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Osteoporosis: HELP
Articles from New Zealand
Based on 147 articles published since 2008
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These are the 147 published articles about Osteoporosis that originated from New Zealand during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6
1 Guideline Bazedoxifene: a guide to its use in postmenopausal osteoporosis. 2012

Keating, Gillian M / Lyseng-Williamson, Katherine A / Duggan, Sean T / McKeage, Kate. ·Adis, Auckland, New Zealand. ·Drugs Aging · Pubmed #22462631.

ABSTRACT: Oral bazedoxifene (Conbriza®) reduces the incidence of new vertebral fractures in patients with postmenopausal osteoporosis. It also appears to reduce the risk of nonvertebral fractures in high-risk patients. Bazedoxifene is generally well tolerated and does not appear to have detrimental effects on endometrial or breast tissue.

2 Editorial Evolve osteoporosis and other guidelines avoiding cognitive bias. 2016

O'Donnell, J L. ·Department of Rheumatology Immunology and Allergy, Christchurch Hospital, Christchurch, New Zealand. · Canterbury Health Laboratories, Canterbury District Health Board, Christchurch, New Zealand. ·Intern Med J · Pubmed #27734619.

ABSTRACT: -- No abstract --

3 Editorial Controversies in osteoporosis management. 2016

Reid, I R. ·Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand. · Department of Endocrinology, Auckland District Health Board, Auckland, New Zealand. ·Intern Med J · Pubmed #27405889.

ABSTRACT: -- No abstract --

4 Editorial Osteoporosis and Fracture Risk in Men with Prostate Cancer. 2016

Grey, Andrew. ·Department of Medicine, University of Auckland, Auckland, New Zealand. Electronic address: a.grey@auckland.ac.nz. ·Eur Urol · Pubmed #26749094.

ABSTRACT: -- No abstract --

5 Editorial Bisphosphonate drug holidays: we reap what we sow. 2016

Silverman, S L / Adachi, J D / Dennison, E / Anonymous1891055. ·David Geffen School of Medicine, University of California, Los Angeles; Division of Rheumatology, Cedars-Sinai Medical Center; and OMC Clinical Research Center, 8641 Wilshire Blvd, suite 301, Beverly Hills, CA, 90211, USA. stuarts@bhillsra.com. · St Joseph's Healthcare, McMaster University, Hamilton, ON, Canada. · MRC Life course Epidemiology Unit Southampton University and Victoria University of Wellington, Wellington, New Zealand. ·Osteoporos Int · Pubmed #26667246.

ABSTRACT: -- No abstract --

6 Editorial Denosumab after 8 years. 2015

Reid, I R. ·Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland, New Zealand. i.reid@auckland.ac.nz. · Department of Endocrinology, Auckland District Health Board, Auckland, New Zealand. i.reid@auckland.ac.nz. ·Osteoporos Int · Pubmed #26475285.

ABSTRACT: -- No abstract --

7 Review Bisphosphonate therapy for spinal osteoporosis in Hajdu-Cheney syndrome - new data and literature review. 2018

Pittaway, James F H / Harrison, Christopher / Rhee, Yumie / Holder-Espinasse, Muriel / Fryer, Alan E / Cundy, Tim / Drake, William M / Irving, Melita D. ·Department of Endocrinology, St Bartholomew's Hospital, West Smithfield, London, EC1A 7BE, UK. jfhpittaway@doctors.org.uk. · Department of Clinical Genetics, Alder Hey Children's NHS Foundation Trust, E Prescot Rd, Liverpool, L14 5AB, UK. · Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea. · Department of Clinical Genetics, Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London, SE1 9RT, UK. · Department of Clinical Genetics, Liverpool Women's NHS Foundation Trust, Crown Street, Liverpool, L8 7SS, UK. · Department of Medicine, University of Auckland, 85 Park Rd, Grafton, Auckland, 1023, New Zealand. · Department of Endocrinology, St Bartholomew's Hospital, West Smithfield, London, EC1A 7BE, UK. ·Orphanet J Rare Dis · Pubmed #29618366.

