Pick Topic
Review Topic
List Experts
Examine Expert
Save Expert
  Site Guide ··   
Osteoporosis: HELP
Articles from Lyon
Based on 119 articles published since 2008
||||

These are the 119 published articles about Osteoporosis that originated from Lyon during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5
1 Guideline Use of CTX-I and PINP as bone turnover markers: National Bone Health Alliance recommendations to standardize sample handling and patient preparation to reduce pre-analytical variability. 2018

Szulc, Pawel / Naylor, Kim / Pickering, Marie-Eva / Hoyle, Nicholas / Eastell, Richard / Leary, Elizabeth. ·Inserm UMR 1033, Service de rhumatologie et de pathologie osseuse, Hôpital Édouard Herriot, Université de Lyon, Lyon, France. · Academic unit of bone metabolism and mellanby centre for bone research, University of Sheffield, Sheffield, United Kingdom. · Murnau laboratory, Murnau, Germany. · ETL Consulting, Seattle, WA 98177, USA, Pacific Biomarkers, Seattle, WA 98119, USA. ·Ann Biol Clin (Paris) · Pubmed #30078776.

ABSTRACT: The International osteoporosis foundation and the International federation of clinical chemistry (IFCC) Bone marker standards working group have identified N-terminal propeptide of type I procollagen (PINP) and C-terminal telopeptide of type I collagen (CTX-I) in blood to be the reference markers of bone turnover for the fracture risk prediction and monitoring of osteoporosis treatment. Although used in clinical research for many years, bone turnover markers (BTM) have not been widely adopted in clinical practice primarily due to their poor within-subject and between-lab reproducibility. The NBHA bone turnover marker project team aim to reduce pre-analytical variability of CTX-I and PINP measurements through standardized sample handling and patient preparation. Recommendations for sample handling and patient preparations were made based on review of available publications and pragmatic considerations to reduce pre-analytical variability. Controllable and un-controllable patient-related factors were reviewed to facilitate interpretation and sample collection. Samples for CTX-I must be collected consistently in the morning hours in the fasted state. EDTA plasma is preferred for CTX-I for its greater sample stability. Sample collection conditions for PINP are less critical as PINP has minimal circadian variability and is not affected by food intake. Sample stability limits should be observed. The uncontrollable aspects (age, sex, pregnancy, immobility, recent fracture, co-morbidities, anti-osteoporotic drugs, other medications) should be considered in BTM interpretation. Adopting standardized sample handling and patient preparation procedures will significantly reduce controllable pre-analytical variability. The successful adoption of such recommendations necessitates the close collaboration of various stakeholders at the global stage, including the laboratories, the medical community, the reagent manufacturers and the regulatory agencies.

2 Editorial Cathepsin K inhibitors and antisclerostin antibodies. The next treatments for osteoporosis? 2016

Chapurlat, Roland. ·Inserm UMR 1033, université de Lyon, 69437 Lyon, France; Service de rhumatologie et de pathologie osseuse, hôpital E.-Herriot, 5, place d'Arsonval, 69437 Lyon, France. Electronic address: roland.chapurlat@inserm.fr. ·Joint Bone Spine · Pubmed #26919802.

ABSTRACT: -- No abstract --

3 Editorial Is it time for treat to target strategy in osteoporosis? 2016

Chapurlat, Roland. ·Inserm UMR 1033, université de Lyon, 69437 Lyon, France; Service de rhumatologie et de pathologie osseuse, hôpital E.-Herriot, 5, place d'Arsonval, 69437 Lyon, France. Electronic address: roland.chapurlat@inserm.fr. ·Joint Bone Spine · Pubmed #26875064.

ABSTRACT: -- No abstract --

4 Review Bone turnover: Biology and assessment tools. 2018

Szulc, Pawel. ·INSERM UMR 1033, University of Lyon, Hôpital Edouard Herriot, Place d'Arsonval, 69437, Lyon, France. Electronic address: pawel.szulc@inserm.fr. ·Best Pract Res Clin Endocrinol Metab · Pubmed #30449551.

ABSTRACT: Bone turnover includes two processes: resorption (removal of old bone) and formation (laying down of new bone). N-terminal propeptide of type I procollagen (PINP) and C-telopeptide of type I collagen (CTX-I) are markers of bone formation and resorption, respectively, that the International Osteoporosis Foundation and the International Federation of Clinical Chemistry recommend for clinical use. Bone turnover markers (BTM) are subject to sources of variability, including feeding (lower resorption) and recent fracture (increased levels of all markers). Controllable patient-related factors should be adapted as much as possible (eg blood collection after an overnight fast) to minimize pre-analytical variability. Uncontrollable factors should be considered in the interpretation of the BTM measurements. BTM do not improve prediction of bone loss or fracture within an individual. In osteoporotic patients, BTM may help to assess the response to anabolic and antiresorptive therapies, to assess compliance to the treatment, or to indicate possible secondary causes of osteoporosis. BTM reflect changes in bone metabolism induced by anti-osteoporotic treatment. Anti-resorptive drugs induce a rapid dose-dependent decrease in bone resorption, whereas bone formation stimulating medications increase the levels of bone formations markers. BTM may be used for monitoring anti-osteoporosis therapy. The expected effect during the anti-resorptive therapy is to decrease the PINP by at least 10 ng/mL and to attain the target level of less than 35 ng/mL. The expected effect during the bone formation-stimulating therapy is to increase the PINP by at least 10 ng/mL and to attain the target level of more than 69 ng/mL.

