Bone Density, Microarchitecture, and Tissue Quality After Long-Term Treatment With Tenofovir/Emtricitabine or Abacavir/Lamivudine

Güerri‐Fernández, Robert; Molina-Morant, Daniel; Villar-García, Judit; Herrera, Sabina; González-Mena, Alicia; Guelar, Ana; Trenchs-Rodríguez, Marta; Díez-Pérez, Adolfo; Knobel, Hernando

doi:10.1097/qai.0000000000001396

Cited by 28 publications

(33 citation statements)

References 17 publications

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“…The increases in BMSi values observed in our and other studies [12,14,15] were not related with changes in BMD illustrating, in a different setting, the independence of measurements of bone material properties from those of mineral density as also reported previously in cross-sectional studies [7][8][9][10][20][21][22][23][24][25][26][27][28]. We recently confirmed the lack of a relationship between BMSi and BMD by direct measurements of bone mineral density distribution (BMDD) by quantitative backscattered electron imaging (qBEI) in whole bone tissue in iliac crest bone biopsies obtained concurrently with BMSi measurements in patients with a wide range of BMD [11].…”

Section: Discussionsupporting

confidence: 84%

Treatments of osteoporosis increase bone material strength index in patients with low bone mass

et al. 2020

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Effects on bone material properties of two-year antiosteoporotic treatment were assessed using in vivo impact microindentation (IMI) in patients with low bone mineral density (BMD) values. Antiresorptive treatment, in contrast to vitamin D ± calcium treatment alone, induced BMD-independent increases in bone material strength index, measured by IMI, the magnitude of which depended on pretreatment values. Introduction Bone material strength index (BMSi), measured by IMI in vivo, is reduced in patients with fragility fractures, but there is no information about changes in values during long-term therapy. In the present study, we assessed changes in BMSi in patients receiving antiosteoporotic treatments for periods longer than 12 months. Methods We included treatment-naive patients with low bone mass who had a BMSi measurement with OsteoProbe® at presentation and consented to a repeat measurement after treatment. Results We studied 54 patients (34 women), median age 58 years, of whom 30 were treated with bisphosphonates or denosumab (treatment group) and 24 with vitamin D ± calcium alone (control group). There were no differences in clinical characteristics between the two groups with the exception of a higher number of previous fragility fractures in the treatment group. Baseline hip BMD and BMSi values were lower in the treatment group. After 23.1 ± 6.6 months, BMSi increased significantly in the treatment group (82.4 ± 4.3 vs 79.3 ± 4.1; p < 0.001), but did not change in the control group (81.5 ± 5.2 vs 82.2 ± 4.1; p = 0.35). Changes in BMSi with antiresorptives were inversely related with baseline values (r = − 0.43; p = 0.02) but not with changes in BMD. Two patients in the control group with large decreases in BMSi values sustained incident fractures. Conclusion In patients at increased fracture risk, antiresorptive treatments induced BMD-independent increases in BMSi values, the magnitude of which depended on pretreatment values.

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Section: Discussionsupporting

confidence: 84%

Treatments of osteoporosis increase bone material strength index in patients with low bone mass

et al. 2020

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“…(44) Recently, Guerri-Fernandez and (10) 0.3 0.1-0.9 Gallant et al, 2004 (11) 1 0.6-1.7 Gedmintas et al, 2017 (12) 2.2 1.9-2.5 Guerri-Fernandez et al, 2013 (14) 0.8 0.3-1.6 Hansen et al, 2012 (15) 2.1 2.0-2.2 Hasse et al, 2011 (16) 0.7 0.6-0.8 Kurita et al, 2014 (17) 0.1 0.0-0.3 Yin et al, 2012 (29) 0.1 0.1-0.1 Yong et al, 2011 (31) 0.5 0.4-1.6 Young et al, 2011 (32) 0. colleagues reported lower BMD in long-term users of tenofovir compared with long-term users of abacavir in a small crosssectional study. (54) Nonetheless, they found no differences in trabecular bone score (TBS) or microindentation-derived BMSi between the two groups. (54) At present, the only associations reported between specific forms of ART and fracture risk are for TDF and protease inhibitors.…”

