Searchable abstracts of presentations at key conferences on calcified tissues
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European Calcified Tissue Society Congress 2013

Lisbon, Portugal
18 May 2013 - 22 May 2013

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European Calcified Tissue Society Congress 2013, 18 - 22 May 2013; Lisbon, Portugal

Poster Presentations

Osteoporosis: treatment

ba0001pp390 | Osteoporosis: treatment | ECTS2013

Abstract withdrawn....

ba0001pp391 | Osteoporosis: treatment | ECTS2013

Electronic clinical decision support for the management of osteoporosis in primary care

Selecki Yvonne , Center Jaqui , Nguyen Tuan , Eisman John

The gap between osteoporosis clinical guidelines and their implementation exists in all countries. The increasing use of computerised patient records offers new opportunities to aide clinical decision making. We have developed a fracture and osteoporosis investigation and treatment clinical decision tool to aide primary care management of osteoporosis. Uniquely, this tool is designed to be integrated with existing patient data software.Electronic clinica...

ba0001pp392 | Osteoporosis: treatment | ECTS2013

Anti-osteoporosis treatment amongst austrian hip fracture patients: status quo, and effects on mortality and subsequent fracture risk

Brozek Wolfgang , Reichardt Berthold , Kimberger Oliver , Kritsch Daniela , Klaushofer Klaus , Zwettler Elisabeth

Osteoporosis is commonly known as the prime risk factor for hip fracture in the elderly. We thus evaluated status and effect of osteoporosis treatment amongst hip fracture patients in a large Austrian cohort.Retrospectively retrieved pseudonymized invoice data from Austrian social insurance authorities covering roughly 98% of the entire population included 31 548 subjects over 50 years with first hip fractures between July 2008 and December 2010, with fo...

ba0001pp393 | Osteoporosis: treatment | ECTS2013

Remarkable bone mineral density increases on teriparatide in patients with glucocorticoid-induced osteoporosis and Crohn's disease

Ko-Wu Kuo Danny , To Kenny , Kendler David

Crohn’s disease often results in abnormalities in bone strength, and ultimately increases the risk of fragility fracture. Up to 55% of patients with Crohn’s disease have bone mineral density in the osteopenia range up to 50% of osteoporosis. Glucocorticoid is frequently used in the treatment of Crohn’s disease and is associated with osteoporosis and increased fracture risk. It has been reported that osteoporotic fractures in patients with Crohn’s disease ar...

ba0001pp394 | Osteoporosis: treatment | ECTS2013

Effects of a new conjugate drug in a rat model of postmenopausal osteoporosis

Liu Careesa , Young Robert , Grynpas Marc

Introduction: Standard clinical treatments for postmenopausal osteoporosis utilize resorption-inhibiting drugs such as bisphosphonates, which selectively bind to bone mineral but also suppress bone formation over time. Prostaglandin E2 (PGE2) has bone-anabolic effects in vivo, but its clinical utility is hindered by side effects upon systemic administration. Since PGE2 acts on bone via the EP4 receptor, our approach utilizes a specific...

ba0001pp395 | Osteoporosis: treatment | ECTS2013

Renal function and safety result after 1 year treatment of zoledronic acid in Chinese women with postmenopausal osteoporosis

Shen Huiyong , Sun Yue , Liu Xun

Objective: Zoledronic acid (Zol) has been demonstrated to be an effective therapy to treat postmenopausal osteoporosis (PMO) in Chinese women in a 12-month post-marketing observational study (ZOOM study). As an I.V. bisphosphonates, Zol are exclusively excreted via the kidneys. We present a report of the renal function and safety data of once-yearly Zol 5 mg treatment.Subjects and methods: A total of 373 PMO patients from 30 different centers in China wi...

ba0001pp396 | Osteoporosis: treatment | ECTS2013

Characterization and risk factors of acute-phase response following a first-dose administration of zoledronic acid for treatment of osteoporosis

Chen Decai

Objective: To explore the characterization and risk factors of acute-phase response (APR) following a first-dose administration of 5 mg zoledronic acid for treatment of osteoporosis.Method: We conducted clinical data of the zoledronic acid users for treatment of osteoporosis in Department of Endocrinology, West China Hospital, Sichuan University from January 2009 to November 2012.Results: A total of 178 patients were eligible for i...

ba0001pp397 | Osteoporosis: treatment | ECTS2013

Intact heparin inhibits BMP6 osteogenic activity

Brkljacic Jelena , Pauk Martina , Erjavec Igor , Vukicevic Slobodan

Introduction: One third of patients in the long-term heparin therapy show reduction in bone density. We have shown that heparin binds to bone morphogenetic protein 6 (BMP6) and inhibits its osteogenic activity in vitro. Here we explored whether heparin effects BMP6 mediated bone efficacy in vivo.Methods: We have used a mouse model of postmenopausal osteoporosis and tested the effect of heparin on BMP6 therapy and its osteogenic activity...

ba0001pp398 | Osteoporosis: treatment | ECTS2013

Health economic consequences of fractures in patients with osteoporosis: a national register based study of total and incremental health costs following fracture

Olsen Kim Rose , Hansen Carrinna , Abrahamsen Bo

Introduction: Osteoporotic fractures are known to be costly to society but estimates tend to be based on small scale prospective studies. In the following we report national data for healthcare costs due to fractures in patients with osteoporosis.Study population and methods: All Danish residents aged 35+, mean age 70.5 years, 13% men, 27.3% prior major osteoporotic fracture, who began bisphosphonates for osteoporosis between 1/1997 and 12/2002 (n</e...

ba0001pp399 | Osteoporosis: treatment | ECTS2013

Assessment of serum 25-hydroxyvitamin D concentrations in postmenopausal osteoporotic women: a retrospective study to evaluate long-term treatment with vitamin D3