ABSTRACT: BACKGROUND: Hajdu-Cheney syndrome (HCS) (#OMIM 102500) is a rare, autosomal dominant condition that presents in early childhood. It is caused by mutations in the terminal exon of NOTCH2, which encodes the transmembrane NOTCH2 receptor. This pathway is involved in the coupled processes of bone formation and resorption. The skeletal features of HCS include acro-osteolysis of the digits and osteoporosis commonly affecting vertebrae and long bones. Fractures are a prominent feature and are associated with significant morbidity. There is no specific treatment, but with both acro-osteolysis and generalized osteoporosis, it is possible that anti-resorptive treatment might be of benefit. However, to date only a few case reports have evaluated the effectiveness of bisphosphonate treatment. METHODS: We describe the clinical features, treatment regimens and response to bisphosphonate treatment in 7 newly described patients aged 6-39 with HCS, and pooled the data with that from 8 previously published cases (a total of 17 courses of treatment in 15 individuals). RESULTS: The mean lumbar spine bone mineral density (BMD) z-score before treatment was - 2.9 (SD 1.2). In 14 courses of treatment (82%), there was an increase in BMD with bisphosphonate treatment, but the impact (in terms of change in spinal BMD z-score) appeared to be less with advancing age (p = 0.01). There was no evidence that acro-osteolysis was prevented. CONCLUSIONS: Although individual response is variable and age-related, the data support a role for bisphosphonates in preventing or treating spinal osteoporosis in HCS, but bone loss from the lumbar spine may be rapid after cessation.

8 Review Calcium supplementation in osteoporosis: useful or harmful? 2018

Chiodini, Iacopo / Bolland, Mark J. ·Department of Medical Sciences and Community Health, University of Milan, Milan, Italy. · Unit of Endocrinology, Fondazione IRCCS Cà Granda, Milan, Italy. · Department of Medicine, University of Auckland, Auckland, New Zealand. ·Eur J Endocrinol · Pubmed #29440373.

ABSTRACT: Osteoporosis and fragility fractures are important social and economic problems worldwide and are due to both the loss of bone mineral density and sarcopenia. Indeed, fragility fractures are associated with increased disability, morbidity and mortality. It is known that a normal calcium balance together with a normal vitamin D status is important for maintaining well-balanced bone metabolism, and for many years, calcium and vitamin D have been considered crucial in the prevention and treatment of osteoporosis. However, recently, the usefulness of calcium supplementation (alone or with concomitant vitamin D) has been questioned, since some studies reported only weak efficacy of these supplementations in reducing fragility fracture risk. On the other hand, besides the gastrointestinal side effects of calcium supplements and the risk of kidney stones related to use of co-administered calcium and vitamin D supplements, other recent data suggested potential adverse cardiovascular effects from calcium supplementation. This debate article is focused on the evidence regarding both the possible usefulness for bone health and the potential harmful effects of calcium and/or calcium with vitamin D supplementation.

9 Review Denosumab: A Review in Postmenopausal Osteoporosis. 2018

Deeks, Emma D. ·Springer, Private Bag 65901, Mairangi Bay, Auckland, 0754, New Zealand. demail@springer.com. ·Drugs Aging · Pubmed #29435849.

ABSTRACT: Denosumab (Prolia

10 Review Management of Spinal Conditions in Patients With Parkinson Disease. 2017

Baker, Joseph F / McClelland, Shearwood / Hart, Robert A / Bess, R Shay. ·From the Department of Orthopaedic Surgery, Waikato Hospital, Hamilton, New Zealand (Dr. Baker), NYU Hospital for Joint Diseases, New York, NY (Dr. McClelland), the Department of Orthopaedic Surgery, Oregon Health and Science University, Portland, OR (Dr. Hart), and the Department of Orthopaedic Surgery, Presbyterian/St. Luke's Medical Center, Denver, CO (Dr. Bess). ·J Am Acad Orthop Surg · Pubmed #28692583.

ABSTRACT: Parkinson disease (PD) is increasingly prevalent in the aging population. Spine disorders in patients with PD may be degenerative in nature or may arise secondary to motor effects related to the parkinsonian disease process. Physicians providing care for patients with PD and spine pathologies must be aware of several factors that affect treatment, including the patterns of spinal deformity, complex drug interactions, and PD-associated osteoporosis. Following spine surgery, complication rates are higher in patients with PD than in those without the disease. Literature on spine surgery in this patient population is limited by small cohort size, the heterogeneous patient population, and variable treatment protocols. However, most studies emphasize the need for preoperative optimization of motor control with appropriate medications and deep brain stimulation, as well as consultation with a movement disorder specialist. Future studies must control for confounding variables, such as the type of surgery and PD severity, to improve understanding of spinal pathology and treatment options in this patient population.

