&thi...
Source: Osteoporosis International - February 23, 2021 Category: Orthopaedics Source Type: research

Decreasing severity of Paget ’s disease of bone in northern Italy over the last two decades: results of a monocentric study on 391 patients
This study aimed to evaluate if the severity of Paget ’s disease of bone (PDB) is decreasing and whether a milder phenotype can have affected the results of studies on disease prevalence.MethodsFrom August 2007 to August 2019, 167 patients with PDB were referred to our centre. Demographic and clinical characteristics were collected and compared with those of a sample of 224 patients enrolled in the same setting between January 2000 and July 2007. Multivariate analyses on 391 patients as a whole were performed assuming the year of presentation as explanatory variable.ResultsPatients of newer sample were diagnosed at a...
Source: Osteoporosis International - February 22, 2021 Category: Orthopaedics Source Type: research

Predictive modeling of hypophosphatasia based on a case series of adult patients with persistent hypophosphatasemia
ConclusionsGiven the high probability of a misdiagnosis, its nonspecific symptoms, and a lack of awareness of serum ALP levels, it is difficult to make a clinical diagnosis of HPP. Predictive models based on biomarkers are necessary to achieve a proper diagnosis. Our proposed machine learning approaches achieved reasonable performance compared to traditional statistical methods used in biomedicine, increasing the likelihood of properly diagnosing such a rare disease as HPP. (Source: Osteoporosis International)
Source: Osteoporosis International - February 22, 2021 Category: Orthopaedics Source Type: research

Early changes in bone turnover and bone mineral density after discontinuation of long-term oral bisphosphonates: a post hoc analysis
AbstractSummaryThis post hoc analysis of a randomized, double-blind study of postmenopausal women with osteoporosis found that there were early increases in bone turnover markers and decreases in bone mineral density after discontinuation of long-term alendronate. These findings might help guide treatment decisions, including monitoring after alendronate withdrawal.IntroductionThe short-term effects of discontinuing long-term bisphosphonates are poorly characterized. This post hoc analysis investigated 1 –12-month changes in bone mineral density (BMD) and bone turnover markers (BTM) after alendronate (ALN) discontinu...
Source: Osteoporosis International - February 19, 2021 Category: Orthopaedics Source Type: research

Correction to: Bisphosphonates and mortality: confounding in observational studies
A Correction to this paper has been published:https://doi.org/10.1007/s00198-021-05884-9 (Source: Osteoporosis International)
Source: Osteoporosis International - February 19, 2021 Category: Orthopaedics Source Type: research

Incremental costs of fragility fractures: a population-based matched -cohort study from Ontario, Canada
ConclusionsFragility fractures were associated with a threefold increase in overall mean healthcare costs per patient compared to patients without fractures. With an aging population, there is an urgent need for improved prevention strategies for patients at high-risk of fracture to decrease the economic burden of fragility fractures on the Canadian healthcare system. (Source: Osteoporosis International)
Source: Osteoporosis International - February 18, 2021 Category: Orthopaedics Source Type: research

Is dual-energy absorptiometry accurate in the assessment of bone status of patients with chronic kidney disease?
ConclusionsTBS and cQCT could accurately assess bone status in CKD patients since DXA may overestimate LS BMD, likely due to an increased AAC volume. (Source: Osteoporosis International)
Source: Osteoporosis International - February 17, 2021 Category: Orthopaedics Source Type: research

Fragility of results from randomized controlled trials supporting the guidelines for the treatment of osteoporosis: a retrospective analysis
ConclusionResults from some RCTs supporting guideline recommendations for the treatment of osteoporosis depend on a small number of events. The FI and FQ may provide additional, intuitive metrics to help interpret the robustness of trial results. (Source: Osteoporosis International)
Source: Osteoporosis International - February 17, 2021 Category: Orthopaedics Source Type: research

Effect of dipeptidyl peptidase IV inhibitors, thiazolidinedione, and sulfonylurea on osteoporosis in patients with type 2 diabetes: population-based cohort study
ConclusionDPP-IV inhibitors do not increase the risk of osteoporosis compared with sulfonylureas in patients with type 2 diabetes mellitus, while a weak association was found between thiazolidinediones and increased risk of osteoporosis. (Source: Osteoporosis International)
Source: Osteoporosis International - February 16, 2021 Category: Orthopaedics Source Type: research

