Bone
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This systematic review and meta-analysis evaluated the outcomes of patients with osteoporosis-related fractures managed through fracture liaison services (FLS) programs. ⋯ FLS programs improved outcomes of osteoporosis-related fractures, with significant increases in BMD testing, treatment initiation, and adherence to treatment and reductions in re-fracture incidence and mortality.
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Review Meta Analysis
Frailty as a predictor of fractures among community-dwelling older people: A systematic review and meta-analysis.
To identify prospective studies examining associations between frailty and fractures and to combine the risk measures to synthesize pooled evidence on frailty as a predictor of fractures among community-dwelling older people. ⋯ This systematic review and meta-analysis showed evidence that frailty and prefrailty are significant predictors of fractures among community-dwelling older people. Treating frailty may potentially lead to lowering fracture risks.
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Review Meta Analysis
Update on long-term treatment with bisphosphonates for postmenopausal osteoporosis: a systematic review.
Osteoporosis is a progressive skeletal disorder that requires long-term treatment. However, there is little guidance regarding optimal treatment duration and what the treatment discontinuation and retreatment criteria should be. Given that bisphosphonates are the most commonly prescribed class of agent for the treatment of osteoporosis, we reviewed the long-term data relating to these therapies and discussed the considerations for using bisphosphonates in postmenopausal women with osteoporosis. ⋯ Clinical studies in postmenopausal women with osteoporosis showed that long-term use of bisphosphonates resulted in persistent antifracture and bone mineral density (BMD) increasing effects beyond 3 years of treatment. No unexpected adverse events were identified in these studies and the long-term tolerability profiles of bisphosphonates remain favorable. Data from the withdrawal extension studies of alendronate and zoledronic acid also showed that residual fracture benefits were seen in patients who discontinued treatment for 3 to 5 years after an initial 3- to 5-year treatment period. BMD monitoring and fracture risk assessments should be conducted regularly to determine whether treatment could be stopped or should be reinitiated. Patients exhibiting T-scores<-2.5 or who have suffered a new fracture while on treatment should continue treatment, while patients with T-scores>-2.5 could be considered for discontinuation of active treatment while undergoing continued monitoring of their bone health. The duration and potential discontinuation of treatment should be personalized for individual patients based on their response to treatment, fracture risk and comorbidities.
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Meta Analysis
Osteoporosis risk and bone mineral density levels in patients with Parkinson's disease: a meta-analysis.
Parkinson's disease (PD) and osteoporosis are common diseases which affect a substantial portion of the elderly population. Accumulating evidence supports that PD patients have a high risk for osteoporosis in recent years. The purpose of the present study is to perform a meta-analysis on the risk of osteoporosis and bone mineral density (BMD) levels in PD patients. ⋯ This meta-analysis suggested that PD patients are at higher risk for osteoporosis and have lower BMD levels than healthy controls overall.