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Osteoporosis: HELP
Articles by Cyrus Cooper
Based on 233 articles published since 2010
(Why 233 articles?)
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Between 2010 and 2020, C. Cooper wrote the following 233 articles about Osteoporosis.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10
1 Guideline Gut microbiota and osteoarthritis management: An expert consensus of the European society for clinical and economic aspects of osteoporosis, osteoarthritis and musculoskeletal diseases (ESCEO). 2019

Biver, Emmanuel / Berenbaum, Francis / Valdes, Ana M / Araujo de Carvalho, Islene / Bindels, Laure B / Brandi, Maria Luisa / Calder, Philip C / Castronovo, Vincenzo / Cavalier, Etienne / Cherubini, Antonio / Cooper, Cyrus / Dennison, Elaine / Franceschi, Claudio / Fuggle, Nicholas / Laslop, Andrea / Miossec, Pierre / Thomas, Thierry / Tuzun, Sansin / Veronese, Nicola / Vlaskovska, Mila / Reginster, Jean-Yves / Rizzoli, René. ·Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland. Electronic address: Emmanuel.Biver@hcuge.ch. · Sorbonne Université, INSERM CRSA, Department of Rheumatology, AP-HP Saint-Antoine Hospital, Paris, France. · Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, Nottingham, UK. · Department of Ageing and Life Course, World Health Organization, 20 Avenue Appia, 1211, Geneva 27, Switzerland. · Louvain Drug Research Institute, Metabolism and Nutrition Research Group, Université Catholique de Louvain, Brussels, Belgium. · Bone Metabolic Diseases Unit, Department of Biomedical, Experimental and Clinical Sciences, University of Florence, Florence, Italy. · Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK. · Metastases Research Laboratory, GIGA-Cancer, University of Liege, Liege, Belgium. · Department of Clinical Chemistry, University of Liege, CHU de Liège, Liège, Belgium. · Geriatria, Accettazione geriatrica e Centro di ricerca per l'invecchiamento, IRCCS INRCA, Ancona, Italy. · NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK; MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK. · MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK. · Department of Specialty, Diagnostic and Experimental Medicine (DIMES), University of Bologna, Bologna, Italy. · Scientific Office, Austrian Medicines & Medical Devices Agency, Federal Office for Safety in Health Care, Vienna, Austria. · Immunogenomics and Inflammation Research Unit, EA 4130, University of Lyon, and Department of Clinical Immunology and Rheumatology, Hospices Civils de Lyon, Lyon, France. · Department of Rheumatology, Hôpital Nord, CHU de Saint-Etienne, and INSERM U1059, University of Lyon, Saint-Etienne, France. · Department of Physical Medicine and Rehabilitation, Cerrahpaşa Medical Faculty, Istanbul University Cerrahpaşa, Istanbul, Turkey. · National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy. · Medical Faculty, Department of Pharmacology, Medical University Sofia, Sofia, Bulgaria. · Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium; Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, Saudi Arabia. · Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland. ·Ageing Res Rev · Pubmed #31437484.

ABSTRACT: The prevalence of osteoarthritis (OA) increases not only because of longer life expectancy but also because of the modern lifestyle, in particular physical inactivity and diets low in fiber and rich in sugar and saturated fats, which promote chronic low-grade inflammation and obesity. Adverse alterations of the gut microbiota (GMB) composition, called microbial dysbiosis, may favor metabolic syndrome and inflammaging, two important components of OA onset and evolution. Considering the burden of OA and the need to define preventive and therapeutic interventions targeting the modifiable components of OA, an expert working group was convened by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) to review the potential contribution of GMB to OA. Such a contribution is supported by observational or dietary intervention studies in animal models of OA and in humans. In addition, several well-recognized risk factors of OA interact with GMB. Lastly, GMB is a critical determinant of drug metabolism and bioavailability and may influence the response to OA medications. Further research targeting GMB or its metabolites is needed to move the field of OA from symptomatic management to individualized interventions targeting its pathogenesis.

2 Guideline Executive summary of European guidance for the diagnosis and management of osteoporosis in postmenopausal women. 2019

Kanis, J A / Cooper, C / Rizzoli, R / Reginster, J-Y / Anonymous3001133. ·Centre for metabolic bone diseases, University of Sheffield, Sheffield, UK. · University of Sheffield Medical School, Sheffield, UK. · Mary McKillop Health Institute, Australian Catholic University, Melbourne, Australia. · MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK. · NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK. · University Hospitals and Faculty of Medicine of Geneva, Geneva, Switzerland. · Chair for Biomarkers of Chronic Diseses, Department of Biochemistry, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia. jyr.ch@bluewin.ch. · Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium. jyr.ch@bluewin.ch. ·Aging Clin Exp Res · Pubmed #30612282.

ABSTRACT: A guidance on the assessment and treatment of postmenopausal women at risk from fractures due to osteoporosis was recently published in Osteoporosis International as a joint effort of the International Osteoporosis Foundation and European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (Kanis et al. Osteoporos Int, https://doi.org/10.1007/s00198-018-4704-5 , 2018). This manuscript updates the previous guideline document, published in 2013 (Kanis et al. Osteoporos Int 24:23-57, 2013) and is written from a European perspective. The present article reports and summarizes the main recommendations included in this 2018 guidance document (Fig. 1).

3 Guideline European guidance for the diagnosis and management of osteoporosis in postmenopausal women. 2019

Kanis, J A / Cooper, C / Rizzoli, R / Reginster, J-Y / Anonymous381134. ·Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, UK. w.j.Pontefract@shef.ac.uk. · Mary McKillop Health Institute, Australian Catholic University, Melbourne, Australia. w.j.Pontefract@shef.ac.uk. · MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK. · NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK. · University Hospitals and Faculty of Medicine of Geneva, Geneva, Switzerland. · Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium. · Prince Mutaib Chair for Biomarkers of Osteoporosis, Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia. ·Osteoporos Int · Pubmed #30324412.

