Pick Topic
Review Topic
List Experts
Examine Expert
Save Expert
  Site Guide ··   
Osteoporosis: HELP
Articles from Hospital Cochin
Based on 69 articles published since 2008

These are the 69 published articles about Osteoporosis that originated from Hospital Cochin during 2008-2019.
+ Citations + Abstracts
Pages: 1 · 2 · 3
1 Review Bone and glucocorticoids. 2018

Briot, Karine. ·Rheumatology department, Cochin Hospital, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France. Electronic address: karine.briot@aphp.fr. ·Ann Endocrinol (Paris) · Pubmed #29685453.

ABSTRACT: Corticosteroid-induced osteoporosis is the most common form of secondary osteoporosis and the most frequent cause of osteoporosis in young people. Bone loss and fracture risk increase rapidly after the initiation of corticosteroid therapy and are proportional to dose and treatment duration. The increase in fracture risk is not fully assessed by bone mineral density measurement, as it is also related to impaired bone quality and increased risk of falls. Prevention should be considered in all patients beginning corticosteroid therapy, especially as the underlying inflammation in itself impairs bone quality. Bisphosphonates and teriparatide have shown efficacy in the treatment of corticosteroid-induced osteoporosis. Several national and international guidelines are available to improve management of corticosteroid-induced osteoporosis, which remains inadequate. Duration of anti-osteoporotic treatment should be discussed at the individual level, depending on the subject's characteristics and on the progression of the underlying inflammation.

2 Review Inflammatory diseases and bone fragility. 2017

Briot, K / Geusens, P / Em Bultink, I / Lems, W F / Roux, C. ·Department of Rheumatology, Cochin Hospital, Assistance-Publique-Hôpitaux de Paris, Paris, France. karine.briot@aphp.fr. · Hôpital Cochin, Service de Rhumatologie, 27, Rue du Faubourg, St. Jacques, 75014, Paris, France. karine.briot@aphp.fr. · INSERM UMR 1153, Paris, France. karine.briot@aphp.fr. · Department of Internal Medicine, Subdivision of Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands. · Hasselt University, Hasselt, Belgium. · Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, VU University Medical Center, Amsterdam, The Netherlands. · Department of Rheumatology, Cochin Hospital, Assistance-Publique-Hôpitaux de Paris, Paris, France. · Hôpital Cochin, Service de Rhumatologie, 27, Rue du Faubourg, St. Jacques, 75014, Paris, France. · INSERM UMR 1153, Paris, France. · Paris Descartes University, Paris, France. ·Osteoporos Int · Pubmed #28916915.

ABSTRACT: Systemic osteoporosis and increased fracture rates have been described in chronic inflammatory diseases such as rheumatoid arthritis, spondyloarthritis, systemic lupus erythematosus, inflammatory bowel diseases, and chronic obstructive pulmonary disease. Most of these patients receive glucocorticoids, which have their own deleterious effects on bone. However, the other main determinant of bone fragility is the inflammation itself, as shown by the interactions between the inflammatory mediators, the actors of the immune system, and the bone remodelling. The inflammatory disease activity is thus on top of the other well-known osteoporotic risk factors in these patients. Optimal control of inflammation is part of the prevention of osteoporosis, and potent anti-inflammatory drugs have positive effects on surrogate markers of bone fragility. More data are needed to assess the anti-fracture efficacy of a tight control of inflammation in patients with a chronic inflammatory disorder. This review aimed at presenting different clinical aspects of inflammatory diseases which illustrate the relationships between inflammation and bone fragility.

3 Review Pregnancy-related fractures: a retrospective study of a French cohort of 52 patients and review of the literature. 2017

Laroche, M / Talibart, M / Cormier, C / Roux, C / Guggenbuhl, P / Degboe, Y. ·Department of Rheumatology, Toulouse University Hospital, Toulouse, France. laroche.m@chu-toulouse.fr. · Centre de Rhumatologie, Hôpital Pierre Paul Riquet, CHU Purpan, 1 place du Dr Baylac, 31059, Toulouse Cedex, France. laroche.m@chu-toulouse.fr. · Department of Rheumatology, Toulouse University Hospital, Toulouse, France. · Department of Rheumatology, Cochin University Hospital, Paris, France. · Department of Rheumatology, Rennes University Hospital, Amiens, France. ·Osteoporos Int · Pubmed #28879474.