Associations between bone attenuation and prevalent vertebral fractures on chest CT scans differ with vertebral fracture locations
AbstractSummaryVertebral fracture (VF) locations are bimodally distributed in the spine. The association between VF and bone attenuation (BA) measured on chest CT scans varied according to the location of VFs, indicating that other factors than only BA play a role in the bimodal distribution of VFs.IntroductionVertebral fractures (VFs) are associated with low bone mineral density but are not equally distributed throughout the spine and occur most commonly at T7 –T8 and T11–T12 (“cVFs”) and less commonly at T4–T6 and T9–T10 (“lcVF”). We aimed to determine whether associations ...
Source: Osteoporosis International - February 16, 2021 Category: Orthopaedics Source Type: research

Effect of metformin and insulin vs. placebo and insulin on whole body composition in overweight patients with type 2 diabetes: a randomized placebo-controlled trial
AbstractSummarySome studies indicate potential beneficial effects of metformin on body composition and bone. This trial compared metformin + insulin vs placebo + insulin. Metformin treatment had a small but positive effect on bone quality in the peripheral skeleton, reduced weight gain, and resulted in a more beneficial body composition compared with placebo in insulin-treated patients with type 2 diabetes.IntroductionGlucose-lowering medications affect body composition. We assessed the long-term effects of metformin compared with placebo on whole body bone and body composition measures in patients with type 2 diabetes mel...
Source: Osteoporosis International - February 16, 2021 Category: Orthopaedics Source Type: research

Virtual fracture liaison clinics in the COVID era: an initiative to maintain fracture prevention services during the pandemic associated with positive patient experience
ConclusionsVirtual clinics are effective in delivery of fracture risk assessment and clinical management with positive patient experience. While a significant proportion will require DXA follow-up to complete the clinical assessment, virtual clinics have mitigated delays in fracture prevention interventions during the COVID-19 pandemic. (Source: Osteoporosis International)
Source: Osteoporosis International - February 13, 2021 Category: Orthopaedics Source Type: research

Associations of hemoglobin and change in hemoglobin with risk of incident hip fracture in older men and women: the cardiovascular health study
AbstractSummaryIn a multi-site longitudinal cohort study, decreasing hemoglobin was associated with increased hip fracture risk in men. Anemia was associated with hip fracture in men and in African American women. Decreasing hemoglobin may be a marker of progressing bone fragility, making its serial measurement useful for fracture risk stratification.IntroductionHematopoiesis and bone health are interdependent. Anemia has been associated with risk of fracture in humans. To further elucidate this relationship, we hypothesized that decreasing hemoglobin could indicate defective hematopoiesis and would also predict fracture r...
Source: Osteoporosis International - February 12, 2021 Category: Orthopaedics Source Type: research

High prevalence and undertreatment of osteoporosis in elderly patients undergoing total hip arthroplasty
ConclusionsDue to a high incidence of undiagnosed and untreated osteoporosis in elderly patients with potential effects on the success of osseointegration as well as other clinical outcomes, DXA measurements should be included in the clinical routine for these patients prior to THA. (Source: Osteoporosis International)
Source: Osteoporosis International - February 11, 2021 Category: Orthopaedics Source Type: research

Multiple vertebral compression fractures in a human immunodeficiency virus-positive patient with glucocorticoid-induced Cushing syndrome treated with percutaneous vertebroplasty: a case report
AbstractThe authors present a rare case of multiple vertebral compression fractures in a young female with iatrogenic glucocorticoid-induced Cushing syndrome and concomitant human immunodeficiency virus (HIV) infection. Both long-term steroid use and HIV infection may lead to osteopenia or even osteoporosis. Multiple vertebral fractures in young patients are very uncommon and should alert the examiner to investigate any underlying cause. Treatment choices include pharmacological agents such as bisphosphonates or parathyroid hormone and even surgical interventions such as percutaneous vertebroplasty. (Source: Osteoporosis International)
Source: Osteoporosis International - February 11, 2021 Category: Orthopaedics Source Type: research

Younger people with rheumatoid arthritis are at increased risk of fracture even before age 50 years: a population-based cohort study
ConclusionsThese results indicate an increased risk of first fracture before age 50 in people with RA diagnosed before this age. It is important that patients with RA of all ages are given timely support from the time of diagnosis to protect their bone health. (Source: Osteoporosis International)
Source: Osteoporosis International - February 11, 2021 Category: Orthopaedics Source Type: research

Opportunistic CT screening predicts individuals at risk of major osteoporotic fracture
ConclusionsoCT screening using abdominal CT scans is effective at predicting individuals with previous fracture at major osteoporotic sites and offers a promising screening tool for skeletal health assessment. (Source: Osteoporosis International)
Source: Osteoporosis International - February 10, 2021 Category: Orthopaedics Source Type: research

Using health-economic evidence to support policy-level decision-making in Singapore —sensitivity analysis that provides further confidence in fracture probability-based cost-effective intervention thresholds
(Source: Osteoporosis International)
Source: Osteoporosis International - February 10, 2021 Category: Orthopaedics Source Type: research