ABSTRACT: Guidance is provided in a European setting on the assessment and treatment of postmenopausal women at risk from fractures due to osteoporosis. INTRODUCTION: The International Osteoporosis Foundation and European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis published guidance for the diagnosis and management of osteoporosis in 2013. This manuscript updates these in a European setting. METHODS: Systematic reviews were updated. RESULTS: The following areas are reviewed: the role of bone mineral density measurement for the diagnosis of osteoporosis and assessment of fracture risk; general and pharmacological management of osteoporosis; monitoring of treatment; assessment of fracture risk; case-finding strategies; investigation of patients; health economics of treatment. The update includes new information on the evaluation of bone microstructure evaluation in facture risk assessment, the role of FRAX® and Fracture Liaison Services in secondary fracture prevention, long-term effects on fracture risk of dietary intakes, and increased fracture risk on stopping drug treatment. CONCLUSIONS: A platform is provided on which specific guidelines can be developed for national use.

4 Guideline Diagnosis and management of osteoporosis in postmenopausal women and older men in the UK: National Osteoporosis Guideline Group (NOGG) update 2013. 2013

Compston, J / Bowring, C / Cooper, A / Cooper, C / Davies, C / Francis, R / Kanis, J A / Marsh, D / McCloskey, E V / Reid, D M / Selby, P / Anonymous4460762. ·University of Cambridge School of Clinical Medicine, Cambridge, UK. jec1001@hermes.cam.ac.uk ·Maturitas · Pubmed #23810490.

ABSTRACT: Since the launch in 2008 by the National Osteoporosis Guideline Group (NOGG), of guidance for the diagnosis and management of osteoporosis in postmenopausal women and older men in the UK there have been significant advances in risk assessment and treatment. These have been incorporated into an updated version of the guideline, with an additional focus on the management of glucocorticoid-induced osteoporosis, the role of calcium and vitamin D therapy and the benefits and risks of long-term bisphosphonate therapy. The updated guideline is summarised below. The recommendations in the guideline are intended to aid management decisions but do not replace the need for clinical judgement in the care of individuals in clinical practice.

5 Guideline European guidance for the diagnosis and management of osteoporosis in postmenopausal women. 2013

Kanis, J A / McCloskey, E V / Johansson, H / Cooper, C / Rizzoli, R / Reginster, J-Y / Anonymous6770739. ·WHO Collaborating Centre, UK University of Sheffield Medical School, Sheffield, UK. w.j.pontefract@sheffield.ac.uk ·Osteoporos Int · Pubmed #23079689.

ABSTRACT: INTRODUCTION: The International Osteoporosis Foundation and European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis published guidance for the diagnosis and management of osteoporosis in 2008. This manuscript updates these in a European setting. METHODS: Systematic literature reviews. RESULTS: The following areas are reviewed: the role of bone mineral density measurement for the diagnosis of osteoporosis and assessment of fracture risk, general and pharmacological management of osteoporosis, monitoring of treatment, assessment of fracture risk, case finding strategies, investigation of patients and health economics of treatment. CONCLUSIONS: A platform is provided on which specific guidelines can be developed for national use.

6 Guideline An appendix to the 2012 IOF-ECTS guidelines for the management of glucocorticoid-induced osteoporosis. 2012

Lekamwasam, S / Adachi, J D / Agnusdei, D / Bilezikian, J / Boonen, S / Borgström, F / Cooper, C / Perez, A Diez / Eastell, R / Hofbauer, L C / Kanis, J A / Langdahl, B L / Lesnyak, O / Lorenc, R / McCloskey, E / Messina, O D / Napoli, N / Obermayer-Pietsch, B / Ralston, S H / Sambrook, P N / Silverman, S / Sosa, M / Stepan, J / Suppan, G / Wahl, D A / Compston, J E / Anonymous3360744. ·Centre for Metabolic Bone Diseases, Department of Medicine, Faculty of Medicine, Galle, Sri Lanka. ·Arch Osteoporos · Pubmed #23225278.

ABSTRACT: The use of glucocorticoids in the treatment of medical disorders can lead to rapid bone loss and increased risk of fragility fracture. Updated clinical guidelines are needed that accommodate recent advances in fracture risk assessment and new pharmacological interventions to reduce fracture risk. This document serves as an appendix to the 2012 IOF-ECTS guidelines for the management of glucocorticoid-induced osteoporosis.

7 Guideline Treatment failure in osteoporosis. 2012

Diez-Perez, A / Adachi, J D / Agnusdei, D / Bilezikian, J P / Compston, J E / Cummings, S R / Eastell, R / Eriksen, E F / Gonzalez-Macias, J / Liberman, U A / Wahl, D A / Seeman, E / Kanis, J A / Cooper, C / Anonymous5410732. ·Department of Internal Medicine and Infectious Diseases, Hospital del Mar-IMIM, Autonomous University of Barcelona, RETICEF, Instituto Carlos III, P. Maritim 25-29, 08003 Barcelona, Spain. adiez@parcdesalutmar.cat ·Osteoporos Int · Pubmed #22836278.

ABSTRACT: INTRODUCTION: This study aims to provide guidelines concerning the definition of failure of therapies used to reduce the risk of fracture. METHODS: A working group of the Committee of Scientific Advisors of the International Osteoporosis Foundation was convened to define outcome variables that may assist clinicians in decision making. RESULTS: In the face of limited evidence, failure of treatment may be inferred when two or more incident fractures have occurred during treatment, when serial measurements of bone remodelling markers are not suppressed by anti-resorptive therapy and where bone mineral density continues to decrease. CONCLUSION: The provision of pragmatic criteria to define failure to respond to treatment provides an unmet clinical need and may stimulate research into an important issue.

8 Editorial Osteoporosis epidemiology in UK Biobank: a unique opportunity for international researchers. 2013

Harvey, N C / Matthews, P / Collins, R / Cooper, C / Anonymous2460770. ·MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, SO16 6YD, UK, nch@mrc.soton.ac.uk. ·Osteoporos Int · Pubmed #24057481.