11 Review Targeting Sclerostin in Postmenopausal Osteoporosis: Focus on Romosozumab and Blosozumab. 2017

Reid, Ian R. ·Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland, New Zealand. i.reid@auckland.ac.nz. ·BioDrugs · Pubmed #28547661.

ABSTRACT: Most current treatments for osteoporosis inhibit bone resorption and reduce total fracture numbers by about one-quarter. The identification of the osteocytic protein sclerostin as a potent regulator of bone turnover and bone density has led to the development of a new therapeutic class-agents that inhibit sclerostin activity, resulting in increased bone formation and reduced bone resorption. Romosozumab and blosozumab are monoclonal antibodies that bind to sclerostin, reducing its inhibition of Wnt signaling. They have comparable activities in phase I and II studies, doubling formation markers, halving resorption indices, and increasing spine bone density by >10% over 12 months. Only romosozumab has progressed to phase III, where the first study showed a 73% reduction in vertebral fracture risk and a 36% reduction in clinical fractures at 1 year. It was well-tolerated. A further phase III study will conclude in 2017. Romosozumab is a very promising medication in the management of established osteoporosis, but much remains to be done to determine its optimal duration and sequence of administration.

12 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.

13 Review Case-Based Review of Osteonecrosis of the Jaw (ONJ) and Application of the International Recommendations for Management From the International Task Force on ONJ. 2017

Khan, Aliya A / Morrison, Archie / Kendler, David L / Rizzoli, Rene / Hanley, David A / Felsenberg, Dieter / McCauley, Laurie K / O'Ryan, Felice / Reid, Ian R / Ruggiero, Salvatore L / Taguchi, Akira / Tetradis, Sotirios / Watts, Nelson B / Brandi, Maria Luisa / Peters, Edmund / Guise, Teresa / Eastell, Richard / Cheung, Angela M / Morin, Suzanne N / Masri, Basel / Cooper, Cyrus / Morgan, Sarah L / Obermayer-Pietsch, Barbara / Langdahl, Bente L / Dabagh, Rana Al / Davison, K Shawn / Sándor, George K / Josse, Robert G / Bhandari, Mohit / El Rabbany, Mohamed / Pierroz, Dominique D / Sulimani, Riad / Saunders, Deborah P / Brown, Jacques P / Compston, Juliet / Anonymous3310890. ·Department of Medicine, Divisions of Endocrinology and Metabolism and Geriatrics, McMaster University, Hamilton, ON, Canada. Electronic address: Aliya@mcmaster.ca. · Division of Oral and Maxillofacial Surgery, Dalhousie University, Halifax, NS, Canada. · Department of Medicine, Division of Endocrinology, University of British Columbia, Vancouver, BC, Canada. · Division of Bone Diseases, Geneva University Hospitals, Geneva, Switzerland. · Departments of Medicine, Community Health Sciences and Oncology, University of Calgary, Calgary, AB, Canada. · Centre of Muscle & Bone Research, Charité-University Medicine Berlin, Campus Benjamin Franklin, Free University & Humboldt University Berlin, Berlin, Germany. · Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA. · Division of Maxillofacial Surgery, Kaiser Permanente Oakland Medical Center, Oakland, CA, USA. · Department of Medicine, University of Auckland, Auckland, New Zealand. · Division of Oral and Maxillofacial Surgery, Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA; Stony Brook School of Dental Medicine, Stony Brook, NY, USA; New York Center for Orthognathic and Maxillofacial Surgery, New York, NY, USA. · Department of Oral and Maxillofacial Radiology, School of Dentistry, Matsumoto Dental University, Shojiri, Japan. · Division of Diagnostic and Surgical Sciences, UCLA School of Dentistry, Los Angeles, CA, USA. · Mercy Health Osteoporosis and Bone Health Services, Cincinnati, OH, USA. · Department of Surgery and Translational Medicine, University of Florence, Florence, Italy. · Department of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada. · Department of Medicine, Division of Endocrinology at Indiana University, Indianapolis, IN, USA. · Department of Human Metabolism, University of Sheffield, Sheffield, UK. · Department of Medicine, University of Toronto, Toronto, ON, Canada; Centre of Excellence in Skeletal Health Assessment, Joint Department of Medical Imaging, University Health Network (UHN), Toronto, ON, Canada; Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada. · Department of Medicine, McGill University, Montreal, QC, Canada. · Jordan Osteoporosis Center, Jordan Hospital & Medical Center, Amman, Jordan. · MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; NIHR Nutrition Biomedical Research Centre, University of Southampton, Southampton, UK; NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK. · Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham Osteoporosis Prevention and Treatment Clinic, Birmingham, AL, USA. · Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University Graz, Graz, Austria. · Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark. · Faculty of Dentistry, University of Toronto, Toronto, Canada. · Department of Education, University of Victoria,Victoria, BC, Canada. · Department of Oral and Maxillofacial Surgery, Oulu University Hospital, University of Oulu, Oulu, Finland. · Division of Endocrinology and Metabolism, University of Toronto, Toronto, ON, Canada. · Division of Orthopaedic Surgery, Department of Surgery, Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada. · Faculty of Dentistry, University of Toronto, Toronto, ON, Canada. · International Osteoporosis Foundation (IOF), Nyon, Switzerland. · College of Medicine, King Saud University, Riyadh, Saudi Arabia. · Department of Dental Oncology, Northeast Cancer Centre/Health Science North, Sudbury, ON, Canada. · Rheumatology Division, CHU de Québec Research Centre, Laval University, Quebec City, QC, Canada. · Department of Medicine, Cambridge Biomedical Campus, Cambridge, UK. ·J Clin Densitom · Pubmed #27956123.