Andersen Camilla Sand , Vestergaard Peter , Gazerani Parisa , Hoeck Hans Christian

Introduction: The purpose of this study was to evaluate whether daily treatment with 400 IU vitamin D3 was sufficient to maintain 25-hydroxyvitamin D (25(OH)D) concentrations above 60 nmol/l over a 3-year period. In addition, the study aimed to clarify if any differences existed in serum 25(OH)D between pre-supplemented women and women who already had serum 25(OH)D above 60 nmol/l at screening.Methods: Serum samples drawn from 251 postmenopaus...

ba0001pp400 | Osteoporosis: treatment | ECTS2013

Osteonecrosis of the jaw and non-malignant disease

Coudert Amelie , Lescaille Geraldine , Baaroun Vanessa , Azerad Jean , Cohen-Solal Martine , Berdal Ariane , Descroix Vianney

Bisphosphonates (BP) are powerful bone resorption inhibitors. They are used for the symptomatic treatment of malignant osteolytic bone disease (e.g. multiple myeloma and bone metastasis), as well as bone diseases associated with high bone resorption (e.g. postmenopausal osteoporosis, cortisone-induced osteoporosis). However, recent data showed that a rare, but serious, adverse effect of BP therapy is osteonecrosis of the jaw (BRONJ). Given the increasing number of persons rece...

ba0001pp401 | Osteoporosis: treatment | ECTS2013

Effectiveness of Strontium Renalate therapy for osteoporosis in men

Kilasonia Lali , Kopaliani Medea , Kirvalidze Nana , Lagvilava Luba , Tsintsadze Neriman

Introduction: Since the identification of the fact that osteoporosis represents not quite rare disease in men, its preconditions-diseases increasing the likelihood of osteoporosis in men has been intensively studied. As a result, a new direction ‘male osteoporosis’ has been established in medicine, although, there is not sufficient information on how the basic medications are selected for men; whether certain drugs have priority effect for the treatment of osteoporos...

ba0001pp402 | Osteoporosis: treatment | ECTS2013

Do Bisphosphonates remain basic drugs for the treatment of osteoporosis?

Kilasonia Lali , Lagvilava Luba , Kirvalidze Nana , Kopaliani Medea , Tsartsidze Neriman

Introduction: If we pay more attention, we will notice that the frequency of drugs against osteoporosis is increasing on world markets every year. At the same time, there is ongoing compromises on medicines, targeted activity mechanisms of new drugs are not fully studies. To be short, recent knowledge gives use impression that only Bisphosphonates maintain their strong positions if the medicines and most importantly, the length of treatment is adequately selected.<p class=...

ba0001pp403 | Osteoporosis: treatment | ECTS2013

Parathyroid hormone changes following denosumab treatment in postmenopausal osteoporosis

Makras Polyzois , Polyzos Stergios , Papatheodorou Athanasios , Kokkoris Panagiotis , Chatzifotiadis Daniel , Anastasilakis Athanasios

Purpose: Denosumab is a new potent antiresorptive treatment of osteoporosis that can potentially induce a compensatory increase of parathyroid hormone (PTH) levels. We aimed to evaluate the alteration of PTH 1 and 6 months after denosumab’s administration (60 mg) with different regimens of calcium and vitamin D (Ca/D) supplementation, as well as the association of PTH with serum Ca and bone markers.Methods: This was a prospective, multicenter, study...

ba0001pp404 | Osteoporosis: treatment | ECTS2013

Sequential therapy after PTH 1–84 treatment: comparison among bisphosphonates and strontium ranelate

Pastore Renato , Mentuccia Daniela , Pasqualetti Patrizio , Frajese Gaetano

Introduction: Evidence in literature shows how is useful to use antiresorptive drugs such as bisphosphonates, in severe osteoporosi severe after PTH (1–34 or 1–84) treatment.Methods: This study was divided into two parts: the first one analyzed BMD changes by DXA at the lumbar and femoral and serum osteocalcin and β-CTX, monitoring their performance after 6, 12 and 18 months in 71 women with severe postmenopausal osteoporosis, treated for ...

ba0001pp405 | Osteoporosis: treatment | ECTS2013

Adherence to therapy: outcomes after seven years of treatment with bisphosphonates

Pastore Renato , Mentuccia Daniela

Introduction: Bisphosphonates are the first-choice treatment for osteoporosis. However, the efficacy observed in clinical trials may not be realized in a real-life setting, partly due to poor adherence to therapy, with a significant worsening of clinical outcomes. The aim of this study conducted on an outpatient cohort is to quantify the adherence to the osteoporosis treatment in real practice setting and to identify the factors that may affect it.Materi...

ba0001pp406 | Osteoporosis: treatment | ECTS2013

In real clinical practice osteoporosis drugs are taken for a very short period: analysis of persistence in the campania region

Iolascon Giovanni , Capaldo Annarita , Orlando Valentina , Menditto Enrica , Gimigliano Francesca

Introduction: Persistence is defined as the period between the start and the interruption of a pharmacological treatment. In osteoporotic patients, persistence to therapy is poor, resulting in reduced benefits and increased risk of fracture.The aim of this study is to analyze persistence with drug therapy in osteoporotic patients in the Campania region.Material and methods: We conducted a retrospective population-based cohort study to examine prescriptio...

ba0001pp407 | Osteoporosis: treatment | ECTS2013

Effect of a mixture of calcium, vitamin D, inulin and soy isoflavones on bone metabolism in post-menopausal women: a retrospective analysis

Bevilacqua Maurizio , Righini Vellela , Certan Diana , Alemanni Matteo , Gandolini Giorgio

Introduction: A retrospective analysis we previously performed on post-menopausal women showed that the addition of inulin (3 g) and soy isoflavones (40 mg) to daily calcium (500 mg) and vitamin D3 (300 UI) supplementation was able to increase calcium absorption by 60%, while reducing circulating parathormone and leaving vitamin D3 levels unchanged. Therefore, we tested whether such a mixture could affect also bone metabolism.Method...