5 Review Use of bone turnover markers in postmenopausal osteoporosis. 2017

Eastell, Richard / Szulc, Pawel. ·Academic Unit of Bone Metabolism, University of Sheffield, Sheffield, UK. Electronic address: r.eastell@sheffield.ac.uk. · INSERM UMR 1033, University of Lyon, Hôpital Edouard Herriot, Lyon, France. ·Lancet Diabetes Endocrinol · Pubmed #28689768.

ABSTRACT: Bone turnover comprises two processes: the removal of old bone (resorption) and the laying down of new bone (formation). N-terminal propeptide of type I procollagen (PINP) and C-telopeptide of type I collagen (CTX-I) are markers of bone formation and resorption, respectively, that are recommended for clinical use. Bone turnover markers can be measured on several occasions in one individual with good precision. However, these markers are subject to several sources of variability, including feeding (resorption decreases) and recent fracture (all markers increase for several months). Bone turnover markers are not used for diagnosis of osteoporosis and do not improve prediction of bone loss or fracture within an individual. In untreated women, very high bone turnover marker concentrations suggest secondary causes of high bone turnover (eg, bone metastases or multiple myeloma). In people with osteoporosis, bone turnover markers might be useful to assess the response to anabolic and antiresorptive therapies, to assess compliance to therapy, or to indicate possible secondary osteoporosis. Much remains to be learnt about how bone turnover markers can be used to monitor the effect of stopping bisphosphonate therapy (eg, to identify a threshold above which restarting therapy should be considered). More studies are needed to investigate the use of bone turnover markers for assessment of the bone safety of new medications.

6 Review Use of CTX-I and PINP as bone turnover markers: National Bone Health Alliance recommendations to standardize sample handling and patient preparation to reduce pre-analytical variability. 2017

Szulc, P / Naylor, K / Hoyle, N R / Eastell, R / Leary, E T / Anonymous3591104. ·INSERM UMR 1033, Hôpital Edouard Herriot, University of Lyon, Pavillon F, Place d'Arsonval, 69437, Lyon, France. pawel.szulc@inserm.fr. · Academic Unit of Bone Metabolism and Mellanby Centre for Bone Research, University of Sheffield, Sheffield, UK. · , Murnau, Germany. · ETL Consulting, Seattle, WA, 98177, USA. · Pacific Biomarkers, Seattle, WA, 98119, USA. ·Osteoporos Int · Pubmed #28631236.

ABSTRACT: The National Bone Health Alliance (NBHA) recommends standardized sample handling and patient preparation for C-terminal telopeptide of type I collagen (CTX-I) and N-terminal propeptide of type I procollagen (PINP) measurements to reduce pre-analytical variability. Controllable and uncontrollable patient-related factors are reviewed to facilitate interpretation and minimize pre-analytical variability. INTRODUCTION: The IOF and the International Federation of Clinical Chemistry (IFCC) Bone Marker Standards Working Group have identified PINP and CTX-I in blood to be the reference markers of bone turnover for the fracture risk prediction and monitoring of osteoporosis treatment. Although used in clinical research for many years, bone turnover markers (BTM) have not been widely adopted in clinical practice primarily due to their poor within-subject and between-lab reproducibility. The NBHA Bone Turnover Marker Project team aim to reduce pre-analytical variability of CTX-I and PINP measurements through standardized sample handling and patient preparation. METHODS: Recommendations for sample handling and patient preparations were made based on review of available publications and pragmatic considerations to reduce pre-analytical variability. Controllable and un-controllable patient-related factors were reviewed to facilitate interpretation and sample collection. RESULTS: Samples for CTX-I must be collected consistently in the morning hours in the fasted state. EDTA plasma is preferred for CTX-I for its greater sample stability. Sample collection conditions for PINP are less critical as PINP has minimal circadian variability and is not affected by food intake. Sample stability limits should be observed. The uncontrollable aspects (age, sex, pregnancy, immobility, recent fracture, co-morbidities, anti-osteoporotic drugs, other medications) should be considered in BTM interpretation. CONCLUSION: Adopting standardized sample handling and patient preparation procedures will significantly reduce controllable pre-analytical variability. The successful adoption of such recommendations necessitates the close collaboration of various stakeholders at the global stage, including the laboratories, the medical community, the reagent manufacturers and the regulatory agencies.