ABSTRACT: Osteonecrosis of the jaw (ONJ) has been associated with antiresorptive therapy in both oncology and osteoporosis patients. This debilitating condition is very rare and advances in diagnosis and management may now effectively reduce the risk of its development and offer valuable treatment options for affected patients. This paper provides a case-based review of ONJ and application of the International Task Force on ONJ (referred to as the "Task Force") recommendations for the diagnosis and management of ONJ. The Task Force was supported by 14 international societies and achieved consensus from representatives of these multidisciplinary societies on key issues pertaining to the diagnosis and management of ONJ. The frequency of ONJ in oncology patients receiving oncology doses of bisphosphonate (BP) or denosumab is estimated at 1%-15%, and the frequency in the osteoporosis patient population receiving much lower doses of BP or denosumab is estimated at 0.001%-0.01%. Although the diagnosis of ONJ is primarily clinical, imaging may be helpful in confirming the diagnosis and staging. In those with multiple risk factors for ONJ for whom major invasive oral surgery is being planned, interruption of BP or denosumab therapy (in cancer patients) is advised, if possible, before surgery, until the surgical site heals. Major oral surgery in this context could include multiple extractions if surgical extractions are required, not simple forceps extractions. ONJ development may be reduced by optimizing oral hygiene and postoperatively using topical and systemic antibiotics as appropriate. Periodontal disease should be managed before starting oncology doses of BP or denosumab. Local debridement may be successful in disease unresponsive to conservative therapy. Successful surgical intervention has been reported in those with stage 3 disease; less severe disease is best managed conservatively. Teriparatide may be helpful in healing ONJ lesions and may be considered in osteoporosis patients at a high fracture risk in the absence of contraindications. Resumption of BP or denosumab therapy following healing of ONJ lesions is recommended, and there have not been reports of subsequent local recurrence.

14 Review Low Energy Availability in Exercising Women: Historical Perspectives and Future Directions. 2017

Slater, Joanne / Brown, Rachel / McLay-Cooke, Rebecca / Black, Katherine. ·Department of Human Nutrition, University of Otago, PO Box 56, Dunedin, New Zealand. · Department of Human Nutrition, University of Otago, PO Box 56, Dunedin, New Zealand. katherine.black@otago.ac.nz. ·Sports Med · Pubmed #27430502.