ABSTRACT: -- No abstract --

9 Editorial Standardising biochemical assessment of bone turnover in osteoporosis. 2011

Vasikaran, Samuel D / Morris, Howard A / Cooper, Cyrus / Kanis, John A. ·Department of Core Clinical Pathology and Biochemistry, PathWest Laboratory Medicine-Royal Perth Hospital, Perth, WA, Australia; School of Pathology and Laboratory Medicine, University of Western Australia, Nedlands, WA, Australia. Electronic address: samuel.vasikaran@health.wa.gov.au. · School of Pharmacy and Medical Sciences, University of South Australia, Adelaide South Australia 5000, Australia. · MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK; NIHR Musculoskeletal Biomedical Research Unit, Institute of Musculoskeletal Sciences, University of Oxford, Oxford OX3 7LD, UK. · Centre for Metabolic Bone Diseases (WHO Collaborating Centre), University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, UK. ·Clin Biochem · Pubmed #21784064.

ABSTRACT: -- No abstract --

10 Editorial Recommendations for bone marker standards in osteoporosis: what, why and where to now? 2011

Vasikaran, Samuel D / Cooper, Cyrus / Kanis, John A. · ·Ann Clin Biochem · Pubmed #21406559.

ABSTRACT: -- No abstract --

11 Editorial Where now with NICE? 2011

Dennison, E M / Cooper, C. · ·Osteoporos Int · Pubmed #21279505.

ABSTRACT: -- No abstract --

12 Review General and Specific Considerations as to why Osteoporosis-Related Care Is Often Suboptimal. 2020

Curtis, Elizabeth M / Woolford, Stephen / Holmes, Claire / Cooper, Cyrus / Harvey, Nicholas C. ·MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, UK. bc@mrc.soton.ac.uk. · MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, UK. · Rheumatology Department, University Hospitals Southampton NHS Foundation Trust, Southampton, UK. · NIHR Oxford Biomedical Research Unit, University of Oxford, Oxford, UK. · NIHR Southampton Biomedical Research Centre, University Hospitals Southampton NHS Foundation Trust, University of Southampton, Southampton, UK. ·Curr Osteoporos Rep · Pubmed #32103393.

ABSTRACT: PURPOSE OF REVIEW: The assessment of fracture risk and use of antiosteoporosis medications have increased greatly over the last 20-30 years. However, despite this, osteoporosis care remains suboptimal worldwide. Even in patients who have sustained a fragility fracture, fewer than 20% actually receive appropriate antiosteoporosis therapy in the year following the fracture. There is also evidence that treatment rates have declined substantially in the last 5-10 years, in many countries. The goal of this article is to consider the causes for this decline and consider how this situation could be remedied. RECENT FINDINGS: A number of possible reasons, including the lack of prioritisation of osteoporosis therapy in ageing populations with multimorbidity, disproportionate concerns regarding the rare side effects of anti-resorptives and adverse changes in reimbursement in the USA, have been identified as contributing factors in poor osteoporosis care. Improved secondary prevention strategies; screening measures (primary prevention) and appropriate, cost-effective guideline and treatment threshold development could support the optimisation of osteoporosis care and prevention of future fractures.

13 Review Quality Improvement Initiatives in Fragility Fracture Care and Prevention. 2019

Mitchell, Paul J / Cooper, Cyrus / Fujita, Masaki / Halbout, Philippe / Åkesson, Kristina / Costa, Matthew / Dreinhöfer, Karsten E / Marsh, David R / Lee, Joon-Kiong / Chan, Ding-Cheng Derrick / Javaid, M Kassim. ·Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK. paul.mitchell@ndorms.ox.ac.uk. · School of Medicine, Sydney Campus, The University of Notre Dame Australia, 140 Broadway, Sydney, NSW, 2007, Australia. paul.mitchell@ndorms.ox.ac.uk. · Fragility Fracture Network, c/o MCI Schweiz AG, Schaffhauserstrasse 550, 8052, Zürich, Switzerland. paul.mitchell@ndorms.ox.ac.uk. · MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK. · NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK. · NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK. · International Osteoporosis Foundation, 9 rue Juste-Olivier, CH-1260, Nyon, Switzerland. · Department of Orthopaedics, Skane University Hospital, Malmö, Sweden. · Department of Clinical Sciences, Lund University, Malmö, Sweden. · Fragility Fracture Network, c/o MCI Schweiz AG, Schaffhauserstrasse 550, 8052, Zürich, Switzerland. · Oxford Trauma, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK. · Department of Musculoskeletal Rehabilitation, Prevention and Health Service Research, Center for Sport Science and Sport Medicine (CSSB), Center for Musculoskeletal Surgery (CMSC), Charité Universitätsmedizin, Berlin, Germany. · Department of Orthopedics and Traumatology, Medical Park Berlin Humboldtmühle, Berlin, Germany. · University College London, Gower St, Bloomsbury, London, WC1E 6BT, UK. · Department of Orthopedic Surgery, Beacon International Specialist Centre, Petaling Jaya, Selangor, Malaysia. · Advanced Neuroscience and Orthopedic Centre (ANOC), Kuala Lumpur, Malaysia. · Department of Geriatrics and Gerontology and Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. · Superintendent Office, Chutung Branch, National Taiwan University Hospital, Hsinchu County, Taiwan. ·Curr Osteoporos Rep · Pubmed #31734907.

ABSTRACT: PURPOSE OF REVIEW: This review sought to describe quality improvement initiatives in fragility fracture care and prevention. RECENT FINDINGS: A major care gap persists throughout the world in the secondary prevention of fragility fractures. Systematic reviews have confirmed that the Fracture Liaison Service (FLS) model of care is associated with significant improvements in rates of bone mineral density testing, initiation of osteoporosis treatment and adherence with treatment for individuals who sustain fragility fractures. Further, these improvements in the processes of care resulted in significant reductions in refracture risk and lower post-fracture mortality. The primary challenge facing health systems now is to ensure that best practice is delivered effectively in the local healthcare setting. Publication of clinical standards for FLS at the organisational and patient level in combination with the establishment of national registries has provided a mechanism for FLS to benchmark and improve their performance. Major efforts are ongoing at the global, regional and national level to improve the acute care, rehabilitation and secondary prevention for individuals who sustain fragility fractures. Active participation in these initiatives has the potential to eliminate current care gaps in the coming decade.