ABSTRACT: A retrospective, multicentre study involving 52 patients was carried out to define the causes and characteristics of pregnancy-related osteoporosis. The mean number of vertebral fractures occurring during the last trimester of pregnancy or at the time of delivery was 3.8. This is often promoted by risk factors before or during pregnancy. INTRODUCTION: In order to define the causes or predisposing factors of pregnancy-related osteoporosis and its clinical, radiological and bone density characteristics, laboratory findings, course and outcome, we carried out a retrospective multicentre study. METHODS: The records of 52 women hospitalised over the last 10 years in the rheumatology departments of six French university hospitals and with a diagnosis of pregnancy-related osteoporosis were examined. RESULTS: The patients' mean age at time of fracture was 32.1 years. In 10 patients, the fractures had occurred during the last trimester of pregnancy, and in 36 at the time of delivery or during the first 2 months post-partum. The mean number of vertebral fractures was 3.8 ± 2.0. Thirty three of the 52 patients had a risk factor of low bone mass before pregnancy. Twelve had disorders or treatments (heparin) that might promote osteoporosis during pregnancy, while 14 had no trigger factors before or during pregnancy. Overall, phosphate and calcium levels were normal, except for hyperphosphoraemia in lactating women (90%). On DXA scan, osteoporosis predominated in the trabecular bone (spinal T-score - 3.4, hip T-score - 2). Only 10 patients had a repeat fracture, and the increase in bone mineral density during follow-up was considerable, and improved by bisphosphonates (annual gain + 10% in the spine) or teriparatide (+ 15%). CONCLUSIONS: Pregnancy-related osteoporosis gives rise to multiple vertebral fractures. It is often promoted by risk factors before or during pregnancy. Its mechanism is still unknown. Treatment with bisphosphonates or teriparatide appears to improve the recovery of bone mineral density.

4 Review Imminent fracture risk. 2017

Roux, C / Briot, K. ·Paris Descartes University, Paris, France. christian.roux@aphp.fr. · Epidemiology and Biostatistics Sorbonne Paris Cité Research Center, UMR U1153, Paris, France. christian.roux@aphp.fr. · Department of Rheumatology, Cochin Hospital, Assistance-Publique-Hôpitaux de Paris, Paris, France. christian.roux@aphp.fr. · Epidemiology and Biostatistics Sorbonne Paris Cité Research Center, UMR U1153, Paris, France. · Department of Rheumatology, Cochin Hospital, Assistance-Publique-Hôpitaux de Paris, Paris, France. ·Osteoporos Int · Pubmed #28236126.

ABSTRACT: The clinical significance of osteoporosis is in the occurrence of fractures and re-fractures. The main risk factor of sustaining a fracture is a previous one, but a recent fracture is a better fracture risk factor than fracture history. The role of the recency of fracture has been shown for both vertebral and non-vertebral fracture risk. This imminent risk is explained by both bone-related factors (underlying osteoporosis) and fall-related factors (including those related to postfracture care). Such a short-term increased risk has been shown also in patients initiating corticosteroids and in frail osteoporotic subjects with central nervous system (CNS) diseases or drugs targeting CNS, and thus a high risk of falls. Patients with an imminent (i.e. 2 years) risk of fracture or refracture should be identified in priority in order to receive an immediate treatment and a program of fall prevention.

5 Review Low-trauma fractures without osteoporosis. 2017

Lespessailles, E / Cortet, B / Legrand, E / Guggenbuhl, P / Roux, C. ·Laboratoire I3MTO, Université d'Orléans, 4708, 45067, Orléans, EA, France. eric.lespessailles@chr-orleans.fr. · Regional Hospital of Orleans, 14 avenue de l'hopital, 45067, Orleans, Cedex 2, France. eric.lespessailles@chr-orleans.fr. · EA 4490 PMOI-Physiopathologie des Maladies Osseuses Inflammatoires, Université de Lille, 59000, Lille, France. · Service de Rhumatologie, CHU Lille, 59000, Lille, France. · Service de Rhumatologie, CHU d'Angers, 49933, Angers, France. · Service de Rhumatologie, CHU Rennes, 35203, Rennes, France. · , INSERM UMR 991, 35000, Rennes, France. · Faculté de Médecine, Université Rennes 1, 35043, Rennes, France. · INSERM U 1153, hôpital Cochin, Université Paris Descartes, Paris, France. ·Osteoporos Int · Pubmed #28161747.

ABSTRACT: In clinical practice, areal bone mineral density (aBMD) is usually measured using dual-energy X-ray absorptiometry (DXA) to assess bone status in patients with or without osteoporotic fracture. As BMD has a Gaussian distribution, it is difficult to define a cutoff for osteoporosis diagnosis. Based on epidemiological considerations, WHO defined a DXA-based osteoporosis diagnosis with a T-score <-2.5. However, the majority of individuals who have low-trauma fractures do not have osteoporosis with DXA (i.e., T-score <-2.5), and some of them have no decreased BMD at all. Some medical conditions (spondyloarthropathies, chronic kidney disease and mineral bone disorder, diabetes, obesity) or drugs (glucocorticoids, aromatase inhibitors) are more prone to cause fractures with subnormal BMD. In the situation of fragility fractures with subnormal or normal BMD, clinicians face a difficulty as almost all the pharmacologic treatments have proved their efficacy in patients with low BMD. However, some data are available in post hoc analyses in patients with T score >-2. Overall, in patients with a previous fragility fracture (especially vertebra or hip), treatments appear to be effective. Thus, the authors recommend treating some patients with a major fragility fracture even if areal BMD T score is above -2.5.