ABSTRACT: Research on the health of female athletes has developed substantially over the past 50 years. This review aims to provide an overview of this research and identify directions for future work. While early cross-sectional studies focused primarily on menstruation, research has progressed to now encompass hormonal changes, bone health and lipid profiles. The seminal work of Loucks and colleagues distinguished that these health concerns were due to low energy availability (LEA) rather than exercise alone. LEA occurs when the body has insufficient energy available to meet the needs of training and normal physiological functioning. While there appears to be agreement that LEA is the underlying cause of this syndrome, controversy regarding terminology has emerged. Originally coined the female athlete triad (Triad), some researchers are now advocating the use of the term relative energy deficiency in sport (RED-S). This group argues that the term Triad excludes male athletes who also have the potential to experience LEA and its associated negative impact on health and performance. At present, implications of LEA among male athletes are poorly understood and should form the basis of future research. Other directions for future research include determination of the prevalence and long-term risks of LEA in junior and developmental athletes, and the development of standardised tools to diagnose LEA. These tools are required to aid comparisons between studies and to develop treatment strategies to attenuate the long-term health consequences of LEA. Continued advances in knowledge on LEA and its associated health consequences will aid development of more effective prevention, early detection and treatment strategies.

15 Review Zoledronic Acid (Reclast 2016

Dhillon, Sohita. ·Springer, Private Bag 65901, Mairangi Bay, 0754, Auckland, New Zealand. demail@springer.com. ·Drugs · Pubmed #27864686.

ABSTRACT: Zoledronic acid (Reclast

16 Review Nonspinal Fragility Fractures. 2016

Aparisi Gómez, Maria Pilar. ·Department of Radiology, Auckland District Health Board, Auckland City Hospital, Greenlane Clinical Center, National Women's Hospital, Auckland, New Zealand. ·Semin Musculoskelet Radiol · Pubmed #27842426.

ABSTRACT: This article focuses on nonspinal fragility or insufficiency fractures. Fragility fractures occur when normal levels of energy are applied to weakened bone, and they normally represent spontaneous fractures or traumatic fractures from minimal energy trauma that would not normally result in fracture in healthy people. This is the case in osteoporosis, where there is reduction of bone mass as well as loss of normal trabecular architecture leading to changes in structural characteristics that compromise biomechanics.The prevalence and most common locations, as well as clinical and diagnostic aspects, of nonspinal fragility fractures are presented. Osteoporosis is highly prevalent and can have different causes. The most common ones are primary, such as postmenopausal and senile osteoporosis, and secondary to several causes.Clinically, patients with insufficiency fractures present with pain, in many cases severe, and usually no history of trauma or eventually a history of minor trauma, such as a fall from standing height. If some cases, when these fractures are not displaced, detection is a challenge. In other cases, due to their location and equivocal features, differential diagnosis with malignancy has to be made. Radiographs, magnetic resonance imaging, multidetector computed tomography, positron emission tomography-computed tomography, and radionuclide scans have diverse roles in the diagnosis of insufficiency fractures.

17 Review Osteoporosis: Modern Paradigms for Last Century's Bones. 2016

Kruger, Marlena C / Wolber, Frances M. ·School of Food and Nutrition, Massey Institute of Food Science and Technology, Massey University, Palmerston North 4442, New Zealand. m.c.kruger@massey.ac.nz. · School of Food and Nutrition, Massey Institute of Food Science and Technology, Massey University, Palmerston North 4442, New Zealand. ·Nutrients · Pubmed #27322315.

ABSTRACT: The skeleton is a metabolically active organ undergoing continuously remodelling. With ageing and menopause the balance shifts to increased resorption, leading to a reduction in bone mineral density and disruption of bone microarchitecture. Bone mass accretion and bone metabolism are influenced by systemic hormones as well as genetic and lifestyle factors. The classic paradigm has described osteoporosis as being a "brittle bone" disease that occurs in post-menopausal, thin, Caucasian women with low calcium intakes and/or vitamin D insufficiency. However, a study of black women in Africa demonstrated that higher proportions of body fat did not protect bone health. Isoflavone interventions in Asian postmenopausal women have produced inconsistent bone health benefits, due in part to population heterogeneity in enteric bacterial metabolism of daidzein. A comparison of women and men in several Asian countries identified significant differences between countries in the rate of bone health decline, and a high incidence rate of osteoporosis in both sexes. These studies have revealed significant differences in genetic phenotypes, debunking long-held beliefs and leading to new paradigms in study design. Current studies are now being specifically designed to assess genotype differences between Caucasian, Asian, African, and other phenotypes, and exploring alternative methodology to measure bone architecture.