Effects of one-year tofacitinib therapy on bone metabolism in rheumatoid arthritis
AbstractSummaryJanus kinase (JAK) inhibitors are used to treat rheumatoid arthritis (RA). We assessed the effects of tofacitinib on bone density and bone markers in association with clinical and laboratory parameters in RA. Tofacitinib stabilized bone density and resulted in a positive balance of bone turnover.IntroductionJanus kinase (JAK) inhibitors emerged as new therapeutic options in rheumatoid arthritis (RA). We have little information on how it affects areal and volumetric bone mineral density (BMD) and bone turnover markers. The aim of this study was to assess the effects of 1-year tofacitinib therapy on bone metab...
Source: Osteoporosis International - February 9, 2021 Category: Orthopaedics Source Type: research

Effectiveness of parathyroid hormone (PTH) analogues on fracture healing: a meta-analysis
ConclusionsMeta-analysis of published data supports the use of PTH analogues to improve functional outcomes but not fracture healing rate or pain for different fracture types. The evidence for PTH analogue use in fracture healing is less clear in younger, non-osteoporotic patient populations. Trial design was heterogeneous and of limited quality, justifying further original trials. (Source: Osteoporosis International)
Source: Osteoporosis International - February 9, 2021 Category: Orthopaedics Source Type: research

How has COVID-19 affected the treatment of osteoporosis? An IOF-NOF-ESCEO global survey
ConclusionsTo conclude through surveying a global sample of osteoporosis healthcare professionals, we have observed an increase in telemedicine consultations, delays in DXA scanning, interrupted supply of medications and reductions in parenteral medication delivery. (Source: Osteoporosis International)
Source: Osteoporosis International - February 8, 2021 Category: Orthopaedics Source Type: research

COVID-19 and effects on osteoporosis management: the patient perspective from a National Osteoporosis Foundation survey
(Source: Osteoporosis International)
Source: Osteoporosis International - February 8, 2021 Category: Orthopaedics Source Type: research

The independent and interactive associations of physical activity intensity and vitamin D status with bone mineral density in prepubertal children: the PANIC Study
ConclusionVitamin D status, MPA and MVPA levels in active prepubertal children were positively associated with aBMD. The influence of MVPA is due to the MPA component, though our findings regarding the role of VPA should be interpreted with caution, as shorter accelerometer epochs are needed to more accurately assess VPA. This study adds evidence to the promotion of MPA and behaviours to encourage optimal vitamin D status in supporting skeletal health in childhood, though these need not be used in conjunction to be beneficial, and a sex-specific approach is not necessary in prepubertal children.Trial registration numberNCT...
Source: Osteoporosis International - February 5, 2021 Category: Orthopaedics Source Type: research

The effect on subsequent fracture risk of age, sex, and prior fracture site by recency of prior fracture
ConclusionThe risk of a recurrent fragility fracture varies by age, sex, and site of sentinel fracture when recency is held constant. (Source: Osteoporosis International)
Source: Osteoporosis International - February 4, 2021 Category: Orthopaedics Source Type: research

Romosozumab efficacy on fracture outcomes is greater in patients at high baseline fracture risk: a post hoc analysis of the first year of the frame study
ConclusionsEfficacy of romosozumab on clinical fracture, osteoporotic fracture, and MOF is significantly greater in patients at high baseline fracture risk compared with placebo. (Source: Osteoporosis International)
Source: Osteoporosis International - February 3, 2021 Category: Orthopaedics Source Type: research

Risk of fractures in primary hyperparathyroidism: a systematic review and meta-analysis
AbstractAn increased risk of fractures in primary hyperparathyroidism (PHPT) has been reported in a number of relatively small studies. Performing a systematic literature search, we identified available studies and calculated common estimates by pooling results from the individual studies in a meta-analysis. Searching EMBASE and PubMed, we identified published studies reporting the risk of fractures in PHPT compared to a control group. We calculated odds ratio (OR) with 95% confidence interval (CI). A total of 804 studies were identified of which 12 studies were included. Risk of any fracture was increased compared to cont...
Source: Osteoporosis International - February 1, 2021 Category: Orthopaedics Source Type: research

Total urinary polyphenols and longitudinal changes of bone properties. The InCHIANTI study
ConclusionsDietary intake of polyphenols estimated by UTP and dietary questionnaire was associated with long-term accelerated deterioration of bone health. Our study does not support the recommendation of increasing polyphenol intake for osteoporosis prevention. (Source: Osteoporosis International)
Source: Osteoporosis International - January 27, 2021 Category: Orthopaedics Source Type: research