6 Review Improving the Management of COPD in Women. 2017

Jenkins, Christine R / Chapman, Kenneth R / Donohue, James F / Roche, Nicolas / Tsiligianni, Ioanna / Han, MeiLan K. ·The George Institute for Global Health, Sydney, NSW, Australia. Electronic address: christine.jenkins@sydney.edu.au. · Asthma and Airway Centre, University Health Network, Toronto Western Hospital, Toronto, ON, Canada. · Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC. · Respiratory and Intensive Care Medicine, Cochin Hospital Group, University Paris Descartes, Paris, France. · University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. · Division of Pulmonary and Critical Care, University of Michigan, Ann Arbor, MI. ·Chest · Pubmed #27816445.

ABSTRACT: COPD is a highly debilitating disease that represents a substantial and growing health burden in women. There is increasing evidence for sex-related differences in COPD risk, progression, and outcomes. However, the disease receives scant attention as a women's health issue. Thus, a multifaceted approach is required to address COPD in women, including greater awareness, minimization of risk, and further elucidation of the sex-specific factors (biological and cultural) that affect risk, disease progression, and treatment success. This article reviews the current literature on the topic and provides suggestions for achieving better outcomes for the millions of women with COPD worldwide.

7 Review Osteoporosis: Is milk a kindness or a curse? 2017

Fardellone, Patrice / Séjourné, Alice / Blain, Hubert / Cortet, Bernard / Thomas, Thierry / Anonymous3600884. ·Service de Rhumatologie, Hôpital Nord, Place Victor-Pauchet, 80054 Amiens Cedex 1, France; Inserm 1088, 80054 Amiens Cedex 1, France. Electronic address: fardellone.patrice@chu-amiens.fr. · Service de Rhumatologie, Hôpital Nord, Place Victor-Pauchet, 80054 Amiens Cedex 1, France; Inserm 1088, 80054 Amiens Cedex 1, France. · Centre de Prévention et de Traitement des Maladies du Vieillissement Antonin-Balmes, Centre Régional Equilibre et Prévention de la Chute du Languedoc-Roussillon, Centre Hospitalier Régional Universitaire de Montpellier, 39, avenue Charles-Flahault, 34295 Montpellier Cedex 5, France. · EA 4490, Service de Rhumatologie, Hôpital Roger-Salengro, CHU Lille, 59037 Lille Cedex, France. · Unité de Rhumatologie, CHU de Saint-Étienne, Hôpital de Bellevue, 42055 Saint-Étienne Cedex 2, France. · Centre d'Évaluation des Maladies Osseuses, Hôpital Cochin, 27, rue du Faubourg Saint Jacques, 75014 Paris, France. ·Joint Bone Spine · Pubmed #27726930.

ABSTRACT: Cow's milk is often severely criticized as a cause of multiple health problems, including an increased risk of fractures. A close look at the scientific literature shows a striking contradiction. On the one hand, experimental studies of surrogate markers (e.g., bone turnover markers and bone mineral density [BMD]) usually indicate benefits from drinking cow's milk. On the other, the findings from epidemiological studies are conflicting and disconcerting. In all age groups, including children and postmenopausal women, consuming cow's milk, powdered milk supplements, or whey protein is associated with a slower bone turnover and unchanged or higher BMD values. These benefits are particularly marked in populations where calcium deficiency is prevalent, for instance in Asian countries. No interventional studies have addressed the fracture risk potentially associated with drinking cow's milk. The only available data come from epidemiological observational studies, whose results are conflicting, with a lower fracture risk in some cases and no difference or a higher risk in others. Several hypotheses have been offered to explain these findings, such as a deleterious effect of D-galactose, lactose intolerance, and acid overload. Epidemiological studies face many obstacles when seeking to detect effects of a single food, particularly the multiplicity of interactions among foods. Furthermore, reliable dietary intake data must be collected over prolonged periods, often long before the occurrence of a fracture, and defective recall may therefore introduce a major yet often unrecognized bias, particularly in populations where calcium deficiency is uncommon. To date, there is no conclusive evidence that we should modify our currently high level of consumption of cow's milk.

8 Review Current role for bone absorptiometry. 2017

Roux, Christian / Briot, Karine. ·Inserm U1153, Université Paris Descartes, 75006 Paris, France; Département de Rhumatologie, Hôpital Cochin, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France. ·Joint Bone Spine · Pubmed #27282091.

ABSTRACT: Bone mineral density (BMD) measurement using dual-energy X-ray absorptiometry (DXA) is a key contributor to the management of bone fragility syndromes, most notably postmenopausal osteoporosis. Experimental studies of bone biomechanics have established that an accurate marker for mechanical strength is areal BMD (aBMD, g/cm

9 Review Comorbidities in rheumatoid arthritis. 2016

Dougados, Maxime. ·Paris Descartes University, Department of Rheumatology - Hôpital Cochin. Assistance Publique - Hôpitaux de Paris, EULAR center of excellence, INSERM (U1153): Clinical epidemiology and biostatistics, PRES Sorbonne Paris-Cité, Paris, France. ·Curr Opin Rheumatol · Pubmed #27027814.