7 Review Osteoporosis and ischemic cardiovascular disease. 2017

Laroche, Michel / Pécourneau, Virginie / Blain, Hubert / Breuil, Véronique / Chapurlat, Roland / Cortet, Bernard / Sutter, Bruno / Degboe, Yannick / Anonymous2270887. ·Centre de rhumatologie, hôpital Pierre-Paul-Riquet, CHU de Purpan, 1, place du Dr-Baylac, 31059 Toulouse cedex, France. Electronic address: laroche.m@chu-toulouse.fr. · Centre de rhumatologie, hôpital Pierre-Paul-Riquet, CHU de Purpan, 1, place du Dr-Baylac, 31059 Toulouse cedex, France. · Service de rhumatologie, CHU de Nice, 06003 Nice, France. · Service de rhumatologie, CHU E.-Herriot, 69003 Lyon, France. · Service de rhumatologie, CHU de Lille, 59000 Lille, France. · Institut de médecine nucléaire, institut Calot, 62600 Berk-sur-Mer, France. ·Joint Bone Spine · Pubmed #27838246.

ABSTRACT: Osteoporosis and cardiovascular disease were long viewed as independent of each other. However, numerous epidemiological studies, which are discussed in the first part of this review, have provided incontrovertible evidence of a link. Thus, the risk of coronary artery disease and stroke is higher in patients with a history of osteoporotic fracture or low bone mineral density than in non-osteoporotic patients. In the other direction, patients with cardiovascular disease are at higher risk for bone loss and osteoporotic fracture. The link between osteoporosis and cardiovascular disease is due in part to shared conventional risk factors such as estrogen deprivation in women, smoking, low physical activity, and diabetes. In addition, atheroma plaque calcification involves cytokines and growth factors that also play a role in bone turnover, including proinflammatory cytokines (IL-6 and TNFα), osteoprotegerin, sclerostin, matrix GLA protein, and FGF-23. Several recent studies have provided support for these pathophysiological hypotheses. Thus, elevation of osteoprotegerin, sclerostin, or FGF-23 levels may explain and predict the occurrence of both osteoporotic fractures and cardiovascular events. The association between osteoporosis and cardiovascular disease found in most epidemiological and pathophysiological studies suggests a need for evaluating potential benefits from routine bone absorptiometry and osteoporotic fracture detection in patients with cardiovascular disease and from exercise testing and arterial Doppler imaging in patients with osteoporosis.

8 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.

9 Review Balancing benefits and risks of glucocorticoids in rheumatic diseases and other inflammatory joint disorders: new insights from emerging data. An expert consensus paper from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). 2016

Cooper, Cyrus / Bardin, Thomas / Brandi, Maria-Luisa / Cacoub, Patrice / Caminis, John / Civitelli, Roberto / Cutolo, Maurizio / Dere, Willard / Devogelaer, Jean-Pierre / Diez-Perez, Adolfo / Einhorn, Thomas A / Emonts, Patrick / Ethgen, Olivier / Kanis, John A / Kaufman, Jean-Marc / Kvien, Tore K / Lems, Willem F / McCloskey, Eugene / Miossec, Pierre / Reiter, Susanne / Ringe, Johann / Rizzoli, René / Saag, Kenneth / Reginster, Jean-Yves. ·MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK. cc@mrc.soton.ac.uk. · NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK. cc@mrc.soton.ac.uk. · Department of Rhumatologie, Hôpital Lariboisière Assistance Publique Hôpitaux de Paris, University Paris VII, Paris, France. · Department of Internal Medicine, University of Florence, Florence, Italy. · Department Hospitalo-Universitaire I2B, INSERM, UMR S 959, CNRS 7211, UPMC University of Paris 06, Paris, France. · Group Hospitalier Pitié-Salpêtrière, Department of Internal Medicine, Paris, France. · UCB Biosciences, 8010 Arco Corporate Drive, Raleigh, NC, USA. · Division of Bone and Mineral Diseases, Washington University, St. Louis, MO, USA. · Research Laboratories and Clinical Academic Division of Rheumatology, University Medical School of Genoa, Genoa, Italy. · Internal Medicine, University of Utah, Salt Lake City, UT, USA. · Rheumatology Department, Saint-Luc University Hospital, Louvain University in Brussels, Brussels, Belgium. · Servicio de Medicina Interna y Enfermedades Infecciosas, Hospital del Mar-IMIM and RETICEF, Barcelona, Spain. · Department of Orthopaedic Surgery, Boston University Medical Center, Boston, MA, USA. · Bone and Cartilage Metabolism Unit, Department of Public Health Sciences, University of Liege, Liège, Belgium. · Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium. · Centre for Metabolic Bone Diseases, Centre for Integrated Research in Musculoskeletal Ageing, University of Sheffield, Sheffield, UK. · Department of Endocrinology, Ghent University Hospital, Ghent, Belgium. · Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. · Department of Rheumatology, VU University Medical Hospital, Amsterdam, The Netherlands. · Immunogenomics and Inflammation Research Unit, Department of Immunology and Rheumatology, University of Lyon 1, Lyon, France. · , Bonn, Germany. · West German Osteoporosis Center (WOC), University of Cologne, Leverkusen, Germany. · Service of Bone Diseases, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland. · Division of Clinical Immunology and Rheumatology, University of Alabama, Birmingham, AL, USA. · Department of Public Health, Epidemiology and Health Economics, University of Liege, Liège, Belgium. ·Aging Clin Exp Res · Pubmed #26746234.