14 Review East meets West: current practices and policies in the management of musculoskeletal aging. 2019

Xia, Weibo / Cooper, Cyrus / Li, Mei / Xu, Ling / Rizzoli, Rene / Zhu, Mei / Lin, Hua / Beard, John / Ding, Yue / Yu, Wei / Cavalier, Etienne / Zhang, Zhenlin / Kanis, John A / Cheng, Qun / Wang, Quimei / Reginster, Jean-Yves. ·Department of Endocrinology, National Health Commission Key Laboratory of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China. · MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, UK. · NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK. · WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liege, Belgium. · Department of Gynaecology and Obstetrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China. · Division of Bone Diseases, Geneva University Hospitals, Faculty of Medicine, Geneva, Switzerland. · Department of Endocrinology, Tianjin Medical University General Hospital, Tianjin, China. · Department of Orthopaedics, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, China. · Department of Aging and Lifecourse, World Health Organization (WHO), 20 Avenue Appia, 1211, Geneva 27, Switzerland. · Department of Orthopaedics, Memorial Hospital of Sun Yat-sen University, Guangzhou, China. · Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China. · Department of Clinical Chemistry, University of Liège, CHU Sart Tilman Route 52, Porte 53, Domaine du Sart-Tilman, Liege, Belgium. · Department of Osteoporosis and Bone Disease, Shanghai JiaoTong University Affiliated Six People's Hospital, Shanghai, China. · Mary McKillop Health Institute, Australian Catholic University, Melbourne, Australia. · Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Sheffield, UK. · Department of Osteoporosis and Bone Disease, Huadong Hospital Affiliated to Fudan University, Shanghai, China. · Department of Geriatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China. · WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liege, Belgium. jyr.ch@bluewin.ch. · Division of Public Health, Epidemiology and Health Economics, University of Liège, CHU Sart Tilman B23, 4000, Liege, Belgium. jyr.ch@bluewin.ch. · Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia. jyr.ch@bluewin.ch. ·Aging Clin Exp Res · Pubmed #31376119.

ABSTRACT: Healthy aging is defined as the process of developing and maintaining the functional ability that enables wellbeing in older age. Healthy aging is dependent upon intrinsic capacity, a composite of physical and mental capacities, and the environment an individual inhabits and their interactions with it. Maintenance of musculoskeletal health during aging is a key determinant of functional ability. Sarcopenia, osteoporosis and osteoarthritis, are a triad of musculoskeletal diseases of aging that are major contributors to the global burden of disease and disability worldwide. The prevention and management of these disorders is of increasing importance with pressure mounting from the aging population. In a new initiative, the Chinese Medical Association, Chinese Society of Osteoporosis and Bone Mineral Research, and the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases jointly organized a symposium to discuss current practices and policies in the management of musculoskeletal aging. The meeting allowed experts from Europe and China to share their experience and recommendations for the management of these three major diseases. Discussing and analyzing similarities and differences in their practice should lead, through a mutual enrichment of knowledge, to better management of these diseases, in order to preserve intrinsic capacity and retard the age-related degradation of physical ability. In future, it is hoped that sharing of knowledge and best practice will advance global strategies to reduce the burden of musculoskeletal disease and promote healthy aging tailored to meet the individual patient's needs.

15 Review Fracture prediction, imaging and screening in osteoporosis. 2019

Fuggle, Nicholas R / Curtis, Elizabeth M / Ward, Kate A / Harvey, Nicholas C / Dennison, Elaine M / Cooper, Cyrus. ·MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK. · MRC Nutrition and Bone Health Research Group, Cambridge, UK. · NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK. · Victoria University of Wellington, Wellington, New Zealand. · MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK. cc@mrc.soton.ac.uk. · NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK. cc@mrc.soton.ac.uk. · NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK. cc@mrc.soton.ac.uk. ·Nat Rev Endocrinol · Pubmed #31189982.

ABSTRACT: Osteoporosis is associated with increased fragility of bone and a subsequent increased risk of fracture. The diagnosis of osteoporosis is intimately linked with the imaging and quantification of bone and BMD. Scanning modalities, such as dual-energy X-ray absorptiometry or quantitative CT, have been developed and honed over the past half century to provide measures of BMD and bone microarchitecture for the purposes of clinical practice and research. Combined with fracture prediction tools such as Fracture Risk Assessment Tool (FRAX) (which use a combination of clinical risk factors for fracture to provide a measure of risk), these elements have led to a paradigm shift in the ability to diagnose osteoporosis and predict individuals who are at risk of fragility fracture. Despite these developments, a treatment gap exists between individuals who are at risk of osteoporotic fracture and those who are receiving therapy. In this Review, we summarize the epidemiology of osteoporosis, the history of scanning modalities, fracture prediction tools and future directions, including the most recent developments in prediction of fractures.