ABSTRACT: PURPOSE OF REVIEW: The aim of this study was to give an overview of recently published articles covering comorbidities in rheumatoid arthritis with a specific focus on their implications in daily practice and clinical research studies. RECENT FINDINGS: Recent studies have confirmed the higher incidence/prevalence of some comorbidities in rheumatoid arthritis such as atherosclerosis-related cardiovascular diseases, some cancers, infections and osteoporosis. Apart from the interest in the underlying pathophysiological pathway, such studies have pointed out the impact of comorbidities on the course of the disease and also on the efficacy and tolerability of frequently used antirheumatic drugs. Such findings have prompted the rheumatology community to propose a standardized way to collect and to prevent these comorbidities. SUMMARY: Several comorbidities are frequently observed in rheumatoid arthritis because of the persistent activity of the disease and/or because of the administered antirheumatic therapies. Programs to adequately collect these comorbidities and/or prevent them are resulting in a better outcome for rheumatoid arthritis patients.

10 Review Points to consider for reporting, screening for and preventing selected comorbidities in chronic inflammatory rheumatic diseases in daily practice: a EULAR initiative. 2016

Baillet, Athan / Gossec, Laure / Carmona, Loreto / Wit, Maarten de / van Eijk-Hustings, Yvonne / Bertheussen, Heidi / Alison, Kent / Toft, Mette / Kouloumas, Marios / Ferreira, Ricardo J O / Oliver, Susan / Rubbert-Roth, Andrea / van Assen, Sander / Dixon, William G / Finckh, Axel / Zink, Angela / Kremer, Joel / Kvien, Tore K / Nurmohamed, Michael / van der Heijde, Desirée / Dougados, Maxime. ·Department of Rheumatology, Université Joseph Fourier, GREPI-CNRS, Grenoble Hospital, France. · Department of Rheumatology, Sorbonne Universités, UPMC Univ Paris 06, Institut Pierre Louis d'Epidémiologie et de Santé Publique, GRC-UPMC 08 (EEMOIS); AP-HP, Pitié Salpêtrière Hospital, Paris, France. · Instituto de Salud Musculoesquelética, Madrid, Spain. · EULAR Standing Committee of People with Arthritis/Rheumatism in Europe (PARE), Zurich, Switzerland. · Integrated Care, Maastricht University Medical Centre, Maastricht, The Netherlands. · Salisbury NHS Foundation Trust Hospital, Salisbury, UK. · Cyprus League Against Rheumatism, Cyprus, Nikosia, Cyprus. · Department of Rheumatology, Centro Hospitalar e Universitário de Coimbra; Health Sciences Research Unit: Nursing (UICiSA:E), Coimbra, Portugal. · Independent Nurse Consultant, North Devon, UK. · Department of Internal Medicine, University of Cologne, Cologne, Germany. · Department of Internal Medicine, Division of Infectious Diseases, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands. · Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK. · Division of Rheumatology, Geneva University Hospital, Geneva, Switzerland. · Epidemiology Unit, German Rheumatism Research Centre, and Rheumatology, Charité, University Medicine, Berlin, Germany. · Albany Medical College and The Center for Rheumatology, Albany, USA. · Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. · Amsterdam Rheumatology immunology Center | VUmc and Reade, The Netherlands. · Department of Rheumatology, Leiden University Medical Center, The Netherlands. · Department of Rheumatology, Paris Descartes University-Hôpital Cochin. Assistance Publique-Hôpitaux de Paris. INSERM (U1153): Clinical epidemiology and biostatistics, PRES Sorbonne Paris-Cité, Paris, France. ·Ann Rheum Dis · Pubmed #26984008.

ABSTRACT: In chronic inflammatory rheumatic diseases, comorbidities such as cardiovascular diseases and infections are suboptimally prevented, screened for and managed. The objective of this European League Against Rheumatism (EULAR) initiative was to propose points to consider to collect comorbidities in patients with chronic inflammatory rheumatic diseases. We also aimed to develop a pragmatic reporting form to foster the implementation of the points to consider. In accordance with the EULAR Standardised Operating Procedures, the process comprised (1) a systematic literature review of existing recommendations on reporting, screening for or preventing six selected comorbidities: ischaemic cardiovascular diseases, malignancies, infections, gastrointestinal diseases, osteoporosis and depression and (2) a consensus process involving 21 experts (ie, rheumatologists, patients, health professionals). Recommendations on how to treat the comorbidities were not included in the document as they vary across countries. The literature review retrieved 42 articles, most of which were recommendations for reporting or screening for comorbidities in the general population. The consensus process led to three overarching principles and 15 points to consider, related to the six comorbidities, with three sections: (1) reporting (ie, occurrence of the comorbidity and current treatments); (2) screening for disease (eg, mammography) or for risk factors (eg, smoking) and (3) prevention (eg, vaccination). A reporting form (93 questions) corresponding to a practical application of the points to consider was developed. Using an evidence-based approach followed by expert consensus, this EULAR initiative aims to improve the reporting and prevention of comorbidities in chronic inflammatory rheumatic diseases. Next steps include dissemination and implementation.