ABSTRACT: PURPOSE: This consensus review article considers the question of whether glucocorticoid (GC) therapy is still relevant in the treatment of rheumatic diseases, with a particular focus on rheumatoid arthritis (RA), and whether its side effects can be adequately managed. Recent basic and clinical research on the molecular, cellular and clinical effects of GCs have considerably advanced our knowledge in this field. An overview of the subject seems appropriate. METHODS: This review is the result of a multidisciplinary expert working group, organised by European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis. The recent literature was surveyed and the salient evidence synthetized. RESULTS: The pathophysiological basis of RA (and other inflammatory rheumatic diseases) now strongly implicates the adaptive immune system in addition to innate mechanisms. The molecular effect of GCs and differential GC sensitivity is better understood, although exploiting this knowledge is still in its infancy. The newer treatment strategies of early and aggressive control of RA have gr eatly improved clinical outcomes, but improvements are still possible. Newer targeted anti-inflammatory drugs have made an important impact, yet they too are associated with numerous side effects. DISCUSSION: Short durations of moderate doses of GCs are generally well tolerated and have a positive benefit/risk ratio. Patients should be assessed for fracture risk and bone preserving agents and be prescribed calcium and vitamin D supplementation. CONCLUSIONS: Within a strategy of a disease modifying approach to inflammatory disease, combination therapy including a GC is effective approach.

10 Review Adjuvant bisphosphonates in early breast cancer: consensus guidance for clinical practice from a European Panel. 2016

Hadji, P / Coleman, R E / Wilson, C / Powles, T J / Clézardin, P / Aapro, M / Costa, L / Body, J-J / Markopoulos, C / Santini, D / Diel, I / Di Leo, A / Cameron, D / Dodwell, D / Smith, I / Gnant, M / Gray, R / Harbeck, N / Thurlimann, B / Untch, M / Cortes, J / Martin, M / Albert, U-S / Conte, P-F / Ejlertsen, B / Bergh, J / Kaufmann, M / Holen, I. ·Department of Bone Oncology, Endocrinology and Reproductive Medicine, Philipps-University of Marburg, Frankfurt, Germany. · Academic Unit of Clinical Oncology, Weston Park Hospital, University of Sheffield, Sheffield r.e.coleman@sheffield.ac.uk. · Academic Unit of Clinical Oncology, Weston Park Hospital, University of Sheffield, Sheffield. · Cancer Centre London, Wimbledon, UK. · INSERM, Research Unit UMR403, University of Lyon, School of Medicine Lyon-Est, Lyon, France. · Breast Center of the Multidisciplinary Oncology Institute, Genolier, Switzerland. · Hospital de Santa Maria & Lisbon School of Medicine, Institute of Molecular Biology, Lisbon, Potugal. · CHU Brugmann, Université Libre de Bruxelles (ULB), Brussels, Belgium. · Medical School, National University of Athens, Athens, Greece. · Medical Oncology, University Campus Bio-medico, Rome, Italy. · Institute for Gynaecological Oncology, Centre for Comprehensive Gynecology, Mannheim, Germany. · Sandro Pitigliani Medical Oncology Unit, Department of Oncology, Hospital of Prato, Prato, Italy. · University of Edinburgh Cancer Research Centre, Western General Hospital, Edinburgh. · Institute of Oncology, Bexley Wing, St James Hospital Leeds, Leeds. · The Royal Marsden Hospital and Institute of Cancer Research, London, UK. · Department of Surgery and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria. · Clinical Trials and Epidemiological Unit, University of Oxford, Oxford, UK. · Breast Center, Department of Obstetrics and Gynaecology, University of Munich, Munich, Germany. · Kantonsspital St Gallen, Breast Center, St Gallen, Switzerland. · Interdisciplinary Breast Cancer Center HELIOS Klinikum Berlin-Buch Germany, Gynecologic Oncology and Obstetrics, Berlin, Germany. · Department of Oncology, Vall d'Hebron Institute of Oncology (VHIO), Barcelona. · Department of Medical Oncology, Institute of Investigation Sanitaria Gregorio Marañón, University Complutense, Madrid, Spain. · Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy. · Danish Breast Cancer Cooperative Group Statistical Center Department of Oncology Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. · Karolinska Institute and University Hospital, Stockholm, Sweden. · Institute for Obstetrics and Gynaecology, Goethe University, Frankfurt, Germany. ·Ann Oncol · Pubmed #26681681.