ba0001pp408 | Osteoporosis: treatment | ECTS2013

Vertebroplasty vs kyphoplasty in osteoporotic vertebral fractures: a finite element comparative analysis

Pietrogrande Luca , Ottardi Claudia , Barbera Luigi La , Raimondo Emanuela , Villa Tomaso

Introduction: Vertebroplasty (VP) and ballon kyphoplasty (BKP) are used in the treatment of the vertebral compression fractures (VCF), that usually result in a typical wedged deformation. It is still under debate which technique is the best, in terms of efficacy, costs, and safety, mainly about the risk of a adjacent new fractures. The aim of this study is to evaluate the biomechanical outcome of vertebroplasty and kyphoplasty by a computational comparative analysis with finit...

ba0001pp409 | Osteoporosis: treatment | ECTS2013

25-OH vitamin D and γ-δ TCR lymphocyte interplay in the pathogenesis of acute phase reaction after zoledronic acid infusion for osteoporosis treatment

Crotti Chiara , Cavaciocchi Francesca , De Santis Maria , Ceribelli Angela , Fabbriciani Gianluigi , Selmi Carlo

Background: Zoledronic acid (ZA) for the treatment of osteoporosis (OP) is associated with a transient post-infusional acute phase reaction (APR) due to ZA-mediated activation of γ-δ TCR lymphocytes (γ-δTCR) and production of cytokines.Primary objective: To investigate if OP patients developing APR (APR+) after ZA infusion have lower 25-OH vitamin D (25-OHvD) levels and a higher percentage of γ-δTCR compared to patients with...

ba0001pp410 | Osteoporosis: treatment | ECTS2013

Bone turnover markers and radiographic progression of vertebral compression fractures during anti-osteoporotic therapy

Corradini Costantino , Macchi Vittorio , Pasqualotto Stefano , Boisio Francesca , Tradati Daniele , Crapanzano Calogero , Verdoia Cesare

Introduction: In postmenopausal women with vertebral compression fractures (VCF) the mechanisms regulating healing processes and an anti-osteoporotic treatment are not completely clarified. The aim of this prospective study was the evaluation of bone turnover markers, bone mineral density and radiographic progression of one or more VCF during assumption of risedronate, strontium ranelate or teriparatide.Materials and methods: Women with recent osteoporot...

ba0001pp411 | Osteoporosis: treatment | ECTS2013

Changes in low back pain and upper gastrointestinal symptoms in Japanese osteoporotic patients after switching to once-monthly oral minodronate from daily or weekly bisphosphonates

Okimoto Nobukazu , Sakai Akinori , Ikeda Satoshi , Yoshioka Toru , Teshima Kitau , Matsumoto Hidehiro , Tsurukami Hiroshi , Okazaki Yuichi , Nagashima Masato , Fukuda Fumio , Arita Shinobu

Introduction: Minodronate, a new-generation bisphosphonate (BP), is the first BP available as a once-monthly oral regimen in Japan. Aside from being a highly potent inhibitor of bone resorption, minodronate has been shown to possess antagonistic action against the P2X2/3 receptor, which has an important role in nociceptive transmission. The purpose of this study was to investigate the analgesic effects of once-monthly oral minodronate (MIN50 mg) on low back pain (LBP) associat...

ba0001pp412 | Osteoporosis: treatment | ECTS2013

Preoperative bisphosphonate treatment in patients with neuromuscular scoliosis improves bone strength of vertebral body

Kashii Masafumi , Nagamoto Yukitaka , Fujimori Takahito , Honda Hirotsugu , Kaito Takashi , Yoshikawa Hideki , Iwasaki Motoki

Background: Boys with muscular dystrophy as presented by Duchenne muscular dystrophy (DMD) lose muscle strength and are usually confined to a wheelchair until 13 years. Furthermore they often have development of myogenic scoliosis, and scoliosis surgery is necessary to acquire sitting balance. Osteoporosis is one of the major concerns to perform surgical treatment. Patients with DMD or congenital muscular dystrophy (CMD) have fragile bones due to loss of ambulation, glucocorti...

ba0001pp413 | Osteoporosis: treatment | ECTS2013

Early response to once-monthly oral minodronate after switching from daily or weekly bisphosphonates in Japanese osteoporotic patients

Sakai Akinori , Ikeda Satoshi , Okimoto Nobukazu , Teshima Kitau , Arita Shinobu , Matsumoto Hidehiro , Tsurukami Hiroshi , Okazaki Yuichi , Nagashima Masato , Fukuda Fumio , Yoshioka Toru

Introduction: Minodronate, a highly potent, new-generation bisphosphonate (BP), is the first BP available as a once-monthly oral regimen in Japan. The aim of the present study was to investigate the effects of once-monthly oral minodronate on bone turnover markers (BTM) and bone mineral density (BMD) in osteoporotic patients previously using daily or weekly BPs in real clinical practice.Methods: We conducted a prospective multicenter study involving 11 i...

ba0001pp414 | Osteoporosis: treatment | ECTS2013

Treatment with eldecalcitol (ED-71) and raloxifene combined increases cancellous and cortical bone strength in ovariectomized rats

Sakai Sadaoki , Takeda Satoshi , Shiraishi Ayako , Koike Nobuo , Mihara Masahiko , Endo Koichi

Eldecalcitol (ED-71; ELD), a 2β-hydroxypropyloxy derivative of 1α,25(OH)2D3, was approved to treat osteoporosis in Japan in 2011. Raloxifene (RAL), a selective estrogen receptor modulator, is available to treat or prevent postmenopausal osteoporosis. In this study, we compared the effects of combining ELD and RAL against each monotherapy in osteoporotic rats.Eight-month-old female Wistar–Imamichi rats were ovariectomi...

