A Review of Osteoporosis Diagnosis and Treatment Options in New and Recently Updated Guidelines on Case Finding Around the World

Leslie, William D.; Schousboe, John T.

doi:10.1007/s11914-011-0060-5

Cited by 54 publications

(58 citation statements)

References 40 publications

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“…Apparently, using our supplementation policy, baseline serum 25(OH)D is the strongest predictor for the magnitude of 25(OH)D change, not the dose itself, even when using high supplementation doses. Using a standard supplementation dose of 800 IU/day, as advocated in many guidelines on osteoporosis and fractre prevention (23,24), the percentage of patients reaching a serum 25(OH)D level R50 nmol/l were similar when using higher doses, at any baseline serum 25(OH)D. This result confirms that baseline serum 25(OH)D is the most important predictor of response to vitamin D3 supplementation. Therefore, if the aim is to achieve a serum 25(OH)D R50 nmol/l, as in our study, higher vitamin D supplementation doses than 800 IU/day are not needed (6,7,24).…”

Section: Discussionsupporting

confidence: 64%

Suboptimal effect of different vitamin D3 supplementations and doses adapted to baseline serum 25(OH)D on achieved 25(OH)D levels in patients with a recent fracture: a prospective observational study

Shab-Bidar

Bours

Geusens

et al. 2013

European Journal of Endocrinology

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Objective: Guidelines on the need for dose adaptation of vitamin D3 supplementation according to baseline serum 25(OH)D are inconclusive. The effects of increasing doses of vitamin D3 at lower baseline serum 25(OH)D values on the serum 25(OH)D after 4.2 and 11 months were determined in an observational study. Design: A prospective observational study. Methods: Out of 1481 consecutive women and men with a recent clinical fracture, 707 had a baseline 25(OH)D level !50 nmol/l and were supplemented with increasing doses of vitamin D3 (400, 800, 1700, and R3500 IU/day) according to the lower baseline 25(OH)D. Final analysis was restricted to the 221 participants who had full follow-up data available for 11 months. Results: Serum 25(OH)D R50 nmol/l was achieved in 57-76% of patients after 4.2 months and in 73-79% after 11 months. These percentages were similar for all doses (PZ0.06 and PZ0.91 respectively). The mean achieved 25(OH)D was similar for all dose groups (56.1-64.0 nmol/l after 4.2 months and 60.2-76.3 nmol/l after 11 months). With multivariate analysis, the increase in 25(OH)D (17G32.0 after 4.2 months and 24.3G34.0 nmol/l after 11 months) was dependent on the baseline 25(OH)D (P!0.001), not on supplementation dose, season, age, BMI, or gender. Conclusions: The increase in serum 25(OH)D was significantly larger with higher vitamin D3 supplementation doses. However, this dose-effect response was mainly explained by the baseline 25(OH)D, not the supplementation dose, with a greater magnitude of response at lower baseline 25(OH)D concentrations. In 21-27% of patients, serum 25(OH)D3 levels did not reach 50 nmol/l after 11 months, at any dose. Further studies are needed to identify possible causes of suboptimal response such as non-compliance, undiagnosed malabsorption syndromes, or variability in cholecalciferol content of the vitamin D supplements.

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Section: Discussionsupporting

confidence: 64%

Suboptimal effect of different vitamin D3 supplementations and doses adapted to baseline serum 25(OH)D on achieved 25(OH)D levels in patients with a recent fracture: a prospective observational study

Shab-Bidar

Bours

Geusens

et al. 2013

European Journal of Endocrinology

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“…Cancer without known skeletal metastases and not requiring therapy to lower sex steroid Risk assessment should be applied as in non-cancer patients [179][180][181][182]. A detailed history and a focused physical examination are recommended to identify risk factors for low BMD, falls and fractures, as well as undiagnosed vertebral fractures.…”