11 Review Choosing the tool for osteoporosis risk prediction. 2015

Cormier, Catherine / Koumakis, Eugenie / Souberbielle, Jean-Claude. ·aDepartment of Rheumatology A, Cochin Hospital bPhysiology Department, Necker-Enfants-Malades Hospital, Paris Descartes University, Paris, France. ·Curr Opin Clin Nutr Metab Care · Pubmed #26241819.

ABSTRACT: PURPOSE OF REVIEW: Predicting fracture risk is a major challenge because it allows the prevention of major osteoporotic fracture in high-risk populations. With the aging of the population, this matter will become of even greater importance. In recent years, novel clinical, biochemical, and imaging tools have been developed to improve the assessment of fracture risk. RECENT FINDINGS: The present review summarizes novel clinical strategies, Dual energy X-ray absorptiometry (DXA)-derived tools, imaging techniques, and biochemical markers that have been developed recently to improve fracture risk prediction. SUMMARY: DXA and clinical fracture risk prediction tools are preferential markers of fracture risk. Clinical fracture risk alone might be used if DXA facilities are unavailable. The fracture risk assessment tool may be used in osteoporosis consultation in many countries. Other tools may be used soon after more studies are performed, particularly trabecular bone score, quantitative ultrasound, bone turnover markers. Specific factors for example falls, hip axis length, vertebral fracture assessment could be used in individual patients. This may significantly improve the clinical decision-making.

12 Review Usefulness of bone density measurement in fallers. 2014

Blain, Hubert / Rolland, Yves / Beauchet, Olivier / Annweiler, Cedric / Benhamou, Claude-Laurent / Benetos, Athanase / Berrut, Gilles / Audran, Maurice / Bendavid, Sauveur / Bousson, Valérie / Briot, Karine / Brazier, Michel / Breuil, Véronique / Chapuis, Laure / Chapurlat, Roland / Cohen-Solal, Martine / Cortet, Bernard / Dargent, Patricia / Fardellone, Patrice / Feron, Jean-Marc / Gauvain, Jean-Bernard / Guggenbuhl, Pascal / Hanon, Olivier / Laroche, Michel / Kolta, Sami / Lespessailles, Eric / Letombe, Brigitte / Mallet, Eric / Marcelli, Christian / Orcel, Philippe / Puisieux, François / Seret, Patrick / Souberbielle, Jean-Claude / Sutter, Bruno / Trémollières, Florence / Weryha, Georges / Roux, Christian / Thomas, Thierry / Anonymous3180790. ·Pôle de Gériatrie, Centre Antonin-Balmes, CHU de Montpellier, 39, avenue Charles-Flahault, 34395 Montpellier Cedex 5, France; Laboratoire Movement to Health, Euromov, Université Montpellier 1, Site de Référence MACVIA-LR, Contre les Maladies Chroniques pour un vieillissement actif en Languedoc-Roussillon, 700, avenue du Pic-Saint-Loup, 34090 Montpellier, France. Electronic address: h-blain@chu-montpellier.fr. · Gérontopôle de Toulouse, Hôpital La Grave-Casselardit, CHU de Toulouse, Toulouse, France. · UPRES EA 4638, Service de gériatrie, CHU d'Angers, Angers, France. · EA4708 I3MTO, University of Orleans, Orleans, France. · Service de Gériatrie, CHU de Nancy, Inserm U1116, Université de Lorraine, Nancy, France. · Service de gériatrie, CHU de Nantes, Nantes, France. · Service de rhumatologie et GEROM, CHU d'Angers, Angers, France. · Médecine Générale, Paris, France. · Service de Radiologie Ostéoarticulaire, Hôpital Lariboisière, Paris, France. · Service de rhumatologie, hôpital Cochin, université Paris-Descartes, Paris, France. · Service de rhumatologie, Hôpital Nord, Amiens, France. · Service de rhumatologie, CHU de Nice-1, université Nice Sophia-Antipolis, Nice, France. · Service de rhumatologie, 35500 Vitré, France. · Service de rhumatologie, CHU de Lyon, Lyon, France. · Inserm U606, Université Paris-Diderot Paris 7, hôpital Lariboisière, Paris, France. · Service de gérontologie, hôpital Broca, université Paris Descartes, Paris, France. · Université Paris-Sud, UMRS 1018, Villejuif, France. · Inserm ERI 12, service de rhumatologie, CHU d'Amiens, Amiens, France. · Service de chirurgie orthopédique, hôpital Saint-Antoine, Paris, France. · Centre de médecine gériatrique, CHR d'Orléans, Orléans, France. · Inserm UMR U 991, Service de rhumatologie, CHU de Rennes, Rennes, France. · Service de gérontologie, hôpital Broca, Paris, France. · Centre de Rhumatologie, CHU Purpan, Toulouse, France. · Service de gynécologie médicale et médecine du couple, hôpital Jeanne-de-Flandre, CHRU de Lille, Lille, France. · Centre de référence des maladies rares du calcium et du phosphore, CIC Inserm 204, CHU de Rouen, Rouen, France. · Service de rhumatologie, hôpital Côte-de-Nacre, Caen, France. · Service de rhumatologie, hôpital Lariboisière, Paris, France. · Service de Gériatrie, CHU de Lille, Lille, France. · Service de rhumatologie, Angers, France. · Laboratoire d'Explorations Fonctionnelles, Inserm U845, Hôpital Necker-Enfants-Malades, Paris, France. · Service de chirurgie orthopédique des adultes de l'Institut Calot-de-Berck, Berck-sur-Mer, France. · Centre de ménopause, hôpital Paule-de-Viguier, Toulouse, France. · Service d'endocrinologie, CHU de Nancy, Vandoeuvre-lès-Nancy, France. · Inserm U1059, Service de Rhumatologie, CHU de Saint-Étienne, 42055 Saint-Étienne Cedex 2, France. ·Joint Bone Spine · Pubmed #24703626.