ABSTRACT: Bisphosphonates have been studied in randomised trials in early breast cancer to investigate their ability to prevent cancer treatment-induced bone loss (CTIBL) and reduce the risk of disease recurrence and metastasis. Treatment benefits have been reported but bisphosphonates do not currently have regulatory approval for either of these potential indications. This consensus paper provides a review of the evidence and offers guidance to breast cancer clinicians on the use of bisphosphonates in early breast cancer. Using the nominal group methodology for consensus, a systematic review of the literature was augmented by a workshop held in October 2014 for breast cancer and bone specialists to present and debate the available pre-clinical and clinical evidence for the use of adjuvant bisphosphonates. This was followed by a questionnaire to all members of the writing committee to identify areas of consensus. The panel recommended that bisphosphonates should be considered as part of routine clinical practice for the prevention of CTIBL in all patients with a T score of <-2.0 or ≥2 clinical risk factors for fracture. Compelling evidence from a meta-analysis of trial data of >18,000 patients supports clinically significant benefits of bisphosphonates on the development of bone metastases and breast cancer mortality in post-menopausal women or those receiving ovarian suppression therapy. Therefore, the panel recommends that bisphosphonates (either intravenous zoledronic acid or oral clodronate) are considered as part of the adjuvant breast cancer treatment in this population and the potential benefits and risks discussed with relevant patients.

11 Review Parkinson's disease: A risk factor for osteoporosis. 2015

Malochet-Guinamand, Sandrine / Durif, Franck / Thomas, Thierry. ·Department of Rheumatology, Clermont-Ferrand University Hospital, 63003 Clermont-Ferrand cedex 1, France. Electronic address: smalochet@chu-clermontferrand.fr. · Department of Neurology, Clermont-Ferrand University Hospital, 63003 Clermont-Ferrand cedex 1, France. · Inserm U1059, Rheumatology Department, University Hospital of Saint-Étienne, 42055 Saint-Étienne cedex 2, France. ·Joint Bone Spine · Pubmed #26453100.

ABSTRACT: Parkinson's disease is the most common neurodegenerative disease after Alzheimer's disease. On the long term, it may be complicated by various musculoskeletal problems, such as osteoporotic fractures, that have significant socioeconomic consequences. Indeed, patients suffering from Parkinson's disease have a higher fracture risk, particularly hip fracture risk, than other subjects of the same age because of both a higher risk of falls and lower bone mineral density. Bone loss in Parkinson's disease may be associated with the severity and duration of the disease. We review here the different suspected mechanisms of accelerated bone loss in Parkinson's disease, amongst which weight loss and reduced mobility appear to play key roles. Antiparkinsonian drugs, particularly levodopa, may also be associated with decreased bone mineral density as a result of hyperhomocysteinaemia. We discuss the role of other nutritional deficiencies, such as vitamin B12, folate or vitamin K. In conclusion, it seems necessary to screen for and treat osteoporosis in this at-risk population, while actions to prevent falls are still disappointing. A better understanding of the factors explaining bone loss in this population would help implementing preventive actions.

12 Review Role of cortical bone in bone fragility. 2015

Bala, Yohann / Zebaze, Roger / Seeman, Ego. ·aLaboratoire Vibration Acoustique, Institut National des Sciences Appliquées de Lyon, Campus LyonTech la Doua, Villeurbanne bINSERM UMR1033, Université de Lyon, Lyon, France cDepartment of Endocrinology dDepartment of Medicine, Austin Health, University of Melbourne, Melbourne, Australia. ·Curr Opin Rheumatol · Pubmed #26002033.

ABSTRACT: PURPOSE OF REVIEW: Trabecular bone loss and vertebral fractures are historical hallmarks of osteoporosis. During the past 70 years, this view has dominated research aiming to understand the structural basis of bone fragility. We suggest this notion needs to be revised to recognize and include the role of cortical bone deterioration as an important determinant of bone strength throughout life. RECENT FINDINGS: About 80% of the fragility fractures involve the appendicular skeleton, at regions comprising large amounts of cortical bone. Up to 70% of the age-related bone loss at these locations is the result of intracortical remodeling that cavitates cortical bone producing porosity. It is now possible to accurately quantify cortical porosity in vivo and use this information to understand the pathogenesis of bone fragility throughout life, assist in identifying patients at risk for fracture, and use this as a potential marker to monitor the effects of treatment on bone structure and strength. SUMMARY: Cortical bone has an important role in determining bone strength. The loss of strength is the result of intracortical and endocortical remodeling imbalance that produces cortical porosity and thinning. Studies are needed to determine whether porosity is an independent predictor of fracture risk and whether a reduction in porosity serves as a surrogate of antifracture efficacy.

13 Review The Role of Collagen Organization on the Properties of Bone. 2015

Garnero, Patrick. ·INSERM UMR 1033, Lyon, France, patrickgarnero@free.fr. ·Calcif Tissue Int · Pubmed #25894071.