Section: General Recommendationsmentioning

confidence: 99%

Cancer-associated bone disease

Rizzoli

Body²,

Brandi³

et al. 2013

Osteoporos Int

122

103

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Bone is commonly affected in cancer. Cancer-induced bone disease results from the primary disease, or from therapies against the primary condition, causing bone fragility. Bone-modifying agents, such as bisphosphonates and denosumab, are efficacious in preventing and delaying cancer-related bone disease. With evidence-based care pathways, guidelines assist physicians in clinical decision-making. Of the 57 million deaths in 2008 worldwide, almost two thirds were due to non-communicable diseases, led by cardiovascular diseases and cancers. Bone is a commonly affected organ in cancer, and although the incidence of metastatic bone disease is not well defined, it is estimated that around half of patients who die from cancer in the USA each year have bone involvement. Furthermore, cancer-induced bone disease can result from the primary disease itself, either due to circulating bone resorbing substances or metastatic bone disease, such as commonly occurs with breast, lung and prostate cancer, or from therapies administered to treat the primary condition thus causing bone loss and fractures. Treatment-induced osteoporosis may occur in the setting of glucocorticoid therapy or oestrogen deprivation therapy, chemotherapy-induced ovarian failure and androgen deprivation therapy. Tumour skeletal-related events include pathologic fractures, spinal cord compression, surgery and radiotherapy to bone and may or may not include hypercalcaemia of malignancy while skeletal complication refers to pain and other symptoms. Some evidence demonstrates the efficacy of various interventions including bone-modifying agents, such as bisphosphonates and denosumab, in preventing or delaying cancer-related bone disease. The latter includes treatment of patients with metastatic skeletal lesions in general, adjuvant treatment of breast and prostate cancer in particular, and the prevention of cancerassociated bone disease. This has led to the development of guidelines by several societies and working groups to assist physicians in clinical decision making, providing them with evidencebased care pathways to prevent skeletal-related events and bone loss. The goal of this paper is to put forth an IOF position paper addressing bone diseases and cancer and summarizing the position papers of other organizations. Epidemiology of cancer-associated bone disease Bone metastasisCancer affects nearly 12.7 million people and is associated with over 7 million deaths in 2008 [1]. Cancer is a rising global health burden and it is estimated that in 2030, cancer deaths will be tallied at over 13 million (World Health Organization (WHO) 2010 Global Status Report [2]). Addressing the morbidity and mortality of cancer is an important public health concern. On purpose, we are limiting our analysis to cancer bone involvement in adults and do not discuss cancer in children.Metastases from cancer are associated with 90 % of cancer deaths [3]. It was estimated that one half of people who die from cancer in the USA have bone involvement [4][5][6]. Different tumou...

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“…The results in this study demonstrated increased prevalence of osteoporosis amongst post-menopausal females, which is consistent with the literature. 26 Conditions that affect bone density can influence osseointegration. Bone-implant contact was reduced by 50% in one study involving implants in osteoporotic rat models, 27 while in humans implant failure appears to parallel decreased bone density.…”

Section: Musculoskeletal Related Diseasementioning

confidence: 99%

Analysis of commonly reported medical conditions amongst patients receiving dental implant therapy in private practice

Austin

Bailey

Chandu

et al. 2015

Australian Dental Journal

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Background: The population seeking implants in private practice is a demographically and medically unique group. Understanding their medical needs can improve treatment planning and service delivery specifically for this population. Methods: Privately practising dental clinicians from Victoria, Australia, participated in a five-year retrospective study. Data were collected from the medical histories of 4116 patients who met the inclusion criterion of at least one implant placed within the study period of 1 January 2005 to 31 December 2009. Descriptive statistics were used to describe patient demographics and commonly reported medical conditions. Results: The most common age group to receive implant therapy was between 51 and 60 years (30.4% of patients). The patient population reported a broad range of co-morbidities including psychiatric disorders (83 patients), cardiovascular disorders (253 patients), gastrointestinal disorders (224 patients) and respiratory disorders (502 patients). Smoking was less prevalent amongst the study population compared to the general population. Conclusions: The population assessed in this study was a medically diverse group. Clinicians must be familiar with their target demographic and understand how the common co-morbidities amongst this patient group can influence clinical decision making and outcomes.

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A Review of Osteoporosis Diagnosis and Treatment Options in New and Recently Updated Guidelines on Case Finding Around the World

Cited by 54 publications

References 40 publications

Suboptimal effect of different vitamin D3 supplementations and doses adapted to baseline serum 25(OH)D on achieved 25(OH)D levels in patients with a recent fracture: a prospective observational study

Suboptimal effect of different vitamin D3 supplementations and doses adapted to baseline serum 25(OH)D on achieved 25(OH)D levels in patients with a recent fracture: a prospective observational study

Cancer-associated bone disease

Analysis of commonly reported medical conditions amongst patients receiving dental implant therapy in private practice

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