Medicine and Health Sciences Commons^™

Presentation Of A Peri-Prosthetic Atypical Femur Fracture After Long Term Anti-Resorptive Medication Use, Jennifer B. Bamford, Jennifer Kelly

Larner College of Medicine Faculty Publications

Peri-prosthetic atypical femur fractures are rare. Most are associated with the use of long-term bisphosphonates and other anti-resorptive medications. This case highlights a 74-year-old female treated with approximately 13 years of bisphosphonate therapy followed by a short course of denosumab, who suffered an atraumatic peri-prosthetic fracture after a several month prodrome. This case report's objectives are to show how the prodrome presents, increase recognition of the condition and work up prior to fracture, and emphasize the need to consider drug holidays.

Bone Health Management In The Continuum Of Prostate Cancer Disease, Ettickan Boopathi, Ruth Birbe, Sunday A. Shoyele, Robert B. Den, Thangavel Chellappagounder

Department of Medicine Faculty Papers

Prostate cancer (PCa) is the second-leading cause of cancer-related deaths in men. PCa cells require androgen receptor (AR) signaling for their growth and survival. Androgen deprivation therapy (ADT) is the preferred treatment for patients with locally advanced and metastatic PCa disease. Despite their initial response to androgen blockade, most patients eventually will develop metastatic castration-resistant prostate cancer (mCRPC). Bone metastases are common in men with mCRPC, occurring in 30% of patients within 2 years of castration resistance and in >90% of patients over the course of the disease. Patients with mCRPC-induced bone metastasis develop lesions throughout their skeleton; the 5-year …

Therapeutic Approaches To Alter Mineral Formation And Growth In Vascular Calcification, Amirala Bakhshiannik

FIU Electronic Theses and Dissertations

Cardiovascular diseases represent the global leading cause of morbidity and mortality. Cardiovascular calcification is the most significant predictor of cardiovascular events, but no therapeutic options exist to prevent or treat mineral formation in the vasculature. The presence of bone-like mineral increases cardiac work required to move blood through systemic circulation and can lead to mechanical stress in atherosclerotic plaques, promoting plaque rupture events that cause heart attacks. Clinical trials correlated bisphosphonates (BiPs), common anti-osteoporosis pharmaceuticals, with contradicting cardiovascular outcomes. Here, we demonstrated the importance of treatment timing in BiP-induced mineral disruption or promotion. We showed that BiPs can alter morphological …

Nanoanalytical Analysis Of Bisphosphonate-Driven Alterations Of Microcalcifications Using A 3d Hydrogel System And In Vivo Mouse Model, Jessica L. Ruiz, Joshua D. Hutcheson, Luis Cardoso, Amirala Bakhshian Nik, Alexandra Condado De Abreu, Tan Pham, Fabrizio Buffolo, Sara Busatto, Stefania Frederici, Andrea Ridolfi, Masanori Aikawa, Sergio Bertazzo, Paolo Bergese, Sheldon Weinbaum, Elena Aikawa

Publications and Research

Vascular calcification predicts atherosclerotic plaque rupture and cardiovascular events. Retrospective studies of women taking bisphosphonates (BiPs), a proposed therapy for vascular calcification, showed that BiPs paradoxically increased morbidity in patients with prior acute cardiovascular events but decreased mortality in event-free patients. Calcifying extracellular vesicles (EVs), released by cells within atherosclerotic plaques, aggregate and nucleate calcification. We hypothesized that BiPs block EV aggregation and modify existing mineral growth, potentially altering microcalcification morphology and the risk of plaque rupture. Three-dimensional (3D) collagen hydrogels incubated with calcifying EVs were used to mimic fibrous cap calcification in vitro, while an ApoE−/− mouse was used …

Mortality Risk Reduction Differs According To Bisphosphonate Class: A 15-Year Observational Study, D Bliuc, T Tran, T Van Geel, J D. Adachi, C Berger, J Van Den Bergh, John A. Eisman, P Geusens, D Golzman, D A. Hanley, R G. Josse, S Kaiser, C S. Kovacs, L Langsetmo, J C. Prior, T V. Nguyen, J R. Center

Medical Papers and Journal Articles

Summary: In this prospective cohort of 6120 participants aged 50+, nitrogen-bisphosphonates but not non-nitrogen bisphosphonates were associated with a significant 34% mortality risk reduction compared to non-treated propensity score matched controls. These findings open new avenues for research into mechanistic pathways.

