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Screening for the primary prevention of fragility fractures among adults aged 40 years and older in primary care: systematic reviews of the effects and acceptability of screening and treatment, and the accuracy of risk prediction tools
ConclusionAn offer of 2-step screening with risk assessment and BMD measurement toselected postmenopausal females with low prevalence of prior fracture probably results in a small reduction in the risk of clinical fragility fracture and hip fracture compared to no screening. These findings were most applicable to the use of clinical FRAX for risk assessment and were not replicated in theoffer-to-screen population where the rate of response to mailed screening questionnaires was low. Limited direct evidence on harms of screening were available; using study data to provide estimates, there may be a moderate degree of overdia...
Source: Systematic Reviews - March 21, 2023 Category: International Medicine & Public Health Source Type: research

Cardiovascular Risks Not Increased With Denosumab
(MedPage Today) -- AUSTIN, Texas – Denosumab (Prolia, Xgeva) carried no increased risk of cardiovascular disease or stroke when compared with zoledronic acid (Reclast, Zometa) to combat osteoporosis, researchers found. Compared with zoledronic...
Source: MedPage Today Cardiovascular - September 13, 2022 Category: Cardiology Source Type: news

Risk of Incident Atrial Fibrillation With Zoledronic Acid Versus Denosumab: A Propensity Score –Matched Cohort Study
ABSTRACTZoledronic acid (ZA) is an effective agent in osteoporosis and malignancy ‐related bone disease but may be associated with increased risk of atrial fibrillation (AF), although current studies disagree on this risk. To examine the risk of incident AF among patients receiving ZA compared with denosumab in the first year of treatment, we performed a new‐user, active comp arator cohort study including privately insured Americans between January 1, 2010, and June 30, 2019. Individuals aged ≥50 years without known arrhythmia or advanced kidney disease who initiated ZA were 1:1 propensity score (PS)‐matched to i...
Source: Journal of Bone and Mineral Research - November 2, 2020 Category: Orthopaedics Authors: Kristin M D'Silva, Sara Jane Cromer, Elaine W Yu, Michael Fischer, Seoyoung C Kim Tags: Original Article Source Type: research

Cardiovascular safety of denosumab across multiple indications: a systematic review and meta ‐analysis of randomized trials
AbstractThe cardiovascular safety of denosumab has not yet been evaluated in a systematic review. This systematic review and meta ‐analysis sought to quantify the number of randomized controlled trials (RCTs) of denosumab (against comparators) reporting cardiovascular adverse events (CAEs) and examine the balance of CAEs between treatment arms. MEDLINE, Embase andclinicaltrials.gov were searched from inception to 26th October 2019 for RCTs of denosumab versus comparators for any indication. Included trials were randomized, enrolled ≥100 participants and reported bone‐related outcomes. Primary outcome for analysis was...
Source: Journal of Bone and Mineral Research - August 10, 2020 Category: Orthopaedics Authors: Alexander H. Seeto, Bo Abrahamsen, Peter R. Ebeling, Alexander J. Rodr íguez Tags: Original Article Source Type: research

Interventions for preventing bone disease in kidney transplant recipients.
CONCLUSIONS: Bisphosphonate therapy may reduce fracture and bone pain after kidney transplantation, however low certainty in the evidence indicates it is possible that treatment may make little or no difference. It is uncertain whether bisphosphonate therapy or other bone treatments prevent other skeletal complications after kidney transplantation, including spinal deformity or avascular bone necrosis. The effects of bone treatment for children and adolescents after kidney transplantation are very uncertain. PMID: 31637698 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - October 21, 2019 Category: General Medicine Authors: Palmer SC, Chung EY, McGregor DO, Bachmann F, Strippoli GF Tags: Cochrane Database Syst Rev Source Type: research

Osteoporosis and Sarcopenia Increase Frailty Syndrome in the Elderly
Conclusions World population is aging and the increase in life expectancy is often unhealthy. In particular, musculoskeletal aging, which leads to sarcopenia and osteoporosis, has several causes such as changes in body composition, inflammation, and hormonal imbalance. Sarcopenia, osteoporosis, and more frequently, sarcopenic obesity are commonly associated with aging and frequently closely linked each other, often leading to the development of a frailty syndrome. Frailty syndrome favors an increased risk of loss function in daily activities, for cardiovascular diseases, cancers, falls, and mortality. As the number of eld...
Source: Frontiers in Endocrinology - April 23, 2019 Category: Endocrinology Source Type: research

New strategies for osteoporosis patients previously managed with strontium ranelate
The aim of this article is to describe potential alternatives to patients no longer eligible for management with strontium ranelate for osteoporosis according to the recommendations by the European Medicines Agency. A systematic search of Pubmed was done for papers on fracture efficacy of various treatments for osteoporosis, and potential harms especially in terms of cardiovascular events and stroke. The results showed that drugs more efficacious in terms of relative risk reduction of fractures than strontium ranelate were alendronate, risedronate, zoledronate, and denosumab. Raloxifene, as for strontium, may be associated...
Source: Therapeutic Advances in Musculoskeletal Disease - November 19, 2014 Category: Orthopaedics Authors: Vestergaard, P. Tags: Reviews Source Type: research

Understanding and Communicating the Benefits and Risks of Denosumab, Raloxifene, and Teriparatide for the Treatment of Osteoporosis
The number needed to treat is a valuable metric to determine the benefit of therapy, but it must be viewed against the respective number needed to harm. Denosumab and teriparatide (TPTD) have proven antifracture efficacy at vertebral and nonvertebral sites, whereas raloxifene has proven antifracture efficacy at the spine only. Denosumab use has been associated with a small, yet statistically significant, increased incidence of eczema and serious cellulitis. Raloxifene use has been associated with statistically significant increases in the risk of venous thromboembolism and possibly deadly stroke, although not an increase in total strokes.
Source: Journal of Clinical Densitometry - October 28, 2013 Category: Radiology Authors: E. Michael Lewiecki, Paul D. Miller, Steve T. Harris, Douglas C. Bauer, K. Shawn Davison, Larry Dian, David A. Hanley, Michael R. McClung, Chui K. Yuen, David L. Kendler Source Type: research