ABSTRACT: The objective of this systematic literature review is to discuss the latest French recommendation issued in 2012 that a fall within the past year should lead to bone mineral density (BMD) measurement using dual-energy X-ray absorptiometry (DXA). This recommendation rests on four facts. First, osteoporosis and fall risk are the two leading risk factors for nonvertebral fractures in postmenopausal women. Second, BMD measurement using DXA supplies significant information on the fracture risk independently from the fall risk. Thus, when a fall occurs, the fracture risk increases as BMD decreases. Third, osteoporosis drugs have been proven effective in preventing fractures only in populations with osteoporosis defined based on BMD criteria. Finally, the prevalence of osteoporosis is high in patients who fall and increases in the presence of markers for frailty (e.g., recurrent falls, sarcopenia [low muscle mass and strength], limited mobility, and weight loss), which are risk factors for both osteoporosis and falls. Nevertheless, life expectancy should be taken into account when assessing the appropriateness of DXA in fallers, as osteoporosis treatments require at least 12months to decrease the fracture risk. Another relevant factor is the availability of DXA, which may be limited due to geographic factors, patient dependency, or severe cognitive impairments, for instance. Studies are needed to better determine how the fall risk and frailty should be incorporated into the fracture risk evaluation based on BMD and the FRAX® tool.

13 Review How long should we treat? 2014

Roux, C / Briot, K. ·Department of Rheumatology, Cochin Hospital, Paris-Descartes University, Paris, France, christian.roux@cch.aphp.fr. ·Osteoporos Int · Pubmed #24668004.

ABSTRACT: Osteoporosis is a chronic disease, for which effective drugs are available. These drugs have reduced the risk of osteoporosis-related fractures in robust trials of 3-5 years duration. There is no evidence of anti-fracture efficacy for treatments of longer duration. The consequences of stopping treatments are very different for the different molecules. Bisphosphonates can be safely discontinued after 3-5 years of treatment if there was optimal adherence and if patients are no longer osteoporotic. This discontinuation cannot be applied in patients with recent fractures or for other treatments. Safety of prolonged treatment is a huge concern which must be managed appropriately. The decision of a prolonged treatment is driven by the underlying risk of fracture. This risk must be assessed regularly in order to share with the patient the benefit-risk ratio of prolonged treatment.

14 Review [Corticosteroid-induced osteoporosis]. 2013

Briot, K / Roux, C. ·Service de rhumatologie, université Paris Descartes, hôpital Cochin, Assistance publique-Hôpitaux de Paris, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France. karine.briot@cch.aphp.fr ·Rev Med Interne · Pubmed #23238181.

ABSTRACT: Corticosteroid-induced osteoporosis is the most common form of secondary osteoporosis and the first cause in young people. Bone loss occurs early after the initiation of corticosteroid therapy and is correlated to dosage and treatment duration. Osteoporosis prevention is justified in all subjects who begin glucocorticoids, since the underlying inflammation has itself a deleterious bone impact. Bone loss magnitude is variable and there is no clearly identified predictor of the individual risk of fracture. Prevention or treatment of osteoporosis should be considered in all patients who received a daily dose of at least 7.5mg equivalent prednisone and a treatment that is expected to last at least 3 months. Bisphosphonates and the anabolic agent parathyroid hormone (1-34) have shown their efficacy in the treatment of corticosteroid-induced osteoporosis. Recent international guidelines are available and should guide management of corticosteroid-induced osteoporosis that remains under-diagnosed and under-treated. Duration of anti-osteoporotic treatment should be discussed at the individual level, depending on the subject's characteristics, and on the underlying inflammation evolution.

15 Review Impact of treatments for osteoporosis on osteoarthritis progression. 2012

Roux, C / Richette, P. ·Assistance-Publique-Hôpitaux de Paris, Hôpital Cochin, Service de Rhumatologie, Université Paris Descartes, 75014, Paris, France. christian.roux@cch.aphp.fr ·Osteoporos Int · Pubmed #23179573.

ABSTRACT: Subchondral bone is involved in the development of osteoarthritis, with an excess in bone resorption at an early stage and increased bone formation thereafter. Experimental and observational studies suggest that acting on bone can change progression of osteoarthritis. Clinical prospective controlled studies failed to confirm this result. Appropriate identification of patients at high risk of developing cartilage deterioration is a key issue for the analysis of impact of treatments for osteoporosis on osteoarthritis progression.

