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  • 1
    Electronic Resource
    Electronic Resource
    Effect of transdermal l7β-estradiol and oral conjugated equine estrogens on biochemical parameters of bone resorption in natural menopause (1993)
    Springer
    Calcified tissue international 53 (1993), S. 13-16 
    Details
    ISSN: 1432-0827
    Keywords: Osteoporosis ; Menopause ; Estrogen ; Pyridinoline ; Bone resorption
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine , Physics
    Notes: Summary Objective: To evaluate and compare the effects or oral and transdermal estrogen replacement therapy on biochemical markers of bone resorption in early postmenopausal women Design: Controlled, randomized group comparison. Setting: Outpatient clinic for menopausal women and research into osteoporosis. Subjects: Sixty healthy women menopausal for less than 5 years and who had never received any medications interfering with bone metabolism. Interventions: The 60 women were randomly allocated to 3 months therapy with either oral conjugated estrogens (0.625 mg/day) (n = 28) or transdermal estradiol (50 jig/day) (n = 32) in cyclical combination with medroxyprogesterone acetate (5 mg/day). Main outcome measures: Traditional (urinary calcium/creatinine and hydroxyproline/creatinine) and the new specific (urinary pyridinoline/creatinine and deoxypyridinoline/creatinine) markers of bone resorption were determined before and after 3 months of treatment. Results: In both groups, circulating levels of estrone and estradiol were significantly (P 〈 0.001) increased during treatment. In women treated with oral conjugated equine estrogens, urinary calcium/creatinine and hydroxyproline/creatinine ratios were significantly (P 〈 0.05) reduced. Pyridinoline/creatinine ratio fell from 69.1 (4) [mean (SEM)] to 50 (4) μmol/μmol (P 〈 0.01) and deoxypyridinoline/creatinine ratio fell from 10.8 (1) [mean (SEM)] to 8.3 (0.8) μmol/μmol (P 〈 0.01). In the group treated with transdermal estradiol, urinary hydroxyproline/creatinine ratio was significantly (P 〈 0.05) reduced. Pyridinoline/creatinine ratio fell from 66.3 (4) [mean (SEM)] to 46.2 (3) μmol/μmol (P 〈 0.01) and deoxypyridinoline/creatinine ratio fell from 11.5 (1.5) [mean (SEM)] to 7.7 (0.6) μmol/μmol (P 〈 0.01). There were no differences between the evolution of the biochemical variables in the two groups. Conclusion: These results suggest that oral conjugated equine estrogens and transdermal estradiol, in the given doses, are equally effective in reducing postmenopausal bone resorption.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01352008
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  • 2
    Electronic Resource
    Electronic Resource
    Investigation of the relationship between osteoporosis and the collagenase gene by means of polymorphism of the 5′upstream region of this gene (1995)
    Springer
    Calcified tissue international 56 (1995), S. 88-91 
    Details
    ISSN: 1432-0827
    Keywords: Allele frequencies ; Collagenase ; Denaturing gradient gel electrophoresis ; Osteoporosis ; Polymorphism
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine , Physics
    Notes: Abstract Osteoporosis is a slowly progressing disease resulting from an imbalance between bone accretion and degradation. As interstitial collagenase is a key enzyme in the degradatior of bone matrix, we investigated a possible relationship between the collagenase gene and osteoporosis. Analysis of an amplified genomic DNA fragment from-524 to +52 by denaturing gradient gel electrophoresis and sequencing allowed us to detect three dimorphic sites upstream of base-300, one of them leading to a BanI restriction site. None of the sites could be directly associated with osteoporosis. The allele frequencies of the three dimorphic sites were estimated. The interallelic ratios were high, thus providing new useful genetic markers for linkage analysis. When comparing these ratios in osteoporotic and nonosteoporotic subjects, no significant differences could be observed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00298750
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  • 3
    Electronic Resource
    Electronic Resource
    Risedronate, a Highly Effective, Short-Term Oral Treatment for Paget's Disease: A Dose-Response Study (1999)
    Springer
    Calcified tissue international 64 (1999), S. 93-99 
    Details
    ISSN: 1432-0827
    Keywords: Key words: Risedronate — Bisphosphonate — Paget's disease.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine , Physics