18 Review Short Anabolic Peptides for Bone Growth. 2016

Amso, Zaid / Cornish, Jillian / Brimble, Margaret A. ·School of Chemical Sciences, The University of Auckland, 23 Symonds St, Auckland, 1142, New Zealand. · Department of Medicine, The University of Auckland, Auckland, 1010, New Zealand. · Maurice Wilkins Centre for Molecular Biodiscovery, School of Biological Sciences, The University of Auckland, Auckland, 1142, New Zealand. ·Med Res Rev · Pubmed #27297498.

ABSTRACT: Loss of bone occurs in the age-related skeletal disorder, osteoporosis, leading to bone fragility and increased incidence of fractures, which are associated with enormous costs and substantial morbidity and mortality. Recent data indicate that osteoporotic fractures are more common than other diseases, which usually attract public attention (e.g., heart attack and breast cancer). The prevention and treatment of this skeletal disorder are therefore of paramount importance. Majority of osteoporosis medications restore skeletal balance by reducing osteoclastic activity, thereby reducing bone resorption. These agents, however, do not regenerate damaged bone tissue, leaving limited options for patients once bone loss has occurred. Recently, attention has turned to bone-anabolic agents. Such agents have the ability to increase bone mass and strength, potentially reversing structural damage. To date, only one bone-anabolic drug is available in the market. The discovery of more novel, cost-effective bone anabolic agents is therefore a priority to treat those suffering from this disabling condition. Short peptides offer an important alternative for the development of novel bone-anabolic agents given their high target binding specificity, which translates into potent activity with limited side effects. This review summarizes attempts in the identification of bone-anabolic peptides, and their development for promoting bone growth.

19 Review Measuring the musculoskeletal aging phenotype. 2016

Dawson, Alice / Dennison, Elaine. ·MRC Lifecourse Epidemiology Unit, University of Southampton, UK. · MRC Lifecourse Epidemiology Unit, University of Southampton, UK; Victoria University, Wellington, New Zealand. Electronic address: emd@mrc.soton.ac.uk. ·Maturitas · Pubmed #27131919.

ABSTRACT: The world is aging. The population aged over sixty years worldwide is predicted to rise from 841 million in 2013 to more than 2 billion by 2050. Musculoskeletal (MSK) disease is a significant burden on the aging population, contributing 7.5% of the disease burden in those aged over 60 years. MSK diseases have a pronounced effect on disability level and independence in old age, with a consequent significant public health burden and impact on quality of later life. As numbers of older individuals and their disease burden increase, it is important to examine MSK disease in older life in detail. The musculoskeletal aging phenotype comprises four often interwoven key elements - osteoporosis, osteoarthritis, sarcopenia and frailty - and this review will focus on these four themes. It is crucial that we are able to accurately measure each phenotype in order that we might identify those individuals at greatest risk of developing these conditions, and design trials of therapeutic agents that might impact their development. Accurate measurement of the musculoskeletal aging phenotype is necessary firstly to document the burden of each condition, and then to enable factors to be identified which may accelerate or retard their development or progression. In some areas of MSK disease, this work is more advanced (osteoporosis); in other areas (sarcopenia) the field is currently very rapidly evolving. We will explore the tools currently used to measure the musculoskeletal aging phenotype and how they compare, as well as highlight areas where more work is needed.

20 Review Ibandronate: A Review in Japanese Patients with Osteoporosis. 2016

Keating, Gillian M. ·Springer, Private Bag 65901, Mairangi Bay, 0754, Auckland, New Zealand. demail@springer.com. ·Drugs Aging · Pubmed #26915075.