16 Review Is There Enough Evidence for Osteosarcopenic Obesity as a Distinct Entity? A Critical Literature Review. 2019

Bauer, Jürgen M / Cruz-Jentoft, Alfonso J / Fielding, Roger A / Kanis, John A / Reginster, Jean-Yves / Bruyère, Olivier / Cesari, Matteo / Chapurlat, Roland / Al-Daghri, Nasser / Dennison, Elaine / Kaufman, Jean-Marc / Landi, Francesco / Laslop, Andrea / Locquet, Médéa / Maggi, Stefania / McCloskey, Eugene / Perna, Simone / Rizzoli, René / Rolland, Yves / Rondanelli, Mariangela / Szulc, Pawel / Vellas, Bruno / Vlaskovska, Mila / Cooper, Cyrus. ·Center for Geriatric Medicine, University of Heidelberg, AGAPLESION Bethanien Krankenhaus Heidelberg, Heidelberg, Germany. Juergen.Bauer@bethanien-heidelberg.de. · Servicio de Geriatría, Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, Spain. · Nutrition, Exercise Physiology, and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA. · Mary McKillop Health Institute, Australian Catholic University, Melbourne, Australia. · Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Sheffield, UK. · Department of Public Health, Epidemiology and Health Economics, University of Liège, CHU Sart Tilman B23, 4000, Liège, Belgium. · WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liège, Belgium. · Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia. · Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy. · INSERM, UMR 1033, Université de Lyon, Hôpital E Herriot, 69437, Lyon Cedex 03, France. · MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK. · Department of Endocrinology, Ghent University Hospital, Ghent, Belgium. · Department of Geriatrics, Neurosciences and Orthopaedics, Orthogeriatric Unit, Teaching Hospital "Agostino Gemelli", Catholic University of the Sacred Heart School of Medicine, Rome, Italy. · Scientific Office, Federal Office for Safety in Health Care, Austrian Agency for Health and Food Safety, Vienna, Austria. · Aging Program, National Research Council, Padua, Italy. · Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK. · Mellanby Centre for Bone Research and Centre for Integrated Research in Musculoskeletal Ageing, University of Sheffield, Sheffield, UK. · Department of Biology, College of Science, University of Bahrain, Sakhir Campus, P.O. Box 32038, ‎Zallaq, Bahrain. · Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland. · CHU Toulouse, Médecine Gériatrie Gérontopôle, Cité de la Santé, 20 Rue du Pont Saint Pierre, Inserm 1027, 31059, Toulouse, France. · IRCCS Mondino Foundation, Pavia, Department of Public Health, Experimental and Forensic Medicine, Unit of Human Nutrition, University of Pavia, Pavia, Italy. · INSERM, UMR 1033, University of Lyon, Hôpital Edouard Herriot, Lyon, France. · Medical Faculty, Department of Pharmacology, Medical University Sofia, 2, Zdrave Str, 1431, Sofia, Bulgaria. · NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK. ·Calcif Tissue Int · Pubmed #31098729.

ABSTRACT: The co-existence of impaired bone health (osteopenia/osteoporosis), reduced muscle mass and strength (sarcopenia), and increased adiposity (obesity) in middle-aged and older people has been identified in recent studies, leading to a proposal for the existence of "osteosarcopenic obesity" as a distinct entity. Evidence for the pathophysiological overlap of these conditions is mounting, although a causal relationship is yet to be established. Each component condition occurs frequently with increasing age, and with shared risk factors in many instances, thus, an overlap of these three conditions is not surprising. However, whether the concurrent existence of sarcopenia, osteoporosis and obesity leads to an increased risk of adverse musculoskeletal outcomes and mortality above and beyond the risks associated with the sum of the component parts remains to be proven and is a question of research interest. In this article, we review evidence for the existence of osteosarcopenic obesity including the current operational definition of osteosarcopenic obesity, prevalence, pathophysiology, outcomes and exploratory approaches to the management of components. We conclude that, there is insufficient evidence to support a discrete clinical entity of osteosarcopenic obesity at this time. To expand knowledge and understanding in this area, there is a need for consensus on a definition of osteosarcopenic obesity which will allow for identification, further epidemiological studies and comparisons between studies. Additionally, studies should assess whether the clinical outcomes associated with osteosarcopenic obesity are worse than the mere addition of those linked with its components. This will help to determine whether defining a person as having this triad will eventually result in a more effective treatment than addressing each of the three conditions separately.

17 Review Practical guidance for engaging patients in health research, treatment guidelines and regulatory processes: results of an expert group meeting organized by the World Health Organization (WHO) and the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). 2019

de Wit, Maarten / Cooper, Cyrus / Tugwell, Peter / Bere, Nathalie / Kirwan, John / Conaghan, Philip G / Roberts, Charlotte / Aujoulat, Isabelle / Al-Daghri, Nasser / Araujo de Carvalho, Islene / Barker, Mary / Bedlington, Nicola / Brandi, Maria Luisa / Bruyère, Olivier / Burlet, Nansa / Halbout, Philippe / Hiligsmann, Mickaël / Jiwa, Famida / Kanis, John A / Laslop, Andrea / Lawrence, Wendy / Pinto, Daniel / Prieto Yerro, Concepción / Rabenda, Véronique / Rizzoli, René / Scholte-Voshaar, Marieke / Vlaskovska, Mila / Reginster, Jean-Yves. ·Department of Medical Humanities, Amsterdam University Medical Centre, Amsterdam, The Netherlands. · MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK. · NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK. · WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liège, Belgium. · Department of Medicine, University of Ottawa, Ottawa, Canada. · Public Engagement Department, European Medicines Agency, 30 Churchill Place, Canary Wharf, London, E14 5EU, UK. · Emeritus Professor of Rheumatic Diseases, University of Bristol, Bristol, UK. · Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK. · NIHR Leeds Biomedical Research Centre, Leeds, UK. · International Consortium for Health Outcomes Measurement, Hamilton House, 4 Mabledon Place, Bloomsbury, London, WC1H 9BB, UK. · Université Catholique de Louvain, Institute of Health & Society, Brussels, Belgium. · Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia. · Department of Ageing and Life Course, World Health Organization, 20 Avenue Appia, 1211, Geneva 27, Switzerland. · European Patients' Forum, Chaussée d'Etterbeek 180, Etterbeek, 1040, Brussels, Belgium. · Department of Surgery and Translational Medicine, University of Florence, Florence, Italy. · Fondazione F.I.R.M.O., Florence, Italy. · Department of Public Health, Epidemiology and Health Economics, University of Liège, CHU Sart Tilman B23, 4000, Liège, Belgium. · International Osteoporosis Foundation, 9 Rue Juste-Olivier, 1260, Nyon, Switzerland. · Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands. · Osteoporosis Canada, Toronto, ON, Canada. · Mary McKillop Health Institute, Australian Catholic University, Melbourne, Australia. · Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Sheffield, UK. · Scientific Office, Federal Office for Safety in Health Care, Austrian Agency for Health and Food Safety, Vienna, Austria. · NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK. · Department of Physical Therapy, College of Health Sciences, Marquette University, Milwaukee, USA. · Center for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. · Spanish Agency for Drugs and Medical Devices, Calle Campezo 1, Building 8, 28022, Madrid, Spain. · Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland. · Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands. · Medical Faculty, Department of Pharmacology, Medical University Sofia, 2, Zdrave Str, 1431, Sofia, Bulgaria. · WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liège, Belgium. jyreginster@uliege.be. · Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia. jyreginster@uliege.be. · Department of Public Health, Epidemiology and Health Economics, University of Liège, CHU Sart Tilman B23, 4000, Liège, Belgium. jyreginster@uliege.be. ·Aging Clin Exp Res · Pubmed #30993659.