    Notes: Abstract. Risedronate is a potent pyridinyl bisphosphonate being developed for bone diseases such as Paget's disease and osteoporosis. In this study, we compared the efficacy, safety, and tolerability of three different doses of oral risedronate in 62 patients with severe Paget's disease of bone [serum alkaline phosphatase (AP) 〉3 times the upper limit of normal]. Patients were treated at six study centers with either 10, 20, or 30 mg oral risedronate daily for 28 days and followed up to day 85. The primary efficacy parameter was percentage change from baseline in AP excess. The data show that there is a dose-response with risedronate: patients who received 30 mg oral risedronate for 28 days benefited most, with a mean percentage decrease in AP excess of 72.2% (20 mg: 57.9%; 10 mg: 48.0%). Time to response—the first time point when there was a ≥30% reduction from baseline in AP excess and ≥50% reduction from baseline in urinary hydroxyproline (HP)/creatinine–was also significantly shorter (median 29 days) in the 30 mg group compared with the other two groups (20 mg: 43 days and 10 mg: 71 days). Long-term follow-up data up to 33 months from the start of the study indicated that AP remained below baseline levels for all patients. Histologic evaluation of bone formed during risedronate therapy demonstrated that normal lamellar bone was formed as opposed to woven pagetic bone, with no evidence of osteomalacia. Risedronate was well tolerated. Transient decreases in serum calcium and increases in serum intact parathyroid hormone were observed, consistent with the pharmacology of risedronate. In conclusion, risedronate administered at daily doses of 10, 20, and 30 mg for 28 days was effective in reducing the biochemical indices of disease activity in patients with severe Paget's disease of bone. A daily dose of 30 mg was most effective without compromising safety or tolerability.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002239900584
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  • 4
    Electronic Resource
    Electronic Resource
    Prevention of postmenopausal bone loss by rectal calcitonin (1995)
    Springer
    Calcified tissue international 56 (1995), S. 539-542 
    Details
    ISSN: 1432-0827
    Keywords: Calcium ; Calcitonin ; Densitometry ; Menopause ; Osteoporosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine , Physics
    Notes: Abstract A group (150) of healthy women, who had been menopausal for less than 5 years and who had never received any form of treatment to prevent bone loss were entered into a randomized, controlled study comprising three arms. They were randomly allocated to the double-blind administration of five suppositories per week containing either 100 IU of salmon calcitonin or a placebo, or to a group receiving a suppository containing 200 IU of salmon calcitonin three times per week. All women received 500 mg/day of calcium supplementation. After 12 months, bone mineral density (BMD) of the spine, measured by dual energy X-ray absorptiometry, decreased significantly (P〈0.01) in the placebo group by 3.1% (SD: 3.6%) but did not change in the two calcitonin groups [+1.3% (3.5%) with 100 IU/day and +2.3% (4.0%) with 200 IU 3/week]. The differences in response between the placebo group and the two calcitonin groups were significant (P〈0.05), but the difference between the two regimens of calcitonin administration was not. No differences appeared among the three groups for the response at the level of the hip. Evolution of biochemical markers reflecting bone turnover did not differ significantly among groups. Nearly 40% of the women withdrew prematurely because of local (rectal or intestinal) intolerance to repetitive suppositories, with a nonsignificantly different frequency in the placebo or calcitonin groups. We conclude that rectal calcitonin might be an interesting preventive approach against trabecular postmenopausal bone loss but that long-term acceptability of suppositories should be evaluated in view of each patient's sensibility or cultural background.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00298586
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  • 5
    Electronic Resource
    Electronic Resource
    Design for an Ipriflavone Multicenter European Fracture Study (1997)
    Springer
    Calcified tissue international 61 (1997), S. S028 
    Details
    ISSN: 1432-0827
    Keywords: Key words: Osteoporotic fractures — Ipriflavone — Fracture intervention trial.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine , Physics
    Notes: Abstract. In order to investigate the efficacy of ipriflavone (IP) on the prevention of vertebral fractures and the effect on bone mineral density (BMD) in women with postmenopausal osteoporosis, a large multicentric European study was designed and is presently ongoing. Included in the study were 460 Caucasian, nonobese postmenopausal women aged 〉45 and 〈75 years, menopaused for at least 12 months. Inclusion was on the basis of a lumbar bone mineral density (BMD) lower than 2 SD compared with healthy women aged 50 years, corresponding to values below 0.860 g/cm2 (antero-posterior measurement) by Hologic QDR 1000. Women with prevalent vertebral fractures were excluded as well as those presenting secondary osteoporosis or having been