Net Guide: Osteoporosis

//Medical Websites

International Osteoporosis Foundation: About Osteoporosis

Among the many resources available to professionals at this site is the FRAX page. Information provided here includes the significant improvements FRAX has made in helping physicians identify patients who are at high risk for fractures, reviews from physicians, and a FRAX slide kit. The “Health Economics” page will allow physicians to gauge the social and economic burden of osteoporosis, as well as understand how the condition impacts people in other parts of the world. The “Quality of Life Questionnaire” featured here will provide physicians with another tool for assessing patients. The site also features national and regional guidelines and a “Special Topics” page, which includes information about fracture risk assessment, exercise, and more.

Link Code: e12411

//The Educated Patient™

National Institute of Arthritis and Musculoskeletal and Skin Diseases: Osteoporosis

Patients recently diagnosed with osteoporosis who want to know more about how bones are affected by osteoporosis should visit the “What is Bone?” section of this site, which provides an explanation of the functions bone serves in the body, and how it is affected by osteoporosis. Under “Detection,” patients can learn more about the value of a bone mineral density (BMD) test. The “Treatment” section will provide more information about the possible avenues a physician may take after a BMD test. Patients who are concerned about falling, one of the biggest problems associated with osteoporosis, should check out the “Fall Prevention” section, which provides advice for both indoor and outdoor environments.

Link Code: e12421

Osteoporosis.net

Causes of osteoporosis, testing, and helpful exercises are just a few of the topics covered at this extensive site. The symptoms of osteoporosis are explained with detailed written descriptions as well as images. Two sections of the site are dedicated to nutrition and osteoporosis and explain how a poor diet can lead to and increase osteoporosis-related problems, and what foods an individual with osteoporosis should be eating. Under “Osteoporosis Exercises,” patients will find workouts that will help with the condition, as well as tips for dealing with the physical changes of osteoporosis.

Link Code: e12422

//eAbstracts

Bone Mineral Density and Respiratory Muscle Strength in Male Individuals with Mental Retardation (with and without Down Syndrome)Journal: Research in Developmental Disabilities (June 11, 2010)

Authors: Maldaner da Silva V, França Barros J, de Azevedo M, et al.

Purpose: The purpose of this study was to “assess the respiratory muscle strength (RMS) in individuals with mental retardation (MR), with or without Down Syndrome (DS), and its association with bone mineral density (BMD).”

Results: “Individuals with MR, both with and without DS, have lower FEV1, FVC, MIP and MEP (p < 0.001) compared to controls. Individuals with DS also had lower BMD, which was associated with lower MIP and MEP. Hypotonia, sedentary lifestyle and obesity are factors that may explain lower MIP and MEP in DS. Strategies to increase RMS could decrease the risk of osteoporosis in the DS population.”

Link Code: e12451

//Clinical Trials

Trial of Lithium Carbonate for Treatment of Osteoporosis-pseudoglioma SyndromeStudy Type: Interventional

Age/Gender Requirement: 4-64 years (male/female)

Sponsor: University of Maryland

Purpose: Because “studies in the mouse model of osteoporosis-pseudoglioma syndrome (OPPG) showed that lithium normalized their bone strength,” researchers are pursuing “a pilot study of up to 10 patients with OPPG from the Old Order Mennonite community, who will be given lithium for six months and have dual energy x-ray absorptiometry, peripheral quantitative computerized tomography and lab assessment at baseline and six months.”

Link Code: e12461

//Online CME

A Postmenopausal Woman with Low Bone DensityCredits: 0.50

Fee: None

Expires: April 6, 2012

Multimedia: None

Designed to “narrow practice and knowledge gaps in the management of osteoporosis,” this program discusses the case of a 57-year-old woman who presents with concerns about the results of her BMD because of her age and a family history of osteoporosis. Diagnostic steps, possible treatment options, and follow-up care are reviewed, as well as the possible causes of secondary osteoporosis and bioidentical hormone therapy. A discussion of the FRAX model, and the limitations of using it to assess fracture risk, is also included in the activity.

Link Code: e12431

Osteoporosis and Chronic Kidney DiseaseCredits: 1.00

Fee: $10.00

Expires: June 2012

Multimedia: None

Osteoporosis, as defined by the National Institutes of Health Consensus Conference, may co-exist with renal bone disease or renal osteodystrophy, skeletal disorders caused by chronic kidney disease (CKD). This activity reviews the definition of CKD and the diagnosis of the condition in patients with osteoporosis, causes of fragility fractures in CKD, and treatment options. Completing the program should also enable physicians to “describe the limitations of determining renal function as an outpatient using only serum creatinine concentrations as opposed to estimating glomerular filtration rate (eGFR) by derived equations” and “recognize the difficulties associated with applying WHO osteoporosis diagnostic criteria to CKD patients.”

Link Code: e12432

Pharma Focus

Zometa (zoledronic acid)

//eAbstracts

Efficacy and Safety of a Once-yearly IV Infusion of Zoledronic Acid 5 mg vs a Onceweekly 70 mg Oral Alendronate in the Treatment of Male OsteoporosisJournal: Journal of Bone and Mineral Research (April 30, 2010)

Authors: Orwoll E, Miller P, Adachi J, et al.

Purpose: Because “zoledronic acid (ZOL) has shown beneficial effects on bone turnover and bone mineral density (BMD) in postmenopausal osteoporosis,” researchers sought to determine whether a once-yearly IV infusion of ZOL would be a safe and effective treatment in men with osteoporosis. Further, they compared efficacy and safety to that of a weekly regimen of oral alendronate (ALN).

Results: “ZOL increased BMD at lumbar spine, total hip, femoral neck and trochanter, and was noninferior to ALN at 24 months... At Month 12, the median change from baseline of markers for bone resorption…and formation…were comparable between ZOL and ALN groups. Most men preferred i.v. ZOL over oral ALN. The incidence of adverse events and serious adverse events was similar in the treatment groups.”

Link Code: e12452

//Clinical Trials

Zoledronic Acid for Osteoporosis in the ElderlyStudy Type: Interventional

Age/Gender Requirement: 65 years+ (female)

Sponsor: University of Pittsburgh

Purpose: Researchers will assess the “safety, efficacy and feasibility of a single dose of intravenous zoledronic acid in the maintenance of skeletal integrity for frail, institutionalized women, who are most at risk for the deleterious outcomes of osteoporosis.”

Link Code: e12462

From the Network

New Understanding of why Common Drugs Cause Bone Loss

Two studies published in Cell Metabolism, focusing on glucocorticoids and the insulin sensitizer rosiglitazone, examine the ways in which these drugs result in bone loss and increase a patient’s risk for bone fractures.

www.hcplive.com/rheumatology/articles/bone_loss_drugs

Osteoporosis Drug may also Be Effective in Schizophrenia

Researchers at Monash University conducted a study to determine the efficacy of Raloxifene, a synthetic estrogen, for the treatment of schizophrenia, finding that women showed a significantly greater improvement in symptoms of psychosis after taking the medication.

www.hcplive.com/psychiatry/articles/estrogen_treatment_for_schizophrenia

Practicing Fall Techniques Could Help Patients with Osteoporosis

Martial arts fall training may help osteoporosis patients as long as appropriate safety measures are taken, according to study results published in BMC Research Notes.

www.hcplive.com/pain-management/articles/Martial_arts_fall_training_osteoarthritis