Introduction: Emerging evidence suggests that bisphosphonates (BP), first-line treatment of osteoporosis, are associated with reduced risks for all-cause mortality. This study aimed to determine the association between different BP types and mortality risk in participants with or without a fracture.

Methods: A prospective cohort study of users of different BPs matched to non-users by propensity score (age, gender, co-morbidities, …

Changes In The Utilization Of Osteoporosis Drugs After The 2010 Fda Bisphosphonate Drug Safety Communication, Bander Balkhi, Enrique Seoane-Vazquez, Rosa Rodriguez-Monguio

Pharmacy Faculty Articles and Research

Introduction

In October 2010, the US Food and Drug Administration (FDA) issued a safety communication regarding the risks of atypical fractures of the femur, with bisphosphonates drugs. This study evaluated the impact of the bisphosphonates FDA safety communication on the utilization of osteoporosis medications in Medicaid programs.

Methods

Osteoporosis drugs utilization data from the July 2006 to June 2014 were extracted from the national Summary Files from the Medicaid State Drug Utilization Data maintained by the Centers for Medicare & Medicaid Services (CMS). We performed an interrupted time series analyses to evaluate trends in utilization of osteoporosis drugs before and …

Changes In The Utilization Of Osteoporosis Drugs After The 2010 Fda Bisphosphonate Drug Safety Communication, Bander Balkhi, Enrique Seoane-Vazquez, Rosa Rodriguez-Monguio

Pharmacy Faculty Articles and Research

Introduction

In October 2010, the US Food and Drug Administration (FDA) issued a safety communication regarding the risks of atypical fractures of the femur, with bisphosphonates drugs. This study evaluated the impact of the bisphosphonates FDA safety communication on the utilization of osteoporosis medications in Medicaid programs.

Methods

Osteoporosis drugs utilization data from the July 2006 to June 2014 were extracted from the national Summary Files from the Medicaid State Drug Utilization Data maintained by the Centers for Medicare & Medicaid Services (CMS). We performed an interrupted time series analyses to evaluate trends in utilization of osteoporosis drugs before and …

Zoledronic Acid Alters Hematopoiesis And Generates Breast Tumor-Suppressive Bone Marrow Cells., Jessalyn M. Ubellacker, Marie-Therese Haider, Molly J. Decristo, Gloria Allocca, Nicola J. Brown, Daniel P. Silver, Ingunn Holen, Sandra S. Mcallister

Department of Medical Oncology Faculty Papers

BACKGROUND: The bone-targeting agent zoledronic acid (ZOL) increases breast cancer survival in subsets of patients, but the underlying reasons for this protective effect are unknown. ZOL modulates the activity of osteoclasts and osteoblasts, which form hematopoietic stem cell niches, and therefore may affect hematopoietic cells that play a role in breast cancer progression.

METHOD: Immunocompetent and immunocompromised strains of mice commonly used for breast cancer research were injected with a single, clinically relevant dose of ZOL (100 μg/kg) or vehicle control. The effects of ZOL on the bone marrow microenvironment (bone volume, bone cell number/activity, extracellular matrix composition) were established …

Microscopic Evaluations Of Bone In Equine And Muroid Models, Heather Ashley Richbourg

LSU Doctoral Dissertations

The use of advanced imaging techniques has greatly improved orthopedic research and education. Histology of bone is a method of evaluating bone morphology, bony cells, and bone remodeling in two-dimensions, while micro-computed tomography (microCT) is a three-dimensional analysis of bone morphology. Combined, these methods assist in providing a comprehensive analysis of bone. In this dissertation, these techniques were utilized to answer questions currently outstanding in veterinary medicine: the effect of bisphosphonates on equine bone, and variation in murine tarsal anatomy. Bisphosphonates are drugs that reduce osteoclast-mediated bone resorption and have recently been approved for the use in horses. Despite prolific …