16 Review [Menopause and bone]. 2012

Lobersztajn, A / Trémollières, F. ·Hôpital Cochin, 27 rue du Faubourg-Saint-Jacques, Paris, France. ·J Gynecol Obstet Biol Reprod (Paris) · Pubmed #23036315.

ABSTRACT: Osteoporosis is a diffuse disease of the skeleton characterized by a decrease and a change in bone microarchitecture, which causes excessive fragility of the bone exposing them to increased risk of fracture. It represents a major public health issue, with 200 million people suffering from this disease in the world. The therapeutic goal is to maintain bone mineral density while avoiding the risk of falling.

17 Review [Drug-induced osteoporosis]. 2012

Briot, Karine. ·Université Paris-Descartes, service de rhumatologie, hôpital Cochin, AP-HP, 75014 Paris. karine.briot@cch.aphp.fr ·Rev Prat · Pubmed #22408857.

ABSTRACT: Optimal care of patients at risk of osteoporosis (low bone density and/or fracture) requires the assessment of risk factors of osteoporosis and fracture (lifestyle risk factors, chronic diseases and drugs). Among drugs, prior and current use of oral corticosteroids is strongly associated with an increased risk of fractures. But other medications could be involved and should be assessed in patients at risk of fractures. There are a strong evidence for GnRH agonists and aromatase inhibitors, antiepileptic, selective serotonin reuptake inhibitors, proton pump inhibitors. Further studies are necessary to confirm bone deleterious effect of other treatments.

18 Review [Vertebral fractures]. 2012

Roux, Christian. ·Université Paris-Descartes, faculté de médecine, AP-HP, hôpital Cochin, service de rhumatologie, 75014 Paris. christian.roux@cch.aphp.fr ·Rev Prat · Pubmed #22408855.

ABSTRACT: Vertebral fractures are well-known fragility fractures related to osteoporosis. Assessment of secondary osteoporosis and other causes of bone fragility is mandatory. Diagnosis of these fractures is relevant, as they are responsible of increased morbidity, and even mortality in frail elderly patients. They are a strong risk factor for sustaining other fractures, including hip fractures. There is a high level of evidence for efficacy of antiosteoporotic treatments in post-menopausal patients with osteoporosis and vertebral fractures.

19 Review [Osteoporosis: being able to recognize its severity]. 2012

Roux, Christian. ·Université Paris-Descartes, faculté de médecine, AP-HP, hôpital Cochin, service de rhumatologie, 75014 Paris. christian.roux@cch.aphp.fr ·Rev Prat · Pubmed #22408853.

ABSTRACT: -- No abstract --

20 Review Clinical utility of serum bone turnover markers in postmenopausal osteoporosis therapy monitoring: a systematic review. 2011

Funck-Brentano, Thomas / Biver, Emmanuel / Chopin, Florence / Bouvard, Beatrice / Coiffier, Guillaume / Souberbielle, Jean-Claude / Garnero, Patrick / Roux, Christian. ·Paris Descartes University, Cochin Hospital, Department of Rheumatology B, Paris, France. ·Semin Arthritis Rheum · Pubmed #21507464.

ABSTRACT: OBJECTIVES: Serum bone turnover markers (sBTM) are used in clinical practice for patients undergoing postmenopausal osteoporosis therapy. The aim of this study was to systematically analyze the literature on the ability of sBTM to monitor therapy, focusing on the following 5 objectives: (1) pretreatment values and treatment choice; (2) short-term changes and clinical response; (3) sBTM effect on persistence to therapy; (4) sBTM ability to predict fracture risk after withdrawal of therapy; and (5) the prediction of serious adverse effects. METHODS: A systematic search on Medline completed manually was performed until November 2010 and was limited to postmenopausal osteoporosis and marketed therapies. RESULTS: Following the PRISMA statement for systematic reviews, 48 studies were selected. Baseline sBTM levels were not able to predict fracture risk reduction with either treatment. There was more evidence for the prediction of fracture risk reduction with bone formation sBTM including PINP than with sCTX. Most of the studies found correlations between sBTM and bone mineral density (BMD) changes under antiresorptive therapies, although inconsistently. The only published study on the impact of sBTM on persistence to therapy showed negative results. There was no evidence that sBTM allow the prediction of adverse effects, especially osteonecrosis of the jaw. CONCLUSIONS: sBTM reflect the skeletal effects of anti-osteoporotic treatments. Pretreatment values are not recommended for selecting therapy. Short-term changes are significantly correlated with BMD variation, but there is no published evidence that they predict benefit on fracture risk at the individual level.

21 Review Osteoporosis in inflammatory joint diseases. 2011

Roux, C. ·Rheumatology Department, Cochin Hospital, Paris Descartes University, Paris, France. christian.roux@cch.aphp.fr ·Osteoporos Int · Pubmed #20552328.