ABSTRACT: There is increasing emphasis on patient-centred research to support the development, approval and reimbursement of health interventions that best meet patients' needs. However, there is currently little guidance on how meaningful patient engagement may be achieved. An expert working group, representing a wide range of stakeholders and disciplines, was convened by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) and the World Health Organization (WHO). Through a structured, collaborative process the group generated practical guidance to facilitate optimal patient engagement in clinical development and regulatory decisions. Patient engagement is a relational process. The principles outlined in this report were based on lessons learned through applied experience and on an extensive dialogue among the expert participants. This practice guidance forms a starting point from which tailoring of the approach to suit different chronic diseases may be undertaken.

18 Review State of the art in osteoporosis risk assessment and treatment. 2019

Liu, J / Curtis, E M / Cooper, C / Harvey, N C. ·MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK. · NIHR Southampton Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK. · NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK. · MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK. nch@mrc.soton.ac.uk. · NIHR Southampton Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK. nch@mrc.soton.ac.uk. ·J Endocrinol Invest · Pubmed #30980341.

ABSTRACT: BACKGROUND: Osteoporosis constitutes a major public health problem, through its association with age-related fractures, particularly of the hip, vertebrae, distal forearm, and humerus. Over recent decades, it has evolved from being viewed as an inevitable consequence of ageing, to being recognised as a serious and eminently treatable disease. MATERIALS AND METHODS: In this article, we review the literature pertaining to the epidemiology of osteoporosis, associated health burden, approaches to risk assessment and treatment. RESULTS: Although there is some evidence that fracture incidence has reached a plateau, or even started to decline, in the developed world, an ageing population and adoption of westernised lifestyles in transitioning populations is leading to an increasing burden of osteoporosis across the world. Whilst the clinical definition of osteoporosis has been based solely on bone mineral density, the prediction of fracture at the individual level has been improved by consideration of clinical risk factors in tools such as FRAX CONCLUSION: Urgent work is needed at the level of health care systems, national and international policy, and in communication with patients and public, to ensure that all patients who should receive treatment for osteoporosis actually do so.

19 Review Executive summary of the European guidance for the diagnosis and management of osteoporosis in postmenopausal women. 2019

Kanis, J A / Cooper, C / Rizzoli, R / Reginster, J-Y / Anonymous3471133. ·Centre for Metabolic Bone Diseases, University of Sheffield, University of Sheffield Medical School, Sheffield, UK. · Mary McKillop Health Institute, Australian Catholic University, Melbourne, Australia. · MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK. · NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK. · Service of Bone Diseases, Faculty of Medicine of Geneva, Geneva University Hospitals, 1211, Geneva 14, Switzerland. Rene.Rizzoli@unige.ch. · Prince Mutaib Chair for Biomarkers, College of Science, King Saud University, Riyadh, Saudi Arabia. · Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium. ·Calcif Tissue Int · Pubmed #30796490.

ABSTRACT: A guidance on the assessment and treatment of postmenopausal women at risk from fractures due to osteoporosis was recently published in Osteoporosis International as a joint effort of the International Osteoporosis Foundation and European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (Kanis et al. in Osteoporos Int https://doi.org/10.1007/s00198-018-4704-5 , 2018). This manuscript updates the previous guidelines document, published in 2013 (Kanis et al. in Osteoporos Int 24:23-57, 2013) and is written in a European perspective. The present article reports and summarizes the main recommendations included in this 2018 guidance document.

20 Review Review of the guideline of the American College of Physicians on the treatment of osteoporosis. 2018

Kanis, J A / Cooper, C / Rizzoli, R / Reginster, J-Y. ·Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, UK. w.j.Pontefract@shef.ac.uk. · Mary McKillop Health Institute, Australian Catholic University, Melbourne, Australia. w.j.Pontefract@shef.ac.uk. · MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK. · NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK. · Service of Bone Diseases, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland. · Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium. · WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liège, Belgium. ·Osteoporos Int · Pubmed #29869039.

ABSTRACT: This review, endorsed by the International Osteoporosis Foundation and the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases, summarizes several failings of the recent guidelines of the American College of Physicians (ACP) on the treatment of low bone density or osteoporosis to prevent fractures. INTRODUCTION: The ACP recently issued guidelines for the treatment of low bone density or osteoporosis to prevent fractures. METHODS: Literature review and critical review of the ACP guidelines. RESULTS: The guideline is lacking in scope due to the endorsement of treatment based on T-scores rather than fracture risk assessment and in failure to adequately consider anabolic therapies. CONCLUSIONS: The ACP guideline appears outdated.

21 Review Inappropriate claims from non-equivalent medications in osteoarthritis: a position paper endorsed by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). 2018

Bruyère, Olivier / Cooper, Cyrus / Al-Daghri, Nasser M / Dennison, Elaine M / Rizzoli, René / Reginster, Jean-Yves. ·Department of Public Health, Epidemiology and Health Economics, University of Liège, CHU Sart Tilman B23, 4000, Liège, Belgium. · WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liège, Belgium. · MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK. · NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK. · Prince Mutaib Chair for Biomarkers of Osteoporosis, Biochemistry Department, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia. · Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland. · Department of Public Health, Epidemiology and Health Economics, University of Liège, CHU Sart Tilman B23, 4000, Liège, Belgium. jyreginster@ulg.ac.be. · WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liège, Belgium. jyreginster@ulg.ac.be. ·Aging Clin Exp Res · Pubmed #29177637.