ba0001pp415 | Osteoporosis: treatment | ECTS2013

Patient preference and adherence to once-monthly oral minodronate in Japanese osteoporotic patients previously using daily or weekly bisphosphonates

Ikeda Satoshi , Sakai Akinori , Okimoto Nobukazu , Teshima Kitau , Arita Shinobu , Matsumoto Hidehiro , Tsurukami Hiroshi , Okazaki Yuichi , Nagashima Masato , Fukuda Fumio , Yoshioka Toru

Introduction: Bisphosphonates (BPs) are currently the mainstay of treatment in osteoporosis; however, the complex dosing regimens might interfere with long-term adherence, which provided the rationale to develop BPs with less-frequent dosing schedules. Minodronate (MIN 50 mg), a highly potent new-generation BP, is the first BP available as a once-monthly oral regimen in Japan. The aim of the present study was to investigate patient preference for, and adherence to, MIN 50 mg i...

ba0001pp416 | Osteoporosis: treatment | ECTS2013

Meta-analysis of the effects of vitamin D supplements on bone mineral density in adults

Reid Ian R , Bolland Mark , Grey Andrew

Recent meta-analyses of vitamin D without co-administration of calcium have not demonstrated fracture prevention, possibly through lack of power, inappropriate choice of doses, or failure to target the intervention to deficient populations. Bone mineral density (BMD) is able to detect biologically significant effects in much smaller cohorts, so is a relevant surrogate measure with which to re-assess the skeletal efficacy of these supplements. We searched Web of Science, Embase...

ba0001pp417 | Osteoporosis: treatment | ECTS2013

A case of atypical femoral fracture with abnormal cortical bone characterized by impaired mineralization and pyrophosphate accumulation

Shabestari Maziar , Eriksen Erik Fink , Roschger Paul , Paschalis Eleftherios , Diez-Perez Adolfo

Impaired bone material properties have been invoked as being responsible for the development of atypical femoral fractures (AFF) after long term bisphosphonate use. We therefore analyzed bone material properties in a bone biopsy obtained at the fracture site from an 88-year-old female with AFF, who had been treated with alendronate for 8 years. We used conventional histology, quantitative backscattered electron imaging (qBEI), and Raman spectroscopy (RS).<p class="abstext"...

ba0001pp418 | Osteoporosis: treatment | ECTS2013

Myricetin suppress LPS-induced MMP expression in human periodontal ligament fibroblasts and inhibit osteoclastogenesis by downregulating NFATc1 in LPS-induced RAW 264.7 cells

Ko Seon-Yle , Jang Young-Joo

Periodontitis is an inflammatory disease that affects connective tissue attachments and the supporting bone that surrounds the teeth. Periodontal ligament fibroblasts induce the overexpression of matrix metalloproteinase (MMP), which is involved in inflammatory progression in periodontitis. Osteoclasts are responsible for skeletal modeling and remodeling but may also destroy bone in several bone diseases, including osteoporosis and periodontitis. This study examined the anti-d...

ba0001pp419 | Osteoporosis: treatment | ECTS2013

Analysis of clinical assessment and efficacy of once-yearly i.v. zoledronic acid for osteoporosis

Park Ye-Soo , Kim Hong-Sik , Lee Jung-Hwan , Won Ye-Yeon , Kang Byung-Moon

Introduction: To analyze clinical assessment and efficacy of once-yearly i.v. zoledronic acid for osteoporosis.Materials and methods: The subjects were 322 osteoporotic patients who received more than single infusion of zoledronic acid in our hospital from October 2008 to March 2011. On clinical assessment, the adherence was evaluated by measuring the rate of reinfusion. Adverse events were recorded for safety assessment. For efficacy assessment, the bon...

ba0001pp420 | Osteoporosis: treatment | ECTS2013

Subsequent hip fracture in Inchon and Bucheon area of Korea (Cohort study)

Moon Kyoung Ho , Kim Ju Young , Lee Kee Haeng

Introduction: A significant number of patient who have experienced previous surgical treatment for an osteoporotic hip fracture, experienced a subsequent hip fracture (SHF) on the opposite side. The incidence of asynchronous bilateral hip fractures is 1.7–14.8%. All hip fracture patients treated at five university hospitals in the Inchon and Bucheon area of Korea, were reviewed. The patients were divided into two groups, a group that had experienced subsequent hip fractur...

ba0001pp421 | Osteoporosis: treatment | ECTS2013

The efficiency of bisphosphonates (alendronate, risedronate, ibandronate) for postmenopausal osteoporosis after 1 year of therapy

Paun Diana , Totolici Nicoleta , Chirita Monica , Petris Rodica , Dumitrache Constantin

Introduction: Bisphosphonates are drugs of first choice in the treatment of postmenopausal osteoporosis; they inhibit bone resorbtion.Aim: This study evaluates the efficiency of bisphosphonates (alendronic acid+cholecalciferol 70 mg/5600 IU per weekly vs risedronic acid 35 mg/weekly vs ibandronic acid 150 mg/monthly) after 1 year of therapy.Methods: We present the results of a retrospective study which included 40 women with postme...

ba0001pp422 | Osteoporosis: treatment | ECTS2013

Bisphosphonates poisonous action

Maria Buyko , Victoria Atrushkevich

Introduction: Bisphosphonates gain increasingly greater significance in treatment oncologic diseases with bone metastasis. However, a lot of articles have lately been published in dental and oncological journals on jaw osteonecrosis (ONJ) associated with long-term ingestion of bisphosphonates. Besides extension of clinical recommendations for zolendronate use, most commonly referred to in connection with ONJ, for treatment of Paget’s diseaseand other disturbances of bone ...

ba0001pp423 | Osteoporosis: treatment | ECTS2013

Three years' experience of zoledronic acid use in the treatment of postmenopausal osteoporosis