The Development And Impact Of Heterotopic Ossification In Burns: A Review Of Four Decades Of Research, Rachel Kornhaber, Nichola Foster, Dale Edgar, Denis Visentin, Elad Ofir, Josef Haik, Moti Harats

Physiotherapy Papers and Journal Articles

Introduction: Heterotopic ossification (HO) is the formation of lamellar bone within connective and other tissue where bone should not form and is a rare complication after burn injury. However, it leads to severe pain and distress, marked reduction in joint range of motion (ROM), impaired function and increased hospital length of stay. The pathophysiology, incidence and risk factors of HO remain poorly understood in burns and other traumas and the management, controversial. The aim of this comprehensive review, therefore, was to synthesise the available evidence on the development and treatment of HO after acute burn injury.

Methods: The review was …

Denosumab Use In A Patient With Bisphosphonate-Resistant Humoral Hypercalcemia Of Malignancy, Maali M. Milhem Md, Adeel Mahmood Md, John Leidy Md-Phd

Marshall Journal of Medicine

ABSTRACT

Objective: To describe the use of denosumab as an option for treating bisphosphonate-resistant humoral hypercalcemia of malignancy.

Methods: We present the clinical history and laboratory findings of a patient with a review of related literature.

Results: A 62 year-old male with stage IV laryngeal squamous cell carcinoma and lung metastases had multiple hospital admissions for asymptomatic hypercalcemia. The patient had no known bone metastases. His laboratory data showed a high calcium level, a low level of intact PTH and a high level of PTHrP, which confirmed the diagnosis of humoral hypercalcemia of malignancy. There was atypically an elevated level …

Histological Changes In The Bone Structure Induced At 12 Weeks By Experimental Administration Of Bisphosphonates, Horea Artimoniu Almaşan, Mihaela Baciut, Oana Cristina Almaşan, Simion Bran, Grigore Baciut

Turkish Journal of Veterinary & Animal Sciences

Histological changes in bone structure were induced at 12 weeks by experimental administration of bisphosphonates, which have been associated with osteonecrosis of the jaws. The purpose of this study was to determine the effect of local administration of bisphosphonate on bone formation in rats. Surgically created bone defects were evaluated at 12 weeks by histological examination after bisphosphonate administration. Fifteen Wistar rats that underwent surgery to create a bone defect at the right femur were divided in 3 groups: 2 experimental groups and a control group. The 1st experimental group received bisphosphonate as a single 1-mL dose into the bone …

Factors Associated With Screening Or Treatment Initiation Among Male United States Veterans At Risk For Osteoporosis Fracture, Richard E. Nelson, Jonathan R. Nebeker, Brian C. Sauer, Joanne Lafleur

Public Health Resources

Male osteoporosis continues to be under-recognized and undertreated in men. An understanding of which factors cue clinicians about osteoporosis risk in men, and which do not, is needed to identify areas for improvement. This study sought to measure the association of a provider's recognition of osteoporosis with patient information constructs that are available at the time of each encounter. Using clinical and administrative data from the Veterans Health Administration system, we used a stepwise procedure to construct prognostic models for a combined outcome of osteoporosis diagnosis, treatment, or a bone mineral density (BMD) test order using time-varying covariates and Cox …

Panuveitis After Intravenous Injection Of Bisphosphonate: A Casereport, Chi-Kai You, Si-Huei Lee, Chen-Liang Chou

Rehabilitation Practice and Science

As human life expectancy has increased, osteoporosis has become a major epidemic disorder. The most common consequences of this are fractures in different parts of the body. In addition to regular follow-up tests of bone-mineral density, treatment methods include: 1. increasing the dietary intake of calcium and vitamin D, 2. maintenance of body weight, avoiding alcohol and tobacco, regular exercise, and fall prevention, 3. medications, the most widely used being bisphosphonates. Bisphosphonates can limit bone loss via the inhibition of osteoclasts. They have been widely prescribed for senile osteoporosis, osteoporosis due to administration of steroids, bone loss due to malignancies …