ABSTRACT: Bone is a complex tissue constituted by a collagen matrix filled in with crystal of hydroxyapatite (HAP). Bone mechanical properties are influenced by the collagen matrix which is organized into hierarchical structures from the individual type I collagen heterotrimer flanked by linear telopeptides at each end to the collagen fibrils that are interconnected by enzymatic and non-enzymatic cross-links. Although most studies focused on the role of collagen cross-links in bone strength, other organizational features may also play a role. At the molecular level it has been shown that homotrimer of type I collagen found in bone tissue of some patients with osteogenesis imperfecta (OI) is characterized by decreased mechanical competence compared to the regular heterotrimer. The state of C-telopeptide isomerization-which can be estimated by the measurement in body fluids of the native and isomerized isoforms-has also been shown to be associated with bone strength, particularly the post-yield properties independent of bone size and bone mineral density. Other higher hierarchical features of collagen organization have shown to be associated with changes in bone mechanical behavior in ex vivo models and may also be relevant to explain bone fragility in diseases characterized by collagen abnormalities e.g., OI and Paget's disease. These include the orientation of collagen fibrils in a regular longitudinal direction, the D-spacing period between collagen fibrils and the collagen-HAP interfacial bonding. Preliminary data indicate that some of these organizational features can change during treatment with bisphosphonate, raloxifene, and PTH suggesting that they may contribute to their anti-fracture efficacy. It remains however to be determined which of these parameters play a specific and independent role in bone matrix properties, what is the magnitude of mechanical strength explained by collagen organization, whether they are relevant to explain osteoporosis-induced bone fragility, and how they could be monitored non-invasively to develop efficient bone quality biomarkers.

14 Review Impact of comorbidities on the treatment of non-Hodgkin's lymphoma: a systematic review. 2015

Terret, Catherine / Albrand, Gilles / Rainfray, Muriel / Soubeyran, Pierre. ·Department of Medical Oncology, Centre Léon Bérard, Regional Comprehensive Cancer Centre, Claude-Bernard Lyon-1 University, 28 rue Laennec, Lyon, France. ·Expert Rev Hematol · Pubmed #25771832.

ABSTRACT: Treating non-Hodgkin's lymphoma in patients with comorbidities can be challenging because of possible interactions that may alter the treatment efficacy. We conducted a systematic review to determine the impact of comorbidities on various outcomes, evaluate the current data, and provide recommendations for future research. Twenty-one articles were selected. However, the study populations and design were greatly heterogeneous, and the quality of reporting was generally weak. The majority of studies demonstrated significant impact of comorbidity on survival, reporting poorer survival rates for patients with comorbidities compared to those with no comorbidities. However, the existing evidence is limited and of insufficient quality to establish solid conclusions and to guide treatment decisions. Prospective, well-designed studies are warranted.

15 Review Emerging drugs for osteoporosis. 2014

Feurer, Elodie / Chapurlat, Roland. ·INSERM UMR 1033 - Université de Lyon, Hôpital Edouard Herriot, Hospices Civils de Lyon, Department of Rheumatology , 5, Place d'Arsonval 69003 Lyon , France +33 4 72 11 74 58 ; +33 4 72 11 74 83 ; elodiefeurer@hotmail.com. ·Expert Opin Emerg Drugs · Pubmed #24995794.

ABSTRACT: INTRODUCTION: Osteoporotic fracture is a cause of pain, loss of autonomy and excess mortality. Current drugs however, do not allow for a satisfactory non vertebral fracture risk reduction and the compliance is suboptimal. AREAS COVERED: Current treatments consist of mainly bisphosphonates, denosumabs, selective estrogen receptor modulators and teriparatides. All drugs currently in development will target some aspect of bone remodeling by using the recent advances in our knowledge of bone biology: cathepsin-K inhibitors (odanacatib) are antiresorptive, antisclerostin monoclonal antibodies (romosozumab and blosozumab) are anabolic agents and PTHrp 1-34 (abaloparatide) is an anabolic agent. EXPERT OPINION: New drugs with better tolerance and ideally with intermittent administration may improve their compliance. New drugs will have to provide higher efficiency levels with regards to reducing the risk of fractures. They may be second-line options, targeted at patients who are poor responders, or those who display contraindications to the older drugs, as a result of cost issues. In addition, some of these new drugs with potent anabolic effect may be confined to niches, for those patients at high risk of refracture after an initial severe fracture such as a hip fracture or a clinical vertebral fracture.

16 Review New developments in biological markers of bone metabolism in osteoporosis. 2014

Garnero, Patrick. ·INSERM Research Unit 1033, University of Lyon, France and Cisbio Bioassays, Codolet, France. Electronic address: patrickgarnero@free.fr. ·Bone · Pubmed #24909537.