Yureneva Svetlana , Yakushevskaya Oksana , Kuznetsov Sergey , Ivanets Tatyana , Smetnik Vera , Sukchich Gennady

Introduction: We aimed to study efficacy of zoledronic acid (Zol) in the treatment of postmenopausal osteoporosis within 3 years.Methods: Clinical, bone mineral density (BMD) by DEXA (L1–L4, femoral Neck) (baseline, 12, 24, and 36 months); biochemical; immunoenzyme assay of bone turnover markers (BTM) – osteocalcin (OK) β-C-terminal telopeptides of type 1 collagen (CTX) (baseline, 1, 3, 6, 9, and 12 after one, two, three infusions).<p ...

ba0001pp424 | Osteoporosis: treatment | ECTS2013

Acute phase response and zoledronic acid therapy

Yureneva Svetlana , Yakushevskaya Oksana , Smetnik Vera , Sukchich Gennady

Introduction: We aimed to study acceptability of zoledronic acid in the treatment of postmenopausal osteoporosis within 3 years.Methods: Clinical, biochemical, shipping registration at poll by phone and on the subsequent visits.Results: We studied 225 patients with postmenopausal osteoporosis. The patients were treated with zoledronic acid (Zol) 5 mg as a once-yearly infusion within 3 years and 2500 mg of calcium carbonate+800 ME v...

ba0001pp425 | Osteoporosis: treatment | ECTS2013

Evaluation with densitometry of patients with breast cancer and low bone mineral density after 2 years of treatment

Gil Sonia Munoz , Dolera Tomas Mut , Lopez Belen C Garrido , Maicas M D Torregrosa , Sarrio R Girones , Tendero P Lopez , Armario M D Garcia , Mira Pascual Munoz

Aim: Evaluate the differences with densitometry after 2-year treatment in patients with breast cancer and LBMD.Materials and methods: A 2 year duration longitudinal study was done in patients diagnosed with breast cancer sent to the Rheumatology Osteoporosis Unit in Hospital d’Ontinyent, who required supplements of calcium and vitamin D+bisphosphonates after a risk fracture study. Socio-demographic data, breast tumor characteristics, risk f...

ba0001pp426 | Osteoporosis: treatment | ECTS2013

Characterization and incidence on acute phase reaction in Paget's disease after zoledronic acid infusion

Mateos A Conesa , Sala D Rotes , Abello J Carbonell

Zoledronic acid (AZ), is considered first-line treatment for Paget’s disease (PD) of bone. The most common adverse event is flu-like syndrome, described between 10 and 50% of patients. Nowadays, there is not known exactly the molecular basis of this syndrome yet. Statins play an important role in the mevalonate pathway, blocking the production of proinflammatory cytokines secreted by T cells γ/δ.Objectives: Characterization and in...

ba0001pp427 | Osteoporosis: treatment | ECTS2013

Risk factors for the development of vertebral fractures after percutaneous vertebroplasty

Martinez-Ferrer Angels , Blasco Jordi , Gifre Laia , Monegal Ana , Guanabens Nuria , Peris Pilar

We recently observed an increased risk for vertebral fractures (VF) in a randomized controlled trial comparing the analgesic effect of vertebroplasty (VP) vs conservative treatment (CT) in symptomatic VF. The aim of the present study was to evaluate the risk factors related to the development of VF after VP in these patients.Methods and results: We evaluated risk factors including age, gender, bone mineral density, the number, type and severity of verteb...

ba0001pp428 | Osteoporosis: treatment | ECTS2013

Persistence with different anti-osteoporosis medications: a population-based cohort study.

Pages-Castella Aina , Carbonell-Abella Cristina , Nogues Xavier , Javaid M Kassim , Arden Nigel K , Cooper Cirus , Diez-Perez Adolfo , Prieto-Alhambra Daniel

Objective: Several reports suggest very low persistence with oral bisphosphonates, but there is a scarcity of data on persistence with other anti-osteoporosis medications. We therefore compared rates of early discontinuation (in the first year of therapy) between all available outpatient anti-osteoporosis drugs in Catalonia, Spain.Study design: population-based retrospective cohort study.Participants and source of data: The data in...

ba0001pp429 | Osteoporosis: treatment | ECTS2013

Study description and baseline characteristics of the population enrolled in the extended forsteo® observational study (ExFOS)

Langdahl Bente , Benhamou Claude , Lindh Erik , Dekker Joannes , Kapetanos Giorgios , Kocjan Tomaz , Ljunggren Osten , Napoli Nicola , Petto Helmut , Nicolic Tatjana

ExFOS is a multicenter, prospective, observational study to evaluate fracture outcomes, back pain, compliance and health-related quality of life in female and male patients with osteoporosis treated with teriparatide [rhPTH(1–34)] (Forsteo)for 18 to 24 months. Post-treatment follow-up will last for at least 18 months. Patients were enrolled in Croatia, Denmark, France, Greece, Italy, Norway, Slovenia, and Sweden. The study design was non-interventional and all consenting ...

ba0001pp430 | Osteoporosis: treatment | ECTS2013

First in man study of a novel and highly selective cathepsin K inhibitor miv-711 – safety, pharmacokinetics and pharmacodynamics of single ascending oral doses in healthy subjects

Grabowska Urszula , Lindstrom Erik , Jerling Markus , Larsson Torbjorn , Bottiger Disa , Danielson Kerstin , Kristensen Jens D , Edenius Charlotte

Aim: To determine the safety, tolerability, pharmacokinetics and pharmacodynamics of the cathepsin K inhibitor MIV-711.Methods: A double-blind, placebo-controlled, randomized study in 27 healthy subjects of both genders. Single ascending doses 20–600 mg were investigated for adverse events, clinical chemistry, vital signs, ECG parameters, pharmacokinetics, and serum levels of CTX-I.Results: MIV-711 was well tolerated with no a...