treated with medications that could affect bone metabolism. This study was designed as a 3-year, double-blind, placebo-controlled, parallel group study that randomized the women to the oral administration of either 3 × 200 mg/day of IP or placebo. All patients received a daily supplement of 500 mg calcium. The primary purpose of the study was to evaluate the efficacy of IP in preventing vertebral nontraumatic fractures. Fracture is defined here as a ≥20% decrease in any anterior, central, or posterior T4–L4 vertebral height. Blinded vertebral X-ray readings and vertebral morphometry have been centralized in an independent Center, with standardized evaluation of two experts. Power calculations have been based on the hypothesis that 21% of placebo-treated patients would fracture within 3 years and that treatment with IP would lead to a 50% reduction in the incidence of fracture. Statistical tests have been designed to have a power of 80%, with a type I error equal to 5%. Secondary endpoints were changes in vertebral, radial, and femoral BMD. Centralized controls on 100% BMD scans would ensure the good quality of BMD readings. This study should verify the hypothesis that IP significantly decreases the risk of vertebral fracture in postmenopausal, osteoporotic women.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002239900382
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  • 6
    Electronic Resource
    Electronic Resource
    Limited Clinical Utility of a Self-Evaluating Risk Assessment Scale for Postmenopausal Osteoporosis: Lack of Predictive Value of Lifestyle-Related Factors (1999)
    Springer
    Calcified tissue international 65 (1999), S. 354-358 
    Details
    ISSN: 1432-0827
    Keywords: Key words: Bone mineral density — Osteoporosis — Risk factor — Screening.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine , Physics
    Notes: Abstract. The aim of this study was to assess the efficiency of a self-administered questionnaire to identify subjects with postmenopausal osteoporosis in the setting of first line medical care. A sample of 300 postmenopausal women completed the questionnaire based on 18 items. Bone mineral density at the lumbar spine (BMD-L), total hip (BMD-H), and femoral neck (BMD-N) was used as objective criterion for evaluation. The mean risk score was 8.2 ± 3.21. BMD was correlated with total risk score: r =−0.32 for BMD-L, −0.36 for BMD-N, and −0.43 for BMD-H. Cutoff points for the risk score (equal likelihood points) according to a T-score threshold of −2.5 were 8.6 for BMD-L and BMD-N and 9.3 for BMD-H; specificity and sensitivity was 62% and 62%, respectively, for BMD-L, 65% and 62% for BMD-N, and 75% and 63% for BMD-H. Stepwise multiple regression analysis of the questionnaire items in relation to BMD showed higher correlation coefficients for models including individual items rather than the overall risk score. Items concerning low weight, older age, and wrist fracture after 50 years of age were always selected as significant determinants of BMD (R = 0.43–0.55). Hormonal replacement therapy was also an important determinant. Lifestyle-related items did not contribute significantly. In conclusion, the diagnostic performance of the 18-item self-administered questionnaire was poorer than a shortened questionnaire omitting lifestyle factors. The clinical utility of a questionnaire should ultimately be evaluated in the specific optic of a chosen global strategy for prevention of osteoporotic fractures.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002239900712
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  • 7
    Electronic Resource
    Electronic Resource
    Recommendations for the Registration of Drugs Intended for Use in the Treatment of Male Osteoporosis (1999)
    Springer
    Calcified tissue international 65 (1999), S. 4-7 
    Details
    ISSN: 1432-0827
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine , Physics
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002239900649
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  • 8
    Electronic Resource
    Electronic Resource
    Prediction of Bone Loss Rate in Healthy Postmenopausal Women (1997)
    Springer
    Calcified tissue international 60 (1997), S. 261 -264 
    Details
    ISSN: 1432-0827
    Keywords: Key words: Menopause — Osteoporosis — Bone — Densitometry — Screening.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine , Physics