ABSTRACT: Over the last 15 years several biological markers of bone turnover have been developed with increased specificity and sensitivity. In osteoporosis clinical studies, the IOF and IFCC organizations have recently recommended the measurements of serum type I collagen N-propeptide (PINP) and the crosslinked C-terminal telopeptide (serum CTX) as markers of bone formation and bone resorption, respectively. However these markers have some limitations including a lack of specificity for bone tissue, their inability to reflect osteocyte activity or periosteal apposition. In addition they do not allow the investigation of bone tissue quality an important determinant of skeletal fragility. To address these limitations, new developments in markers of bone metabolism have been recently achieved. These include assays for periostin, a matricellular protein preferentially localized in the periosteal tissue, sphingosine 1-phosphate, a lipid mediator which acts mainly on osteoclastogenesis and the osteocyte factors such as sclerostin and FGF-23. Recent studies have shown an association between the circulating levels of these biological markers and fracture risk in postmenopausal women or elderly men, although data require confirmation in additional prospective studies. Finally, recent studies suggest that the measurements of circulating microRNAs may represent a novel class of early biological markers in osteoporosis. It is foreseen that with the use of genomics and proteomics, new markers will be developed to ultimately improve the management of patients with osteoporosis.

17 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.

18 Review [Vitamin D: skeletal and muscular effects]. 2013

Thomas, Thierry / Briot, Karine. ·CHU de Saint-Étienne, service de rhumatologie, Inserm U1059, 42055 Saint-Étienne, France. Electronic address: thierry.thomas@chu-st-etienne.fr. ·Presse Med · Pubmed #24054764.

ABSTRACT: Insufficient serum levels of 25-hydroxyvitamin D [25(OH)D] is a risk factor for osteoporosis. A new paradigm is emerging with the locally synthesized 1,25(OH)2D within osteoblasts and osteoclasts as the essential pathway for the effects of 25(OH)D in regulating bone remodeling via direct or indirect activation of the specific receptor VDR. Vitamin D has positive effects on fracture risk, muscular function and risk of falls; these effects are observed when serum levels of 25(OH)D are above 30 ng/ml (75 nmol/l). Vitamin D dosing interval may be relevant for reducing the risk of fracture, with evidence suggesting positive effects with short intervals of 3 months or less. It is recommended to maintain an optimal serum level of 25(OH)D when managing patients with osteoporosis or at risk of this bone disease.

19 Review Drug carriers in osteoporosis: preparation, drug encapsulation and applications. 2013

Miladi, K / Sfar, S / Fessi, H / Elaissari, A. ·University of Lyon, F-69622, Lyon, France. ·Int J Pharm · Pubmed #23376227.

ABSTRACT: Carriers are largely used to enhance therapy efficiency via the encapsulation of active molecules. The encapsulation enhances the stability of drug molecules, improves the targeting properties and prolongs pharmacological activity via continuous local release of active molecules. The aim of this review is to report the carrier systems used in osteoporosis therapy. This state of the art research has mainly focused on describing all types of carriers used in this area, their elaboration and properties, the drug characteristics used in such specific application, and drug release and efficiency. In this field, various processes have been used in order to obtain well-defined capsules, spheres and more complex carriers. In this exhaustive review, each process is described, illustrated and discussed.

20 Review [Medical treatment of postmenopausal osteoporosis]. 2012

Thomas, Thierry. ·Inserm U1059, service de rhumatologie, CHU de Saint-Etienne, 42055 Saint-Etienne Cedex 2. thierry.thomas@chu-st-etienne.fr ·Rev Prat · Pubmed #22408865.

ABSTRACT: The primary objective of postmenopausal osteoporosis treatment is to reduce the risk of fragility fracture. Therefore, the necessary first step is to identify patients at high risk of fracture to treat them in the most efficient manner In case of patients with a so-called severe fracture including hip fracture, vertebral and humeral fracture, characterized by an increased risk of mortality in the following years, it is mandatory to treat osteoporosis. In the other cases with or without fracture, the decision will rely on clinical fracture risks and the result of densitometry assessment. The treatment will be prescribed for a first period of 5 years and then reassessed for deciding whether the treatment will be continued or interrupted. Reassessments will then be performed regularly. When treating is decided, the choice between the different drugs is based on their respective ability to reduce the risk of vertebral or non-vertebral fracture, their potential extra-skeletal benefits, tolerance and contra-indications as well as administration conditions which have an impact on adherence to treatment. The latter is important to obtain the expected efficacy of the treatment and it has to be clearly explained to the patient and controlled during follow-up.

21 Review [Osteoporosis without fracture: when do we treat?]. 2012

Chapurlat, Roland. ·Inserm UMR 1033, université de Lyon, service de rhumatologie et pathologie osseuse, hôpital Edouard-Herriot, 69437 Lyon Cedex 03. roland.chapurlat@inserm.fr ·Rev Prat · Pubmed #22408861.

ABSTRACT: Osteoporosis without prevalent fracture is defined by a low bone mineral density (BMD), which is a risk factor for fracture. We also use the FRAX tool to determine treatment indications. The objective of the treatment is to reduce fracture risk--which has been defined by BMD and clinical risk factors--with various types of therapeutic classes, such as bisphosphonates, strontium ranelate, denosumab and raloxifene. Calcium and vitamin D may be a useful addition.