ba0001pp431 | Osteoporosis: treatment | ECTS2013

Bisphosphonate treatment of painful vertebral fractures due to osteoporosis in five boys with Duchenne muscular dystrophy

Eva AEstrom

Introduction: Duchenne muscular dystrophy (DMD) is caused by mutation in the dystrophin gene on the X-chromosome, leading to progressive deterioration in muscle function from early childhood. Corticosteroid treatment prolongs the time to loss of walking ability and improves life span. The combination of muscular weakness, reduced mobility and steroids increases the risk of secondary osteoporosis.Subjects and methods: In this prospective observational stu...

ba0001pp432 | Osteoporosis: treatment | ECTS2013

Effects of a mutated sclerostin peptide on bone and lean mass in mice

Gerbaix Maude , Pierroz Dominique , Bonnet Nicolas , Boschert Verena , Mueller Thomas , Ferrari Serge

Sclerostin, a product of osteocytes, is known to inhibit Wnt signaling by binding the LRP5/6 receptor.We investigated the effects of a mutated mouse sclerostin protein (muScl, R118A/R144A) with potential sclerostin antagonistic activity. In vitro, muScl fully competed with wild type sclerostin for binding to LRP6, whereas its IC50 for Wnt3a activity was 4× higher than sclerostin (i.e. 600 nM). Moreover, serum osteocalcin increased in mice a...

ba0001pp433 | Osteoporosis: treatment | ECTS2013

Denosumab is associated with progressive improvements in hip cortical mass and thickness

Poole K , Treece G , Gee A , Brown J P , McClung M R , Wang A , Libanati C

Denosumab (DMAb) significantly improves bone strength at the hip, estimated by FEA from QCT scans, from baseline (B/L) and vs placebo (Pbo) (Keaveny ASBMR 2010). We determined the extent and distribution of mass and thickness changes at the proximal femur, a key skeletal site for fracture risk, using a novel cortical bone mapping technique on the same serial QCT scans. A FREEDOM substudy included 80 women who underwent hip QCT scanning at B/L and months 12, 24 and 36 during DM...

ba0001pp434 | Osteoporosis: treatment | ECTS2013

Bone histology and histomorphometry: effects of 5 years of denosumab in the FREEDOM Extension

Brown Jacques P , Wagman Rachel , Dempster David W , Kendler David , Miller Paul , Bolognese Michael , Valter Ivo , Beck Jensen Jens-Erik , Zerbini Cristiano , Zanchetta Jose R , Daizadeh Nadia , Reid Ian

DMAb increases BMD and reduces bone resorption and risk of vertebral, nonvertebral and hip fractures in women with PMO. Transiliac crest bone biopsies in 47 subjects treated with DMAb for 1–3 years showed reduced bone turnover vs 45 Pbo-treated subjects, which reversed on treatment cessation. Since bone turnover reduction is sustained and fracture incidence low over 6 years’ DMAb treatment, we evaluated DMAb’s effects on tissue-level remodelling in the FREEDOM E...

ba0001pp435 | Osteoporosis: treatment | ECTS2013

Denosumab's dynamic CTX profile is maintained over 6 years of treatment: first 3 years of the FREEDOM extension study

Roux C , McClung MR , Franchimont N , Adami S , Ebeling PR , Reid IR , Resch H , Weryha G , Daizadeh N , Wang A , Wagman RB , Eastell R

Denosumab (DMAb) has a unique profile of bone resorption inhibition: CTX decreases rapidly by 3 days and inhibition is released at the end of the 6-month dosing interval, when DMAb serum levels decrease (McClung NEJM 2006). The dynamic CTX inhibition profile is not curtailed by continued treatment. In the 3-year FREEDOM study, CTX values at 6 months were influenced by baseline CTX values and days since the 1st injection (Eastell JBMR 2011). With 3 additional ...

ba0001pp436 | Osteoporosis: treatment | ECTS2013

Bone mineral density changes in patients with prior fracture suboptimally treated with a bisphosphonate: results from denosumab (DMAb)/ibandronate and DMAb/risedronate trials

Recknor Christopher , Roux Christian , Ho Pei-Ran , Hall Jesse , Bone Henry , Bonnick Sydney , van den Bergh Joop , Ferreira Irene , Wagman Rachel , Brown Jacques P

: In osteoporosis, poor adherence to bisphosphonate (BP) therapy is common, and is associated with poor outcomes and increased treatment costs (Siris 2006; Recker 2005). Although compliance is improved with monthly vs weekly dosing (Reginster 2008), no evidence suggests cycling through BP agents offers therapeutic benefit, assessed by bone mineral density (BMD). In two randomized, open-label studies in postmenopausal women aged ≥55 years previously treated with, but subo...

ba0001pp437 | Osteoporosis: treatment | ECTS2013

The spatial relationship between bone formation and bone resorption in healthy and ovariectomized mice treated with PTH, bisphosphonate or mechanical loading

Ruffoni Davide , Weigt Claudia , Fattorini Elisa , Levchuk Alina , Schulte Friederike , Kuhn Gisela , Muller Ralph

Bone is continuously remodeled to remove damage, to adapt to changes in mechanical demands and to regulate calcium homeostasis. The first aim is accomplished by coupled bone formation and resorption whereas adaptation requires sites of formation to differ from those of resorption. The regulation of circulating ions is achieved by a stochastic exchange of bone packets. Here, we investigated these different aspects of remodeling in healthy and ovariectomized (OVX) mice treated w...

ba0001pp438 | Osteoporosis: treatment | ECTS2013

Optimizing fracture prevention: the fracture liaison service, an observational study

Eekman Danielle , van Helden Sven , Huisman Margriet , Verhaar Harald , Bultink Irene , Geusens Piet , Lips Paul , Lems Willem