ABSTRACT: Osteoarthritis (OA) is a progressive joint disease, that occurs frequently in the aging population and is a major cause of disability worldwide. Both glucosamine and chondroitin are biologically active molecules that are substrates for proteoglycan, an essential component of the cartilage matrix. Evidence supports the use of glucosamine and chondroitin as symptomatic slow-acting drugs for osteoarthritis (SYSADOAs) with impact on OA symptoms and disease-modifying effects in the long term. Glucosamine and chondroitin are administered in exogenous form as a sulfate salt and multiple formulations of these agents are available, both as prescription-grade products and nutritional supplements. However, while all preparations may claim to deliver a therapeutic level of glucosamine or chondroitin not all are supported by clinical evidence. Only patented crystalline glucosamine sulfate (pCGS) is shown to deliver consistently high glucosamine bioavailability and plasma concentration in humans, which corresponds to demonstrated clinical efficacy. Similarly, clinical evidence supports only the pharmaceutical-grade chondroitin sulfate. The European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) advocates, through careful consideration of the evidence base, that judicious choice of glucosamine and chondroitin formulation is essential to maximize clinical benefit, patient adherence and satisfaction with treatment. In future, the ESCEO recommends that complex molecules with biological activity such as pCGS may be treated as "biosimilars" akin to the European Medicines Agency guidance on biological medicinal products. It seems likely that for all other complex molecules classed as SYSADOAs, the recommendation to use only formulations clearly supported by the evidence-base should apply.

22 Review Quality of life assessment in musculo-skeletal health. 2018

Beaudart, Charlotte / Biver, Emmanuel / Bruyère, Olivier / Cooper, Cyrus / Al-Daghri, Nasser / Reginster, Jean-Yves / Rizzoli, René. ·Department of Public Health, Epidemiology and Health Economics, University of Liège, Quartier Hôpital, Avenue Hippocrate 13, CHUB23, 4000, Liège, Belgium. c.beaudart@ulg.ac.be. · Division of Bone Diseases, Faculty of Medicine, Geneva University Hospitals, Rue Gabrielle Perret-Gentil 4, 1211, Geneva 14, Switzerland. · Department of Public Health, Epidemiology and Health Economics, University of Liège, Quartier Hôpital, Avenue Hippocrate 13, CHUB23, 4000, Liège, Belgium. · MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK. · NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK. · Prince Mutaib Chair for Biomarkers of Osteoporosis, Biochemistry Department, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia. · Director of the Bone, Cartilage and Muscle Metabolism Unit and Chair of the Department of Public Health Sciences, CHU Liège, Quai Godefroid Kurth 45, 4000, Liège, Belgium. ·Aging Clin Exp Res · Pubmed #28664458.

ABSTRACT: Musculoskeletal disorders affect morbidity, quality of life and mortality, and represent an increasing economic and societal burden in the context of population aging and increased life expectancy. Improvement of quality of life should be one of the priorities of any interventions to prevent and treat musculoskeletal disorders in the ageing population. Two main approaches, namely generic and disease-specific instruments, can be applied to measure health-related quality of life. Among the generic tools available in scientific literature, the short form 36 questionnaire (SF-36) and the Euroqol five item questionnaire (EQ-5D) are two of the most popular questionnaires used to quantify the health related quality of life in people with musculoskeletal disorders. However, because generic tools may not always be able to detect subtle effects of a specific condition on quality of life, a specific tool is highly valuable. Specific tools improve the ability to clinically characterize quality of life in subjects with a specific musculoskeletal disorder, as well as the capacity to assess changes over time in the QoL of these subjects. The recent development of specific tools should help to validate preventive and therapeutic interventions in this field.

23 Review Management of Aromatase Inhibitor-Associated Bone Loss (AIBL) in postmenopausal women with hormone sensitive breast cancer: Joint position statement of the IOF, CABS, ECTS, IEG, ESCEO IMS, and SIOG. 2017

Hadji, Peyman / Aapro, Matti S / Body, Jean-Jacques / Gnant, Michael / Brandi, Maria Luisa / Reginster, Jean Yves / Zillikens, M Carola / Glüer, Claus-C / de Villiers, Tobie / Baber, Rod / Roodman, G David / Cooper, Cyrus / Langdahl, Bente / Palacios, Santiago / Kanis, John / Al-Daghri, Nasser / Nogues, Xavier / Eriksen, Erik Fink / Kurth, Andreas / Rizzoli, Rene / Coleman, Robert E. ·Krankenhaus Nordwest, Frankfurt, Germany. · Genolier Cancer Center, Switzerland. · CHU Brugmann, Université Libre de Bruxelles, Belgium. · Medical University of Vienna, Austria. · University of Florence, Italy. · University of Liège, Belgium. · Erasmus MC, Rotterdam, Netherlands. · Univeristy of Kiel, Germany. · University of Stellenbosch, Cape Town, South Africa. · University of Sydney, Australia. · Indiana University School of Medicine, USA. · University of Southampton, UK. · Aarhus University, Denmark. · Instituto Palacios Madrid, Spain. · Catholic University of Australia, Melbourne, Australia and University of Sheffield, UK. · University of Riyadh, Saudi Arabia. · Autonomous University of Barcelona, Spain. · University of Oslo, Norway. · Klinikum Birkenwerder, Germany. · Geneva University, Switzerland. · University of Sheffield, UK. ·J Bone Oncol · Pubmed #28413771.