ABSTRACT: Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) are two inflammatory joint diseases characterized by bone complications including osteoporosis. In RA, periarticular bone loss, bone erosions, and systemic osteoporosis are observed, with an increased risk of fractures. Determinants of fractures are underlying conditions (as RA has a female preponderance and an increased prevalence with age), severity of the disease, and use of glucocorticoids. However, bone loss can occur even in glucocorticoid-naive patients. Prospective data show that the optimal control of inflammation in RA is associated with decrease in structural damage and bone loss. RA illustrates the role of inflammation on bone resorption. In AS, osteoporosis is an early event and vertebral fracture risk is increased. Bone loss is related mainly to inflammation, as the disease can occur in young male adult populations, and glucocorticoids are not used in this disease. However, AS is characterized by progressive stiffness and ankylosis of the spine and illustrates also the potential role of inflammation on local bone formation.

22 Review [Management of osteoporosis: room for improvment]. 2010

Roux, Christian. ·Hôpital Cochin, 27, rue du Faubourg St Jacques, 75679--Paris cedex 14. christian.roux@cch.aphp.fr ·Bull Acad Natl Med · Pubmed #22046711.

ABSTRACT: The objective of anti-osteoporotic treatments is the prevention of the first or recurrent fractures. Screening of at risk patients is the basis of improvement of osteoporosis management. Prevalent fractures are strong determinants of incident fractures. In patients without fractures screening of risk factors, and quantification of risk using FRAX tool, allows detection of patients who should receive highest priority for treatment. Several drugs have shown that they are able to decrease the risk of fracture, providing persistence and compliance. Non pharmacological approach (including nutrition and physical activity) is part of optimal management of osteoporosis.

23 Review Osteoporosis and mortality. 2010

Leboime, Ariane / Confavreux, Cyrille B / Mehsen, Nadia / Paccou, Julien / David, Claire / Roux, Christian. ·Service de Rhumatologie B, Université Paris-Descartes, Hôpital Cochin, 27 rue du faubourg Saint-Jacques, Paris, France. ·Joint Bone Spine · Pubmed #21211746.

ABSTRACT: Osteoporosis is classified as a public health problem by healthcare authorities because it is associated with an increased risk of potentially serious fractures. Osteoporotic fractures are known to generate a heavy burden of morbidity and financial cost [1]. However, recent data indicate that some osteoporotic fractures are also associated with excess mortality. These data have led to public health measures such as the addition by the World Health Organization of fracture prevention to the list of public health priorities [2] and the update on hip fractures issued recently by the statistics department of the French ministry of health (DREES [3]). Hip fractures constitute the most severe complication of osteoporosis because they can induce permanent physical disability, loss of self-sufficiency, institutionalization and, above all, an increased risk of death. Interestingly, two recent publications support the hypothesis that optimal osteoporosis management may affect the risk of death. Here, we will review the main data linking osteoporotic fractures overall (as opposed to hip fractures only) and mortality.

24 Review Hormonal deprivation therapy-induced osteoporosis in postmenopausal women with breast cancer. 2009

Ghazi, Mirieme / Roux, Christian. ·Pairs-Descartes University, Rheumatology Department, Cochin Hospital, Paris, France. ·Best Pract Res Clin Rheumatol · Pubmed #19945692.

ABSTRACT: Aromatase inhibitor (AI) therapy significantly increases the disease-free survival in postmenopausal patients with hormone receptor-positive breast cancer. AIs are potent inhibitors of oestradiol production. Large adjuvant trials showed that the third-generation AIs (i.e., anastrozole, letrozole and exemestane) are risk factors for an increased bone loss, and are associated with an increase in the risk of fractures in women with bone fragility. A comprehensive assessment of risk of fractures must be performed at the initiation of an AI therapy. Antiresorptive drugs (i.e., bisphosphonates and denosumab) are effective for bone loss prevention and treatment in these patients.

25 Review Male osteoporosis: diagnosis and fracture risk evaluation. 2009

Briot, Karine / Cortet, Bernard / Trémollières, Florence / Sutter, Bruno / Thomas, Thierry / Roux, Christian / Audran, Maurice / Anonymous3970620. ·Service de Rhumatologie, Hôpital Cochin, 27 rue du Faubourg St Jacques, 75014 Paris, France. karine.briot@cch.aphp.fr ·Joint Bone Spine · Pubmed #19176288.

ABSTRACT: Male osteoporosis is challenging to diagnose and to treat. Underestimation of the risk of male osteoporosis, the combined presence of several interwoven causative factors in many patients, and uncertainty regarding the absorptiometry cutoffs associated with fractures are major obstacles to the diagnosis of male osteoporosis and to the identification of men at risk for fractures. The lifetime risk of osteoporotic fracture is estimated at 15% among men older than 50 years. One-third of proximal femoral fractures occur in men, and the associated mortality rate is 2- to 3-fold that in women. In men, nearly half the cases of osteoporosis are related to disease, medications, or risk factors. Although the criteria for diagnosing male osteoporosis are not agreed on, the definitions developed by the World Health Organization can be used provided the reference population is composed of young males. An absorptiometry T-score < or = -2.5 is useful for diagnosing osteoporosis but fails to adequately predict the fracture risk. The identification of men at high risk for fractures requires a combined evaluation of bone mineral density data, clinical risk factors, and risk factors for falls.