Objective: Increase the percentage of elderly fracture patients undergoing a dual energy X-ray absorptiometry (DXA) measurement, and investigate why some patients did not respond to invitation to our fracture liaison service (FLS).Materials and methods: In four Dutch hospitals, fracture patients ≥50 years were invited for a DXA measurement and visit to our FLS. Patients who did not respond, were contacted by telephone. In patients diagnosed with os...

ba0001pp439 | Osteoporosis: treatment | ECTS2013

The direct and indirect costs of an osteoporotic fracture: a prospective evaluation of elderly patients with a clinical fracture

Eekman Danielle , ter Wee Marieke , Coupe Veerle , Erisek-Demirtas Seher , Kramer Mark , Lems Willem

Objective: The aim of this study was to gain insight into all the current overall costs (direct medical, direct non-medical and indirect costs) of clinical fractures in osteoporotic patients aged 50 years and older in the Netherlands.Materials and methods: This prospective study was part of a larger study in which the effect of a fracture nurse on diagnosis and subsequent treatment of elderly osteoporotic patients with a recent fracture was assessed. Inc...

ba0001pp440 | Osteoporosis: treatment | ECTS2013

Strontium potently inhibits mineralisation in bone-forming osteoblast cultures while osteoclast formation from marrow mononuclear cells is moderately reduced

Wornham Daniel , Hajjawi Mark , Orriss Isabel , Arnett Timothy

Strontium ranelate (SrR) is now widely used for the prevention of osteoporotic fractures. The mechanisms by which this occurs, however, remain unclear. We investigated the actions of Sr2+ salts in bone-forming cultures of primary osteoblasts from rat calvariae. Osteoblasts were treated continuously with either SrR or SrCl2 for 14 days. Abundant, discretely mineralised ‘trabecular’ bone structures formed in alizarin red-stained control cultures. ...

ba0001pp441 | Osteoporosis: treatment | ECTS2013

Reducing the risk of hypocalcaemia with parenteral antiresorptive therapies: an audit

Xu Wei , Baker Kenneth , Reavley Rachel , Oates Emily , Aspray Terry

Introduction: Intravenous bisphosphonates (IB) and subcutaneous denosumab (SD) are potent antiresorptive agents widely used in the treatment of osteoporosis, Paget’s disease and metastatic malignancy. Several case reports have identified the risk of life-threatening hypocalcaemia with these treatments, particularly in the context of vitamin D deficiency and further highlighted by recent UKMHRA advice.Design: To optimise vitamin D status and decrease...

ba0001pp442 | Osteoporosis: treatment | ECTS2013

Design of a prospective observational study to evaluate persistence and adherence during denosumab treatment, and patient characteristics in postmenopausal women with osteoporosis in routine clinical practice

Maurille Feudjo Tepie , Moller Gerd , Hadji Peyman , Ferreira Irene , Siddhanti Suresh , Boonen Stephen , Fahrleitner-Pammer Astrid , Papaioannou Nikos

Treatment of postmenopausal osteoporosis (PMO) has been traditionally hampered by poor persistence and adherence to short-term (≤1-monthly) medications. The efficacy of 6-monthly (Q6M) denosumab treatment has been proven in clinical trials, but effectiveness will be dependent on persistence and adherence in routine clinical practice. This study is designed to evaluate real-world persistence and adherence to denosumab, and to establish how this is best assessed in long-ac...

ba0001pp443 | Osteoporosis: treatment | ECTS2013

Zoledronic acid vs alendronate in the management of osteoporosis

Ferguson Lyn , Panarelli Maurizio , Dargie Rosemary

Zoledronic acid has been shown to reduce the risk of fractures and improve bone mineral density (BMD) in osteoporosis vs placebo. This study compared changes in BMD in patients with osteoporosis treated with zoledronic acid vs alendronate. BMD at the lumbar spine and total hip pre- and post-bisphosphonate were recorded for 65 patients with osteoporosis (T score ≤−2.5) from retrospective analysis of DEXA scans. 35 patients received annual 5 mg IV zoledronic...

ba0001pp444 | Osteoporosis: treatment | ECTS2013

Correction of vitamin D deficiency in women with postmenopausal osteoporosis

Povoroznyuk Vladyslav , Balatska Nataliya

The aim of the research: To investigate the effect of combined calcium and vitamin D therapy (calcium 1000 mg, vitamin D 400 IU) on 25(OH)D level and concentration of bone turnover markers in patients with systemic postmenopausal osteoporosis.Methods: 20 women with systemic postmenopausal osteoporosis were examined. The average age of the patients was (63.0 (59.00; 68.00)) years. The study was performed during winter season to exclude the influence of se...

ba0001pp445 | Osteoporosis: treatment | ECTS2013

Effectiveness of the active metabolite of vitamin D in the treatment of postmenopausal osteoporosis

Klimovitskiy Fedir , Povoroznyuk Vladyslav , Balatska Nataliya

The aim of the research was to determine the efficacy of alfacalcidol (Alpha D3 Teva) in the treatment of women with postmenopausal osteoporosis and vitamin D deficiency.Methods: 20 women with systemic postmenopausal osteoporosis were examined. All patients had vitamin D deficiency (the average level of 25(OH)D in blood serum was (37.16 (24.9, 45.1)) nmol/l). Alfacalcidol was prescribed for 12 month in doses 1 μg. duration of observation was 12 mont...

ba0001pp446 | Osteoporosis: treatment | ECTS2013

Effects of odanacatib on BMD and safety in the treatment of osteoporosis in postmenopausal women previously treated with alendronate– a randomized placebo-controlled trial

Chapurlat Roland , De Villiers Tobias , Bonnick Sydney , Odio Alberto , Palacios Santiago , Scott Boyd , De Tilleghem Celine Le Bailly , DaSilva Carolyn , Leung Albert , Gurner Deborah