ABSTRACT: Once-monthly intravenous (IV) ibandronate (Bonviva(®)) 1 mg and once-monthly oral ibandronate 100 mg are approved in Japan for the treatment of osteoporosis. In two well-designed trials in Japanese patients with primary osteoporosis, IV ibandronate 1 mg once monthly was noninferior to oral risedronate 2.5 mg once daily in terms of the cumulative incidence of new or worsening vertebral fractures at 3 years (MOVER trial) and oral ibandronate 100 mg once monthly was noninferior to IV ibandronate 1 mg once monthly in terms of the increase from baseline in lumbar spine bone mineral density at 12 months (MOVEST trial). Once-monthly IV and oral ibandronate were generally well tolerated in patients with osteoporosis. In conclusion, once-monthly IV and oral ibandronate are useful options for the treatment of Japanese patients with osteoporosis.

21 Review Should we prescribe calcium or vitamin D supplements to treat or prevent osteoporosis? 2015

Bolland, M J / Grey, A / Reid, I R. ·a Department of Medicine , University of Auckland , Auckland , New Zealand. ·Climacteric · Pubmed #26473773.

ABSTRACT: Systematic reviews of randomized, controlled trials (RCTs) are considered the highest level of evidence to inform clinical practice. Meta-analyses of large RCTs of calcium and/or vitamin D supplements completed in the last 15 years provide strong evidence for clinical recommendations. These meta-analyses with data for > 50,000 older adults reported that calcium with or without vitamin D has only weak, inconsistent effects on fracture, and that vitamin D without calcium has no effect on fracture. Only one RCT of co-administered calcium and vitamin D in frail, institutionalized, elderly women with low dietary calcium intake and vitamin D levels showed significant reductions in fracture risk. These RCTs have also reported previously unrecognized adverse events of calcium supplements including kidney stones, myocardial infarction, hypercalcemia, and hospitalization with acute gastrointestinal symptoms. The small risk of these important adverse effects, together with the moderate risk of minor side-effects such as constipation, probably outweighs any benefits of calcium supplements on fracture. These data suggest the role for calcium and vitamin D supplements in osteoporosis management is very limited. Neither calcium nor vitamin D supplements should be recommended for fracture prevention in community-dwelling adults, although vitamin D should be considered for prevention of osteomalacia in at-risk individuals.

22 Review Life-course approach to nutrition. 2015

Mitchell, P J / Cooper, C / Dawson-Hughes, B / Gordon, C M / Rizzoli, R. ·Synthesis Medical NZ Ltd, Auckland, New Zealand. · University of Notre Dame Australia, Sydney, Australia. · NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK. cc@mrc.soton.ac.uk. · MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK. cc@mrc.soton.ac.uk. · Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA. · Divisions of Adolescent Medicine and Endocrinology, Hasbro Children's Hospital, Alpert Medical School of Brown University, Providence, RI, USA. · Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland. ·Osteoporos Int · Pubmed #26412214.

ABSTRACT: This narrative review summarizes the role that nutrition plays in the development and maintenance of a healthy skeleton throughout the life-course. Nutrition has a significant influence on bone health throughout the life cycle. This narrative review summarizes current knowledge and guidance pertaining to the development and maintenance of a healthy skeleton. The primary objectives proposed for good bone health at the various stages of life are the following: Children and adolescents: achieve genetic potential for peak bone mass Adults: avoid premature bone loss and maintain a healthy skeleton Seniors: prevention and treatment of osteoporosis Findings from cohort studies, randomized controlled trials, systematic reviews and meta-analyses, in addition to current dietary guidelines, are summarized with the intention of providing clear nutritional guidance for these populations and pregnant women.

23 Review Calcium supplements: benefits and risks. 2015

Reid, I R / Bristow, S M / Bolland, M J. ·Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand. · Department of Endocrinology, Auckland District Health Board, Auckland, New Zealand. ·J Intern Med · Pubmed #26174589.