ABSTRACT: BACKGROUND: Several guidelines have been reported for bone-directed treatment in women with early breast cancer (EBC) for averting fractures, particularly during aromatase inhibitor (AI) therapy. Recently, a number of studies on additional fracture related risk factors, new treatment options as well as real world studies demonstrating a much higher fracture rate than suggested by randomized clinical controlled trials (RCTs). Therefore, this updated algorithm was developed to better assess fracture risk and direct treatment as a position statement of several interdisciplinary cancer and bone societies involved in the management of AI-associated bone loss (AIBL). PATIENTS AND METHODS: A systematic literature review identified recent advances in the management of AIBL. Results with individual agents were assessed based on trial design, size, follow-up, and safety. RESULTS: Several fracture related risk factors in patients with EBC were identified. Although, the FRAX algorithm includes fracture risk factors (RF) in addition to BMD, it does not seem to adequately address the effects of AIBL. Several antiresorptive agents can prevent and treat AIBL. However, concerns regarding compliance and long-term safety remain. Overall, the evidence for fracture prevention is strongest for denosumab 60 mg s.c. every 6 months. Additionally, recent studies as well as an individual patient data meta-analysis of all available randomized trial data support additional anticancer benefits from adjuvant bisphosphonate treatment in postmenopausal women with a 34% relative risk reduction in bone metastasis and 17% relative risk decrease in breast cancer mortality that needs to be taken into account when advising on management of AIBL. CONCLUSIONS: In all patients initiating AI treatment, fracture risk should be assessed and recommendation with regard to exercise and calcium/vitamin D supplementation given. Bone-directed therapy should be given to all patients with a T-score<-2.0 or with a T-score of <-1.5 SD with one additional RF, or with ≥2 risk factors (without BMD) for the duration of AI treatment. Patients with T-score>-1.5 SD and no risk factors should be managed based on BMD loss during the first year and the local guidelines for postmenopausal osteoporosis. Compliance should be regularly assessed as well as BMD on treatment after 12 - 24 months. Furthermore, because of the decreased incidence of bone recurrence and breast cancer specific mortality, adjuvant bisphosphonates are recommended for all postmenopausal women at significant risk of disease recurrence.

24 Review Mind the (treatment) gap: a global perspective on current and future strategies for prevention of fragility fractures. 2017

Harvey, N C W / McCloskey, E V / Mitchell, P J / Dawson-Hughes, B / Pierroz, D D / Reginster, J-Y / Rizzoli, R / Cooper, C / Kanis, J A. ·MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK. · NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK. · MRC ARUK Centre for Integrated Research in Musculoskeletal Ageing, Metabolic Bone Centre, Northern General Hospital, Sheffield, UK. e.v.mccloskey@sheffield.ac.uk. · Mellanby Centre for Bone Research, University of Sheffield, Sheffield, UK. e.v.mccloskey@sheffield.ac.uk. · Synthesis Medical NZ Ltd, Auckland, New Zealand. · University of Notre Dame Australia, Sydney, Australia. · Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA. · International Osteoporosis Foundation (IOF), Nyon, Switzerland. · Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium. · Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland. · NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK. · Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Sheffield, UK. · Institute for Health and Aging, Catholic University of Australia, Melbourne, Australia. ·Osteoporos Int · Pubmed #28175979.

ABSTRACT: This narrative review considers the key challenges facing healthcare professionals and policymakers responsible for providing care to populations in relation to bone health. These challenges broadly fall into four distinct themes: (1) case finding and management of individuals at high risk of fracture, (2) public awareness of osteoporosis and fragility fractures, (3) reimbursement and health system policy and (4) epidemiology of fracture in the developing world. Findings from cohort studies, randomised controlled trials, systematic reviews and meta-analyses, in addition to current clinical guidelines, position papers and national and international audits, are summarised, with the intention of providing a prioritised approach to delivery of optimal bone health for all. Systematic approaches to case-finding individuals who are at high risk of sustaining fragility fractures are described. These include strategies and models of care intended to improve case finding for individuals who have sustained fragility fractures, those undergoing treatment with medicines which have an adverse effect on bone health and people who have diseases, whereby bone loss and, consequently, fragility fractures are a common comorbidity. Approaches to deliver primary fracture prevention in a clinically effective and cost-effective manner are also explored. Public awareness of osteoporosis is low worldwide. If older people are to be more pro-active in the management of their bone health, that needs to change. Effective disease awareness campaigns have been implemented in some countries but need to be undertaken in many more. A major need exists to improve awareness of the risk that osteoporosis poses to individuals who have initiated treatment, with the intention of improving adherence in the long term. A multisector effort is also required to support patients and their clinicians to have meaningful discussions concerning the risk-benefit ratio of osteoporosis treatment. With regard to prioritisation of fragility fracture prevention in national policy, there is much to be done. In the developing world, robust epidemiological estimates of fracture incidence are required to inform policy development. As the aging of the baby boomer generation is upon us, this review provides a comprehensive analysis of how bone health can be improved worldwide for all.

25 Review Relationship Between Low Bone Mineral Density and Fractures With Incident Cardiovascular Disease: A Systematic Review and Meta-Analysis. 2017

Veronese, Nicola / Stubbs, Brendon / Crepaldi, Gaetano / Solmi, Marco / Cooper, Cyrus / Harvey, Nicolas Cw / Reginster, Jean-Yves / Rizzoli, Renè / Civitelli, Roberto / Schofield, Patricia / Maggi, Stefania / Lamb, Sarah E. ·Department of Medicine (DIMED), Geriatrics Division, University of Padova, Padova, Italy. · National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy. · Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK. · Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience King's College London, London, UK. · Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, UK. · Department of Neurosciences, University of Padova, Padova, Italy. · National Health Care System, Padova Local Unit ULSS 17, Padova, Italy. · Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Nuffield Orthopaedic Centre, University of Oxford, Oxford, UK. · MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, UK. · National Institute for Health Research Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton General Hospital, Southampton, UK. · Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium. · Division of Bone Diseases, Department of Internal Medicine Specialties, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland. · Department of Medicine, Division of Bone and Mineral Diseases, Musculoskeletal Research Center, Washington University, St. Louis, MO, USA. · Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK. ·J Bone Miner Res · Pubmed #28138982.

ABSTRACT: An increasing evidence base suggests that low bone mineral density (BMD) and fractures are associated with cardiovascular disease (CVD). We conducted a systematic review and meta-analysis summarizing the evidence of low BMD and fractures as risk factors for future CVD. Two independent authors searched major databases from inception to August 1, 2016, for longitudinal studies reporting data on CVD incidence (overall and specific CVD) and BMD status and fractures. The association between low BMD, fractures, and CVD across longitudinal studies was explored by calculating pooled adjusted hazard ratios (HRs) ±95% confidence intervals (CIs) with a random-effects meta-analysis. Twenty-eight studies (18 regarding BMD and 10 fractures) followed a total of 1,107,885 participants for a median of 5 years. Taking those with higher BMD as the reference, people with low BMD were at increased risk of developing CVD during follow-up (11 studies; HR = 1.33; 95%CI, 1.27 to 1.38; I

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