Odanacatib (ODN) is an orally-active cathepsin K inhibitor being developed for the treatment of postmenopausal osteoporosis. This study evaluated the effects of ODN 50mg once weekly on BMD, bone turnover markers and safety in patients previously treated with alendronate (ALN).This was a randomized, double-blind, placebo-controlled, 24-month study. The primary endpoint was % change from baseline at month 24 of femoral neck (FN) BMD. Postmenopausal women (...

ba0001pp447 | Osteoporosis: treatment | ECTS2013

Effects of sclerostin antibody and maintenance of new bone induced by sclerostin antibody in animal models

Li Xiaodong , Ominsky Michael S , Liu Min , Boyce Rogely W , Ke Hua Zhu

Treatment with sclerostin antibody (Scl-Ab) increases bone formation and strength in animal models. Here, we aimed to i) characterize the longer-term effects of Scl-Ab on bone in cynomolgus monkeys (cynos) and ovariectomized (OVX) rats and ii) test whether follow-up treatment with OPG-Fc would maintain the bone mass gains induced by Scl-Ab in OVX rats. In the cynos study, 3 to 5-year-old male cynos were treated for 6 months with weekly SC injections of vehicle (Veh), 3, 10, or...

ba0001pp448 | Osteoporosis: treatment | ECTS2013

Resolution of effects on bone turnover markers and bone mineral density after discontinuation of long-term bisphosphonate use

Benhamou Claude , De Villiers Tobias , Johnston C Conrad , Langdahl Bente , Saag Kenneth , Denker Andrew , Pong Annpey , McGinnis John P , Rosenberg Elizabeth , Santora Arthur

Relatively little is known about immediate consequences of continuing vs interrupting long-term bisphosphonate treatment. This report describes changes in bone turnover and BMD in a 1-year, dose-finding trial of the calcium-sensing receptor antagonist MK-5442 in postmenopausal, BP-treated women, randomized to continued alendronate 70 mg weekly, switch to placebo, or switch to MK-5442. Recruited women (n=526) had taken alendronate for ≥12 months and an oral BP fo...

ba0001pp449 | Osteoporosis: treatment | ECTS2013

Odanacatib treatment reduces remodeling- and stimulates modeling-based bone formation in adult OVX monkeys

Chen C , Shih M , Zheng H , Duong L

Odanacatib (ODN), a selective and reversible cathepsin K inhibitor was shown to histomorphometrically reduce trabecular (Tb) and intracortical (Ic) bone remodeling while preserving endocortical (Ec) and stimulating periosteal (Ps) bone formation (BF) in monkeys. Here, we investigate the bone site specific mechanism of ODN on bone modeling (Mo) versus remodeling (Re)-based osteons. Rhesus monkeys (13–19 yrs, n=8–11/group) were ovariectomized and treated with ...

ba0001pp450 | Osteoporosis: treatment | ECTS2013

Transdermal delivery of BA058, a novel analog of hPTHrP (1-34), with a short wear time patch in preclinical and clinical studies

Hattersley Gary , Hansen Kris , Determan Amy , Brown Ken , Mckay Kate , Guerriero Jonathan , McCarthy Dan , Lyttle C Richard , St L O'Dea Louis

BA058 is being developed as an anabolic therapy for the treatment of osteoporosis. Daily BA058 SC injection has produced promising safety and efficacy results in early clinical studies, and is currently enrolling in a Phase 3 fracture prevention study. There is, however, a significant need for an alternative to injection that improves patient convenience and compliance. We have investigated the use of a solid Microstructured Transdermal System (3M) for transdermal (TD) deliver...

ba0001pp451 | Osteoporosis: treatment | ECTS2013

Estimation of vertebral and femoral strength during the first three years of denosumab therapy using an alternative smooth non-linear finite element methodology

Zysset Philippe , Pahr Dieter , Engelke Klaus , Genant Harry , McClung Michael , Kendler David , Recknor Christopher , Kinzl Michael , Schwiedrzik Jakob , Museyko Oleg , Wang Andrea , Libanati Cesar

Denosumab subcutaneous administration every 6 months reduced the incidence of new fractures in postmenopausal women with osteoporosis by 68% at the spine and 40% at the hip over 36 months compared with placebo in the FREEDOM study (Cummings et al., NEJM, 2009:361:756). This efficacy was supported by differential improvements from baseline in vertebral and femoral strength at 36 months (18.2 and 8.6%, respectively) estimated by an established voxel-based finit...

ba0001pp452 | Osteoporosis: treatment | ECTS2013

Curbing our enthusiasm when prescribing strenuous exercises in osteopenia/osteoporosis, when fracture may occur under good intensions

Sinaki Mehrsheed

Exercise can prevent or mitigate musculoskeletal challenges of aging. To prescribe an effective /osteogenic exercise program the individual’s muscle strength, bone mineral density, and cardiovascular status would need to be considered.Osteoporotic vertebral fractures and resulting mal-posture create musculoskeletal challenges that cannot be met with pharmacotherapy alone. Bone loss, disequilibrium along with pain can increase inactivity, and further...

ba0001pp453 | Osteoporosis: treatment | ECTS2013

Factors influencing levels of bone resorption during denosumab dosing

Eastell Richard , Siris Ethel , Roux Christian , Black Dennis M. , Franchimont Nathalie , Jang Graham , Daizadeh Nadia , Wagman Rachel B. , Austin Matt

Denosumab treatment is associated with low fracture incidence, sustained BMD increases, and reduced sCTX. The decrease in median sCTX is at the quantifiable limit (0.049 ng/ml) one month post-dose, remains low, and attenuates at the end of the 6-month dosing interval. Using 7 years of data from the FREEDOM study and its extension, we characterized changes in sCTX over time and the influencing factors. In the bone turnover marker and pharmacokinetic substudies, serum was collec...