    Notes: Abstract. Prevention of fractures is the only way to drastically reduce osteoporosis-related health expenditures. In order to optimize the cost/benefit ratio of a strategy of prevention, it is essential to identify, as early as possible, women who will develop fractures later in their life. Therefore, and since postmenopausal bone loss is an asymptomatic process, screening procedures should detect, at the time of the menopause, women whose postmenopausal bone loss is higher than the mean, and will, a couple of years later, exhibit a low mineral content and a subsequent high risk for fractures. For 3 years we have followed a cohort of 92 healthy women who had undergone menopause less than 36 months previously. By a multivariate discriminant analysis based on the differences in lumbar bone density, assessed by dual photon absorptiometry, and in a few routine biochemical parameters (serum phosphorus, estrone, androstenedione, and urine calcium) observed during the first 6 months of the study, we have been able to correctly predict the rate of spinal bone loss, observed at the end of the 3 years, in 76% of the subjects. All of the women who presented a bone loss higher than 10% over the 3 years were correctly isolated by our discriminant functions after 6 months of follow-up. We conclude that a measurement of lumbar bone mineral density coupled with a few routine biochemical determinations, repeated twice at a 6-month interval in healthy postmenopausal women, can isolate 100% of postmenopausal ``fast bone losers'' with an overall specificity of 76%.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002239900226
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  • 9
    Electronic Resource
    Electronic Resource
    Recommendations for the registration of new chemical entities used in the prevention and treatment of osteoporosis (1995)
    Springer
    Calcified tissue international 57 (1995), S. 247-250 
    Details
    ISSN: 1432-0827
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine , Physics
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00298877
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  • 10
    Electronic Resource
    Electronic Resource
    Harmonization of Clinical Practice Guidelines for the Prevention and Treatment of Osteoporosis and Osteopenia in Europe: A Difficult Challenge (1996)
    Springer
    Calcified tissue international 59 (1996), S. S024 
    Details
    ISSN: 1432-0827
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine , Physics
    Notes: Abstract. Europe is a patchwork of various medical cultures and financial resources. Variations abound with respect to financing, accessibility to public health systems, health expenditures, drug registration and reimbursement, the prescription of drugs, and clinical applications, as well as the perception of osteoporosis itself. However, there are possibilities for the harmonization of medical services among the various countries within Europe. The European Agency for the Evaluation of Medicinal Products (EAEMP) is attending to the centralized or decentralized procedures for the registration of drugs. The Group for the Respect of Ethics and Excellence in Science (GREES) is investigating guidelines for drug registration as well as gathering and making available medical references. The European Foundation for Osteoporosis and Bone Diseases (EFFO) is increasing awareness of the prevalence of the disease and the need for prevention and treatment. Finally, the International Federation of Societies on Skeletal Diseases (IFSSD) is coordinating epidemiologic, clinical, and social research. There is a need for increased awareness of osteoporosis throughout Europe. Health authorities are in need of cost/benefit reports leading to the registration and reimbursement of agents. Primary care physicians need information about osteoporosis and need to become involved in the diagnosis and science of the disease. Awareness needs to be generated among specialists; they need to be educated in the latest techniques for diagnosis and treatment. Finally, the general population needs to become aware of osteoporosis and to be encouraged to participate in the prevention and treatment of this disease. Current screening and detection in Europe is being done by densitometry. However, other techniques on the horizon include ultrasound and biochemical markers. Primary prevention, i.e., maximizing peak bone mass, includes examining the genetics of osteoporosis to determine the high-risk population and promoting reasonable physical exercise and dietary/life-style habits (e.g., increased calcium and avoidance of tobacco). Secondary prevention includes the identification of high-risk groups through risk factors, biochemical markers, and densitometry and adherence to the World Health Organization definition of osteopenia-osteoporosis (adapted to financial concerns by GREES guidelines). Other therapies include hormone replacement agents (although there are risks for cancer and concerns about durability), calcium and other inhibitors of bone resorption, physical activity, and vitamin D prophylaxis in the elderly. Treatment of established or severe osteoporosis includes drugs upon availability (inhibitors of bone resorption and stimulators of bone formation), surgery, and experimental approaches.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002239900172
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