22 Review The role of bone turnover markers in monitoring treatment in postmenopausal osteoporosis. 2012

Szulc, Pawel. ·INSERM UMR 1033, Hôpital Edouard Herriot, Pavillon F, Place d'Arsonval, 69437 Lyon, France. pawel.szulc@inserm.fr ·Clin Biochem · Pubmed #22330940.

ABSTRACT: Bone metabolism is assessed using biochemical bone turnover markers (BTM). BTM reflect the metabolic effect of drugs on bone turnover, help to establish the lowest dose inducing the largest change in the BTM, predict treatment-related reduction in fracture risk, and are helpful in bridging studies. Changes in BTM during anti-osteoporotic therapy depend on the cellular mechanism of action of the drug, degree of change in bone turnover rate and route of administration. BTM help to establish the optimal dose of anti-osteoporotic drugs because treatment-related changes in BTM are more rapid compared with change in BMD. A greater decrease in BTM levels during the first year of tantiresorptive treatment is associated with greater antifracture efficacy over 3 years. According to preliminary data, measurement of BTM can improve persistence with anti-resorptive treatment. The use of BTM to monitor anti-osteoporotic therapy in "real life" is limited at this stage.

23 Review Prognostic interest of bone turnover markers in the management of postmenopausal osteoporosis. 2012

Chopin, Florence / Biver, Emmanuel / Funck-Brentano, Thomas / Bouvard, Béatrice / Coiffier, Guillaume / Garnero, Patrick / Thomas, Thierry. ·Inserm U1059, Department of Rheumatology, University Hospital of Saint-Etienne, 42055 Saint-Etienne cedex 2, France. ·Joint Bone Spine · Pubmed #21723772.

ABSTRACT: OBJECTIVE: The aim was to review the literature dealing with the use of biochemical bone turnover markers (BTM) as predictors of bone loss and individual risk of fracture in postmenopausal osteoporosis. METHODS: We performed a generalized search in MEDLINE using Mesh Database from 1995 through 2009 with the following terms "biological markers" with "osteoporosis" or "bone resorption", or "bone fracture", "fracture risk". From this research, 197 abstracts were read, 91 articles were screened then 43 original articles were selected. RESULTS: In most of the selected articles, the upper limit of the premenopausal range was used as a cut-off definition for increased bone resorption. Based on this review, we found a moderate and positive relationship between baseline level of BTM and rate of bone loss, more particularly for high level of BTM over 2 SD, especially when high turnover is constant in repeated sampling. In addition, an increase in BTM levels is associated with an increase in the risk of hip and non-vertebral fractures in elderly women over 75 years old. This is especially demonstrated with bone resorption markers (e.g. uCTX) in the highest quartile with an 1.7 to 2.2 fold increase. The combination of data from bone mineral density (BMD) and bone resorption markers may improve fracture prediction. CONCLUSION: The measurement of BTM, together with the assessment of other risk factors including low BMD, will improve the prediction of risk fracture, but there is a lack of practical guidelines.

24 Review [Hip fracture surgery in the elderly patient: epidemiological data and risk factors]. 2011

Aubrun, Frédéric. ·Département D'anesthésie-Réanimation, Groupe Hospitalier Nord, hôpital de la Croix-Rousse de Lyon, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France. frederic.aubrun@chu-lyon.fr ·Ann Fr Anesth Reanim · Pubmed #21958698.

ABSTRACT: Health care administration is concerned about the escalating cost of geriatric trauma care and more specifically hip fracture (HF). By 2050, the wordwide annual incidence of HF among elderly people will be 4.5 million (predictible incidence in France: 150,000) and prevention will be more important than ever. The risk of hip fracture in older people increases exponentially with age. The main other risk factors are osteoporosis and osteopenia, gender, weight, physical activity. The most important cause of osteoporosis is the gradual bone loss that occurs after the menopause. Similarly, there is a strong association with gender: the female-to-male ratio of HF is greater than 2/1 in people over 50 years of age (mean age: 83.2 yrs in female and 79.6 yrs in male in France). One year mortality after hip fracture is remarkably high, around 20 to 30%.

25 Review Pathophysiology of bone loss in disuse osteoporosis. 2011

Alexandre, Christian / Vico, Laurence. ·U. Inserm 1059, université de Lyon, Saint-Etienne, France. christian.alexandre@univ-st-etienne.fr ·Joint Bone Spine · Pubmed #21664854.

ABSTRACT: Osteoporosis, or rather the localised bone loss observed in patients with spinal cord injury, as well as during any type of immobilisation involves various processes and structures including the direct response of the musculoskeletal system to unloading, the central and peripheral nervous systems and their effects on bone cells and on the vascular system, the bone remodelling unit in its marrow compartment and a number of local factors controlling cell-cell cross-talk as well as calciotropic hormones. The authors present a detailed review of these different mechanisms which are all involved regardless of the type of immobilisation: pathological, environmental, or experimental. These factors are interconnected and put bone at the centre of the regulation of body homeostasis. A better knowledge of these mechanisms should promote the development of preventive therapies for the often neglected osteoporotic fractures that occur in patients with spinal cord injury.

Next