Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
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Randomized Controlled Trial Multicenter Study
Predictors of new and severe vertebral fractures: results from the HORIZON Pivotal Fracture Trial.
We examined prevalent and recent vertebral fractures in 1 year as predictors of new vertebral fractures over subsequent 2 years using data from RCT placebo patients. We found that prevalent and recent vertebral fractures strongly and independently predicted subsequent vertebral fractures including those which were severe. ⋯ Prevalent and incident vertebral fractures are highly predictive of subsequent new and severe vertebral fractures. Women with both of these risk factors are likely to benefit from anti-osteoporosis treatment.
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Meta Analysis
Vertebral fracture efficacy during risedronate therapy in patients using proton pump inhibitors.
Recent evidence suggests that proton pump inhibitor (PPI) use may affect fracture risk, an important issue for patients being concurrently treated for osteoporosis. The results of our post hoc analysis showed that, regardless of PPI concomitant use, risedronate significantly reduced the risk of new vertebral fractures compared with placebo. ⋯ Risedronate significantly reduced the risk of new vertebral fractures compared with placebo, regardless of PPI concomitant use.
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Randomized Controlled Trial
The effect of high-dose vitamin D on bone mineral density and bone turnover markers in postmenopausal women with low bone mass--a randomized controlled 1-year trial.
Vitamin D is widely used in osteoporosis treatment, although the optimal dose is not known. This 1-year clinical study among 297 women aged 50-80 years old showed that a vitamin D(3) dose of 6,500 IU/day was not better than the standard dose of 800 IU/day in improving bone mineral density (BMD) in the hip and spine. ⋯ One year treatment with 6,500 IU vitamin D(3)/day was not better than 800 IU/day regarding BMD in vitamin D-replete postmenopausal women with reduced bone mass and was less efficient in reducing bone turnover.
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Twenty-one excised femurs were studied using (1) a high-resolution digital X-ray device to estimate three textural parameters, (2) dual-energy X-ray absorptiometry (DXA) to measure bone mineral density (BMD), and (3) mechanical tests to failure. Textural parameters significantly correlated with BMD (p < 0.05) and bone strength (p < 0.05). Combining texture parameters and BMD significantly improved the fracture load prediction from adjusted r(2) = 0.74 to adjusted r(2) =0.82 (p < 0.05). ⋯ In these excised femurs, the combination of bone texture parameters with BMD demonstrated a better performance in the failure load prediction than that of BMD alone.
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Review Comparative Study
Balloon kyphoplasty and vertebroplasty in the management of vertebral compression fractures.
Vertebral compression fractures (VCFs) are the most prevalent fractures in osteoporotic patients. The classical conservative management of these fractures is through rest, pain medication, bracing and muscle relaxants. The aim of this paper is to review prospective controlled studies comparing the efficacy and safety of minimally invasive techniques for vertebral augmentation, vertebroplasty (VP) and balloon kyphoplasty (BKP), versus non-surgical management (NSM). ⋯ However, the long-term benefits and safety in terms of risk of subsequent vertebral fractures have not been clearly demonstrated and further prospective randomized studies are needed with standards for reporting. Referral physicians should be aware of VP/BKP and their potential to reduce the health impairment of patients with VCFs. However, VP and BKP are not substitutes for appropriate evaluation and treatment of osteoporosis to reduce the risk of future fractures.