Recommendations by the Spanish Society of Rheumatology on Osteoporosis

Hernández, Antonio Naranjo; Fontecha, Petra Díaz del Campo; Acín, María Pilar Aguado; Rodríguez, Luis Arboleya; Burgos, Enrique Casado; Castañeda, Santos; Aresté, Jordi Fiter; Gifre, Laia; Vaquero, Carmen Gómez; Rodríguez, Gloria Candelas; Hernández, Félix Manuel Francisco; Gay, Núria Guañabens

doi:10.1016/j.reumae.2018.09.011

Cited by 14 publications

(11 citation statements)

References 207 publications

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“…Low muscle mass was defined according to ALM adjusted for body mass index (BMI) as a threshold of 7.26 kg/m 2 for men and 5.50 kg/m 2 for women [ 12 ]. Obesity and osteoporosis was defined according to international standards [ 32 , 33 ]…”

Section: Methodsmentioning

confidence: 99%

Relationship of Body Composition with the Strength and Functional Capacity of People over 70 Years

Villada

González-Bernal

González‐Santos

et al. 2020

IJERPH

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Background: Aging is a multifactorial physiological phenomenon, in which a series of changes in the body composition occur, such as a decrease in muscle mass and bone mineral density and an increase in fat mass. This study aimed to determine the relationship of muscle mass, osteoporosis, and obesity with the strength and functional capacity of non-dependent people over 70 years of age. Methods: A cross-sectional study was designed, whose study population was all people aged over 70 years, living independently and attending academic and recreational programs. Muscle strength and functional capacity of the participants were assessed by isometric exercises of lower and upper limbs and by four tests taken from the Senior Fitness Test, respectively. Bone mineral density, total mass, fat mass, total lean mass, arms lean mass, legs lean mass, and appendicular lean mass (ALM) was calculated by dual energy X-ray absorptiometry. Differences in muscle strength and functional capacity, according to the sex, muscle mass, mineral bone density and fat mass, were measured by χ2 test, independent samples Student’s t-test, analysis of covariance and a 2-factor analysis of covariance; Results: 143 subjects were included in the study group. Men and women with an adequate amount of ALM adjusted for body mass index (BMI) had a maximal dynamic biceps strength in a single repetition, a maximal isometric leg extension strength, a maximal dynamic leg extension strength in a single repetition, a maximum right hand grip strength and maximum hand grip strength (the highest). Significantly higher values were observed in the maximal isometric biceps’ strength in men with osteoporosis. Obese men had less isometric strength in the biceps and took longer to perform the chair stand test; Conclusions: Men and women with an adequate amount of ALM adjusted for BMI obtained better results in tests of muscle strength and functional capacity. However, osteoporosis and obesity are not related to these parameters.

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Section: Methodsmentioning

confidence: 99%

Relationship of Body Composition with the Strength and Functional Capacity of People over 70 Years

Villada

González-Bernal

González‐Santos

et al. 2020

IJERPH

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“…Raloxifene (RLX) and bazedoxifene are the SERMs indicated in women with postmenopausal osteoporosis, since they increase BMD and reduce the risk of vertebral fracture. The unproven efficacy in reducing the risk of non-vertebral or hip fracture and the increased risk of venous thromboembolism restrict its use to postmenopausal women under 70 years of age at risk of vertebral fracture and low risk of hip fracture and venous thrombosis 15 .…”

Section: Menopausal Hormone Therapy (Thm)mentioning

confidence: 99%

Tratamiento secuencial en osteoporosis. Nuevas tendencias

Casado¹,

Neyro²

2021

Rev Osteoporos Metab Miner

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Treatment for osteoporosis is usually long term, so it is often necessary to implement a sequential treatment strategy. The clinician must know not only how to select the best available therapy in each clinical situation, but also how to discontinue or change treatment at a certain point in the evolution of the disease. Here, we briefly review the mechanisms of action and the consequences of discontinuing each of the drugs for osteoporosis, as well as what happens with the different treatment sequences. Discontinuation of denosumab has clearly negative consequences for the skeleton, and only bisphosphonates, due to its particular remaining antiresorptive effect, could be discontinued for a limited time (drug holidays). Switching from antiresorptive to another antiresorptive with a different mechanism of action is an option that may be favorable in the management of some patients with osteoporosis. Switching from antiresorptive to anabolic may be associated with an initial bone mineral density loss that does not appear to have negative consequences on antifracture efficacy. Starting with anabolic (teriparatide or romosozumab) and subsequently switching to antiresorptive is the best treatment sequence, so it could be the preferred option in patients who present a very high risk of fracture.

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“…In RA patients it is advisable to periodically evaluate the risk of fracture using fracture risk scales such as FRAX ® (Fracture Risk Assessment Tool; https://www.sheffield.ac.uk/FRAX/tool.aspx?lang=sp) and/or periodic determination of bone mineral density (BMD) by dual X-ray densitometry (DXA). This recommendation is even more important in patients older than 50 years of age, suffering severe RA and/or who have received prolonged treatment with GCs 28 .…”

Section: Op Treatment In Patients With Rheumatoid Arthritismentioning

confidence: 99%

Fisiopatología de la osteoporosis en las enfermedades articulares inflamatorias crónicas

Castañeda

Garcés-Puentes²,

Pineda

2021

Rev Osteoporos Metab Miner

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The immune system and the bone often share the same anatomical niches and spaces, as there is a close functional relationship between both of them. As a consequence, there is a constant interaction between them and a bidirectional flow of information between the immune cells and those of the bone tissue (osteoclasts, osteoblasts and osteocytes) often unknown, in which multiple inflammatory mediators and various growth and cell differentiation factors are involved. This leads to a very close interaction between inflammation and bone loss. In fact, osteoporosis (OP) is one of the most frequent systemic complications in chronic inflammatory diseases (CIDs). The prevalence of OP in CIDs depends on each pathological scenario. Rheumatoid arthritis (RA) is a paradigmatic disease which causes chronic inflammation, where the presence of OP is frequent and shows even prior to the appearance of the first symptoms of the RA. The pathogenesis of RA-associated OP is complex and includes the cooperation of multiple pro-inflammatory cytokines that promote osteoclastogenesis and inhibit bone formation. Tumor necrosis factor alpha (TNF-α) and different interleukins (IL), such as IL-1, IL-6 and IL-17, stand out among all, IL-6 having a relevant hierarchical role. In this study, we review the role of pro-inflammatory cytokines in bone and joint destruction in different CIDs, giving special emphasis to RA, as we set out the bases of possible pathways that open new therapeutic horizons in the their framework.

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Recommendations by the Spanish Society of Rheumatology on Osteoporosis

Cited by 14 publications

References 207 publications

Relationship of Body Composition with the Strength and Functional Capacity of People over 70 Years

Relationship of Body Composition with the Strength and Functional Capacity of People over 70 Years

Tratamiento secuencial en osteoporosis. Nuevas tendencias

Fisiopatología de la osteoporosis en las enfermedades articulares inflamatorias crónicas

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