Section: Bone and Antiretroviral Therapymentioning

confidence: 94%

“…(54) Nonetheless, they found no differences in trabecular bone score (TBS) or microindentation-derived BMSi between the two groups. (54) At present, the only associations reported between specific forms of ART and fracture risk are for TDF and protease inhibitors. (8,9) It is important to note that most of the studies that evaluated the incidence of fractures in people living with HIV had insufficient power to evaluate the association between specific antiretrovirals and fractures.…”

Section: Bone and Antiretroviral Therapymentioning

confidence: 94%

“…It is important to note, however, that both ART regimens were associated with bone loss . Recently, Guerri‐Fernandez and colleagues reported lower BMD in long‐term users of tenofovir compared with long‐term users of abacavir in a small cross‐sectional study . Nonetheless, they found no differences in trabecular bone score (TBS) or microindentation‐derived BMSi between the two groups …”

Section: Bone and Antiretroviral Therapymentioning

confidence: 98%

“…Although switching to antiretroviral drugs, such as integrase inhibitors and tenofovir alafenamide, reduces adverse skeletal effects, the long-term effects of this approach on viral resistance is not known. (44,45,(50)(51)(52)(53)(54) For this reason, any change in ART should be evaluated in conjunction with the patient's HIV treatment team.…”

Section: Managementmentioning

confidence: 99%

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The Hidden Burden of Fractures in People Living With HIV

Premaor

Compston

2018

JBMR Plus

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The survival of people living with human immunodeficiency virus (HIV) has increased markedly since the advent of antiretroviral therapy (ART). However, other morbidities have emerged, including osteoporosis. The estimated incidence of fractures at any site in people living with HIV ranges from 0.1 per 1000 person‐years to 8.4 per 1000 person‐years: at least twice that of people without HIV. This increased risk seems to be related to HIV itself and its treatment. Risk factors for bone disease in HIV‐positive (HIV+) subjects include both classical risk factors for osteoporosis and fracture and factors linked to HIV itself, such as inflammation, reconstitution syndrome, low CD4, ART, and co‐infection with hepatitis B and C viruses. The risk of fractures in these individuals can be at least partially assessed by measurement of BMD and the Fracture Risk Assessment Tool (FRAX™). Only alendronate and zoledronic acid have been studied in HIV+ individuals; both show beneficial effects on BMD, although data on fracture reduction are not available. © 2018 The Authors. JBMR Plus Published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research.

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Normative Data for Impact Microindentation for Australian Men: Cross‐Sectional Data From the Geelong Osteoporosis Study

et al. 2020

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Impact microindentation (IMI) is a novel technique for assessing the bone material strength index (BMSi) in vivo. However, no studies have presented normative data for BMSi. The aim of this study was to develop such normative data using a population‐based sample of men, randomly selected from electoral rolls for the Barwon Statistical Division in southeastern Australia to participate in the Geelong Osteoporosis Study. BMSi was measured on the tibial plateau using an OsteoProbe in 405 men (ages 33 to 96 years) during the period 2016 to 2019. Associations between BMSi, age, and anthropometry were examined using linear regression models. BMSi values ranged from 49.0 to 100.5. BMSi was negatively correlated with age (r = −0.152, p = 0.002), weight (r = −0.103, p = 0.039), and BMI (r = −0.187, p < 0.001), and positively correlated with height (r = +0.107, p = 0.032). Mean ± SD BMSi was 82.6 ± 7.0 for the whole group, and ranged from 85.6 ± 6.0 for ages 30 to 39 years to 79.8 ± 6.6 for ages 80+ years. This study provides normative data that can be used to calculate T‐ and Z‐scores for BMSi. These data will be useful for identifying men with low BMSi. Further research is warranted to derive optimal cut points for BMSi that discriminate fracture risk. © 2020 The Authors. JBMR Plus published by Wiley Periodicals LLC. on behalf of American Society for Bone and Mineral Research.

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Bone Density, Microarchitecture, and Tissue Quality After Long-Term Treatment With Tenofovir/Emtricitabine or Abacavir/Lamivudine

Cited by 28 publications

References 17 publications

Treatments of osteoporosis increase bone material strength index in patients with low bone mass

Treatments of osteoporosis increase bone material strength index in patients with low bone mass

The Hidden Burden of Fractures in People Living With HIV

Normative Data for Impact Microindentation for Australian Men: Cross‐Sectional Data From the Geelong Osteoporosis Study

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