ABSTRACT: Calcium is an essential element in the diet, but there is continuing controversy regarding its optimal intake, and its role in the pathogenesis of osteoporosis. Most studies show little evidence of a relationship between calcium intake and bone density, or the rate of bone loss. Re-analysis of data from the placebo group from the Auckland Calcium Study demonstrates no relationship between dietary calcium intake and rate of bone loss over 5 years in healthy older women with intakes varying from <400 to >1500 mg day(-1) . Thus, supplements are not needed within this range of intakes to compensate for a demonstrable dietary deficiency, but might be acting as weak anti-resorptive agents via effects on parathyroid hormone and calcitonin. Consistent with this, supplements do acutely reduce bone resorption and produce small short-term effects on bone density, without evidence of a cumulative density benefit. As a result, anti-fracture efficacy remains unproven, with no evidence to support hip fracture prevention (other than in a cohort with severe vitamin D deficiency) and total fracture numbers are reduced by 0-10%, depending on which meta-analysis is considered. Five recent large studies have failed to demonstrate fracture prevention in their primary analyses. This must be balanced against an increase in gastrointestinal side effects (including a doubling of hospital admissions for these problems), a 17% increase in renal calculi and a 20-40% increase in risk of myocardial infarction. Each of these adverse events alone neutralizes any possible benefit in fracture prevention. Thus, calcium supplements appear to have a negative risk-benefit effect, and so should not be used routinely in the prevention or treatment of osteoporosis.

24 Review Short-term and long-term effects of osteoporosis therapies. 2015

Reid, Ian R. ·Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand. ·Nat Rev Endocrinol · Pubmed #25963272.

ABSTRACT: Progress continues to be made in the development of therapeutics for fracture prevention. Bisphosphonates are now available orally and intravenously, often as inexpensive generics, and remain the most widely used interventions for osteoporosis. The major safety concern associated with the use of bisphosphonates is the development of femoral shaft stress fractures and, although rare, this adverse event affords the principal rationale for restricting bisphosphonate therapy to those individuals with femoral T-scores <-2.5, and for providing drug holidays in those individuals requiring therapy for >5 years. Newer antiresorptive therapies, in the form of denosumab and cathepsin K inhibitors, might increase efficacy and possibly circumvent some of the safety concerns associated with bisphosphonate use (for example, gastrointestinal and renal complications). The combination of teriparatide with antiresorptives markedly increases effects on BMD; new anabolic agents are also very promising in this regard. However, whether or not these changes in BMD translate into improved efficacy of fracture prevention remains to be determined. Vitamin D is important for the prevention of osteomalacia, but does not influence BMD or fracture risk in patients not deficient in vitamin D. The balance of risks and benefits of calcium supplementation is contentious, but patients should be encouraged to adhere to a balanced diet aimed at maintaining a healthy body weight. Consideration of a patient's risk of falling, and its mitigation, are also important. In this Review, I summarize the short-term and long-term effects of osteoporosis therapies.

25 Review Osteoporosis and sarcopenia in older age. 2015

Edwards, M H / Dennison, E M / Aihie Sayer, A / Fielding, R / Cooper, C. ·MRC Lifecourse Epidemiology Unit, University of Southampton, UK. · MRC Lifecourse Epidemiology Unit, University of Southampton, UK; Victoria University, Wellington, New Zealand. · Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA. · MRC Lifecourse Epidemiology Unit, University of Southampton, UK; NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science, University of Oxford, Oxford OX3 5UG, UK; NIHR Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Trust, Southampton General Hospital, Southampton SO16 6YD, UK. Electronic address: cc@mrc.soton.ac.uk. ·Bone · Pubmed #25886902.

ABSTRACT: Osteoporosis and sarcopenia are common in older age and associated with significant morbidity and mortality. Consequently, they are both attended by a considerable socioeconomic burden. Osteoporosis was defined by the World Health Organisation (WHO) in 1994 as a bone mineral density of less than 2.5 standard deviations below the sex-specific young adult mean and this characterisation has been adopted globally. Subsequently, a further step forward was taken when bone mineral density was incorporated into fracture risk prediction algorithms, such as the Fracture Risk Assessment Tool (FRAX®) also developed by the WHO. In contrast, for sarcopenia there have been several diagnostic criteria suggested, initially relating to low muscle mass alone and more recently low muscle mass and muscle function. However, none of these have been universally accepted. This has led to difficulties in accurately delineating the burden of disease, exploring geographic differences, and recruiting appropriate subjects to clinical trials. There is also uncertainty about how improvement in sarcopenia should be measured in pharmaceutical trials. Reasons for these difficulties include the number of facets of muscle health available, e.g. mass, strength, function, and performance, and the various clinical outcomes to which sarcopenia can be related such as falls, fracture, disability and premature mortality. It is imperative that a universal definition of sarcopenia is reached soon to facilitate greater progress in research into this debilitating condition. This article is part of a Special Issue entitled "Muscle Bone Interactions".

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