The effect of exercise training on osteocalcin, adipocytokines, and insulin resistance: a systematic review and meta-analysis of randomized controlled trials
This study aimed to determine the impact of an exercise intervention on ucOC, adiponectin, leptin, and insulin resistance (measured by HOMA-IR). PubMed, CINAHL, Medline, Google Scholar, and Scopus databases and reference lists of included studies were searched. Twenty-two randomized controlled trials (RCTs) of exercise training impact in adults were included in the analysis. Results showed an overall significant increase in serum ucOC (MD: 0.15  ng/ml; 95% CI: 0.05 to 0.25) and adiponectin (MD: 2.83 mg/ml; 95% CI: 1.67 to 3.98), a significant decline in leptin (MD: − 4.89 pg/ml; 95% CI: −&...
Source: Osteoporosis International - January 27, 2021 Category: Orthopaedics Source Type: research

Cancer patients with fractures are rarely assessed or treated for osteoporosis: a population-based study
ConclusionsA large care gap exists among cancer patients who sustain a fracture, similar to the general population, whereby the evaluation or treatment for osteoporosis is seldom conducted. Care maps may need to be developed for cancer populations to improve post-fracture care. (Source: Osteoporosis International)
Source: Osteoporosis International - January 27, 2021 Category: Orthopaedics Source Type: research

Identification of non-Hodgkin lymphoma patients at risk for treatment-related vertebral density loss and fractures
ConclusionUsing VD measurements in routine CT scans, substantial vertebral bone loss in NHL patients could be documented with a high incidence of fractures. (Source: Osteoporosis International)
Source: Osteoporosis International - January 27, 2021 Category: Orthopaedics Source Type: research

Longitudinal change in bone mineral density among Chinese individuals with HIV after initiation of antiretroviral therapy
ConclusionsThis is the first study to report changes in BMD among PLWH after initiation of TDF-based antiretroviral therapy in China. Our findings provide important knowledge for the long-term clinical management of PLWH from this region. (Source: Osteoporosis International)
Source: Osteoporosis International - January 27, 2021 Category: Orthopaedics Source Type: research

Methotrexate osteopathy: five cases and systematic literature review
ConclusionMTX osteopathy while rare must be known by the rheumatologist, especially when using this treatment for inflammatory conditions. The mechanisms are still poorly understood, raising the question of a possible remnant effect of MTX on osteo-forming bone cells, potentially dose-dependent.Mini-abstractMethotrexate (MTX) osteopathy, described as a clinical triad, pain, osteoporosis, and atypical stress fractures, while rare, must be known by the rheumatologist. Our cohort of 5 cases represent the largest series of the literature. Pathophysiological studies raised the question of a dose-dependent remnant effect of MTX ...
Source: Osteoporosis International - January 27, 2021 Category: Orthopaedics Source Type: research

Gender-specific SBNO2 and VPS13B as a potential driver of osteoporosis development in male ankylosing spondylitis
ConclusionsGender-specific SBNO2 and VPS13B may be key genes involved in OP in male AS. (Source: Osteoporosis International)
Source: Osteoporosis International - January 27, 2021 Category: Orthopaedics Source Type: research

Differential effects of abaloparatide and teriparatide on hip cortical volumetric BMD by DXA-based 3D modeling
ConclusionThese results suggest previously reported differences in areal BMD increases between ABL and TPTD may be due to differential effects on cortical vBMD. Further studies are warranted to investigate how these differences affect therapeutic impact on hip strength in postmenopausal women with osteoporosis. (Source: Osteoporosis International)
Source: Osteoporosis International - January 26, 2021 Category: Orthopaedics Source Type: research

In memory of Harry K Genant
(Source: Osteoporosis International)
Source: Osteoporosis International - January 26, 2021 Category: Orthopaedics Source Type: research

Pelvic fragility fractures —the forgotten osteoporotic fracture!
(Source: Osteoporosis International)
Source: Osteoporosis International - January 25, 2021 Category: Orthopaedics Source Type: research

Efficiency of coordinator-based osteoporosis intervention in fragility fracture patients: a prospective randomized trial
ConclusionThe coordinator-based interventions for fragility fractures improved bone density assessment implementation and treatment rates and enhanced treatment persistence rates in the early stages following bone fractures. The findings suggest that liaison intervention may help both fracture and osteoporosis physicians for the evaluation of osteoporosis and initiation and continuation of osteoporosis medication. (Source: Osteoporosis International)
Source: Osteoporosis International - January 23, 2021 Category: Orthopaedics Source Type: research

Does treatment with bisphosphonates protect against fractures in real life? The HUNT study, Norway
ConclusionsUse of BPs was associated with reduced risk of fractures in hip and forearm in women, and the magnitude of effect is comparable to results from RCTs. (Source: Osteoporosis International)
Source: Osteoporosis International - January 21, 2021 Category: Orthopaedics Source Type: research

The influence of lactation on BMD measurements and TBS: a 12-month follow-up study
AbstractSummaryAlthough lactation is associated with transient bone loss and body weight changes, the unchanged TBS could highlight a limited effectiveness in detecting dynamic bone properties in the first year postpartum.PurposeTo evaluate trabecular bone score (TBS) and bone mineral density (BMD) in postpartum women.MethodsThis was a 12-month prospective cohort study with 40 lactating postpartum women and 44 non-pregnant women. The inclusion criteria were as follows: aged between 18 and 35 years old, an uncomplicated term ( ≥37 weeks) pregnancy with a single fetus, and no intention of becoming pregnant within 12 month...
Source: Osteoporosis International - January 21, 2021 Category: Orthopaedics Source Type: research

Comment on an article: “Osteoporosis in the age of COVID-19 patients”
(Source: Osteoporosis International)
Source: Osteoporosis International - January 21, 2021 Category: Orthopaedics Source Type: research

Vertebral fracture: epidemiology, impact and use of DXA vertebral fracture assessment in fracture liaison services
AbstractSummaryVertebral fractures are independent risk factors for vertebral and nonvertebral fractures. Since vertebral fractures are often missed, the relatively new introduction of vertebral fracture assessment (VFA) for imaging of the lateral spine during DXA-measurement of the spine and hips may contribute to detect vertebral fractures. We advocate performing a VFA in all patients with a recent fracture visiting a fracture liaison service (FLS). Fracture liaison services (FLS) are important service models for delivering secondary fracture prevention for older adults presenting with a fragility fracture. While commonl...
Source: Osteoporosis International - January 21, 2021 Category: Orthopaedics Source Type: research

Are all fractures the same?
(Source: Osteoporosis International)
Source: Osteoporosis International - January 21, 2021 Category: Orthopaedics Source Type: research

Authors ’ response to KD Stathopoulos regarding “Stop (Mis)classifying Fractures as High or Low Trauma or as Fragility Fractures”
(Source: Osteoporosis International)
Source: Osteoporosis International - January 21, 2021 Category: Orthopaedics Source Type: research

Patients 80  + have similar medication initiation rates to those aged 50–79 in Ontario FLS
ConclusionA systematic approach to identifying patients at high risk for future fracture and tailoring treatment recommendations to these patients appeared to eliminate differences in treatment initiation rates based on older age. (Source: Osteoporosis International)
Source: Osteoporosis International - January 20, 2021 Category: Orthopaedics Source Type: research

Restoration of the intravertebral stability in K ümmell’s disease following the treatment of severe postmenopausal osteoporosis by 1-34PTH—a retrospective study
AbstractSummaryFollowing the 1-34PTH application for conservative treatment of K ümmell’s disease, the intravertebral cleft was filled or bridged by the osseous tissue; the radiological evidence of further collapsing was absent. Pain and the neurological disorder were relieved; bone turnover markers, BMD as well as the health-related quality of life were improved.IntroductionK ümmell’s disease (KD) patients with severe osteoporosis were applied by the 1-34PTH; the fracture union and the increased bone mineral density (BMD) following this treatment were retrospectively reviewed.MethodsTwenty-one postme...
Source: Osteoporosis International - January 20, 2021 Category: Orthopaedics Source Type: research

Long-term effects on bone mineral density after four years of treatment with two intensive combination strategies, including initially high-dose prednisolone, in early rheumatoid arthritis patients: the COBRA-light trial
ConclusionIn a treat-to-target design in early RA, over 4  years, no differences between groups were found in change in BMD at total hip, femoral neck and the lumbar spine. At the hip, bone loss was around 3% in both groups, while mild bone loss was observed at lumbar spine, both in patients starting prednisolone 60 and 30 mg/day. These data suggest tha t the well-known negative effects of prednisolone can be modulated by modern treatment of RA. (Source: Osteoporosis International)
Source: Osteoporosis International - January 19, 2021 Category: Orthopaedics Source Type: research

Osteoporotic fractures in second-generation immigrants and Swedish natives
ConclusionsWe observed a similar risk of osteoporotic fractures among second-generation immigrants as in Swedish natives, which suggests that environmental factors are important for osteoporotic fractures. (Source: Osteoporosis International)
Source: Osteoporosis International - January 19, 2021 Category: Orthopaedics Source Type: research