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Join Bone Health Experts for a Complimentary Own the Bone Regional Symposium
The Own the Bone New England Regional Symposium, held in conjunction with the AOA 124th Annual Meeting at the Westin Copley Place in Boston, will provide you with an opportunity to hear how medical practitioners and their colleagues have improved patient bone health and post-fragility fracture care at their institutions. The New England Symposium begins on Saturday, June 25th at 8:30am with the American Orthopaedic Association Annual Meeting Symposium 7, “Osteoporotic Drug Therapy Affects Orthopaedic Treatments: Fracture Healing, Spine Fusions, Arthroplasty.”
Moderator: Mathias Bostrom, MD
Panelists: Joseph Lane, MD and Susan Bukata, MD
The symposium will also feature:
• An overview of the need for systems-based interventions, such as Own the Bone.
Speaker: Andrew D. Bunta, MD
• A panel discussion about how medical practitioners have implemented these interventions within their own institutions and how they can contribute to improved outcomes for patients with fragility fractures.
Panel: Kyle J. Jeray, MD; William B. Macaulay, Jr., MD; Eric D. Newman, MD; and Meryl S. LeBoff, MD
We will kick off the New England Regional Symposium with a continental breakfast at 7:30am and will conclude at noon. Orthopaedic surgeons, non-orthopaedic physicians, nurses, residents and other healthcare practitioners interested in improving patient bone health at their institutions are encouraged to attend this informative event.
For additional information and to register, please visit www.ownthebone.org
or call 847.318.7336.
Headlines
Program Updates and Announcements:
Upcoming Bone Health Conferences: Learn More about Own the Bone
Own the Bone to be Presented at Minnesota Orthopaedic Society Annual Meeting, April 29th
University of Pennsylvania Health System Takes the Lead in Post-Fracture Care
The National Osteoporosis Foundation Invites you to Attend the 9th International Symposium on Osteoporosis
Link to Bone Health News:
Osteoporosis: Now and the Future
Can Vitamin D Supplements Help Prevent Osteoporosis?
Making Sense of Hormone Therapy After Menopause
Green Tea and Tai Chi Enhance Bone Health, Reduce Inflammation in Postmenopausal Women
USPSTF Updates Screening Recommendations for Osteoporosis
Nitroglycerin Boosts Bone Density and Bone Strength
Novel Study Confirms Strontium Ranelate's Bone-Forming Benefits
How the Medication Review Can Help to Reduce Risk of Falls in Older Patients
Common Osteoporosis Medication Reduces Mortality Risk in the Elderly
Bisphosphonate Use and the Risk of Subtrochanteric or Femoral Shaft Fractures in Older Women
Program Updates and Announcements:
Upcoming Bone Health Conferences: Learn More about Own the Bone
Visit the Own the Bone team at the following meetings to find out how Own the Bone can transform the way your hospital or medical center treats fragility fracture patients:
• Michigan Orthopaedic Society (MOS) 2011 Annual Orthopaedic Trauma Program
April 28, 2011 in Plymouth, MI
www.mosonline.org
• Wisconsin/Chicago Bone Club 16th Annual Meeting
May 7, 2011 in Fontana, WI
• National Association of Orthopaedic Nurses (NAON) 31st Annual Congress
May 15-17, 2011 in Baltimore, MD
www.orthonurse.org
• National Osteoporosis Foundation’s 9th International Symposium on Osteoporosis
May 19-21, 2011 in Las Vegas, NV
www.nof-iso.org
• Chicago Trauma Symposium 13th Annual Meeting
August 25-28, 2011 in Chicago, IL
www.chicagotraumasymposium.com
Own the Bone to be Presented at Minnesota Orthopaedic Society Annual Meeting, April 29th
Drs. Gregg Strathy and Marc Swiontkowski from the Park Nicollet Methodist Hospital/University of Minnesota will briefly present on their early experiences with the Own the Bone program on Friday, April 29th at the Minnesota Orthopaedic Society 2011 Annual Meeting at the Hyatt Regency in Minneapolis.
Are you planning to attend the MOS meeting? Don’t miss the afternoon Trauma Session to hear more about Park Nicollet Methodist Hospital’s Own the Bone program and first year data. For more information on the meeting, visit www.mnorthopaedic.org/annualmtg.asp.
University of Pennsylvania Health System Takes the Lead in Post-Fracture Care
Recently, the Hospital of the University of Pennsylvania featured their participation in Own the Bone in their online newsletter, HUPdate:
Osteoporosis causes over 1.5 million fractures each year in this country. Indeed, by 2020, half of all Americans over 50 will have -- or be at risk for -- the disease. "It’s reaching epidemic proportions," said Samir Mehta, MD, chief of Orthopaedic Trauma and Fracture Service.
The problem is two-fold, he continued. “Musculo-skeletal issues have not always been appropriately managed because they’re not high on the priority list in terms of overall health-care management,” he said. “Elderly patients rarely talk to their doctors about osteoporosis. Calcium and vitamin D intake might be poor lifelong.”
Read the full article.
The National Osteoporosis Foundation Invites you to Attend the 9th International Symposium on Osteoporosis
NOF’s Annual International Symposium on Osteoporosis (ISO9) provides the most current, clinically relevant and evidence-based information on the prevention, diagnosis and treatment of osteoporosis. This year, the National Osteoporosis Foundation will sponsor the ISO9 in Las Vegas, NV on May 18-21, 2011.
NOF meetings feature evidence-based topics relevant to clinical practice, and presentations are delivered by some of the top researchers in the field. The goal is to provide clinicians with the best available information to improve the quality of care of those at risk for osteoporosis and fractures. The latest information about the meeting as well as the most up-to-date program agenda is posted on the NOF website for the meeting at www.nof-iso.org.
Highlights of the program this year include:
• The inaugural Lawrence G. Raisz, MD Memorial Lecture;
• Healthy Bones, Build Them for Life™ Consumer and Patient Forum (Saturday);
• Silhouette Awards Dinner, NOF’s premier fundraising event;
• NOF-ASBMR jointly-sponsored session New Horizons in Bone Research
• Cutting edge clinical presentations on diagnosis and treatment of osteoporosis and much more.
The National Osteoporosis Foundation is the leading consumer and community-focused health organization dedicated to the prevention of osteoporosis and broken bones, the promotion of strong bones for life and the reduction of human suffering through programs of public and clinician awareness, education, advocacy and research. For registration information, follow this link: www.nof-iso.org.
Bone Health News:
Osteoporosis: Now and the Future
As the country's population continues to age, the medical and socioeconomic effect of osteoporosis, particularly postmenopausal osteoporosis, is expected to increase. A thorough understanding of bone biology with molecular insights into the communication between bone-forming osteoblasts and bone-resorbing osteoclasts and the orchestrating signaling network has led to the identification of new therapeutic targets. New treatment strategies aim to inhibit excessive bone resorption and increase bone formation. The most promising new treatments include; denosumab, a monoclonal antibody for receptor activator of NF- B ligand, a key osteoclast cytokine; odanacatib, a specific inhibitor of the osteoclast protease cathepsin K; and antibodies against the proteins sclerostin and dickkopf-1, two endogenous inhibitors of bone formation. There are also several new antiosteoporotic compounds currently in advanced clinical trials, indicating that the number of available drugs will increase considerably in the near future. While available antiresorptive treatments are effective, some are limited by side-effects, concurrent comorbidities, and inadequate long-term compliance. Many of the new drugs combine efficacy with convenient administration that could improve adherence. With numerous new drugs on the edge of clinical approval, treatment for osteoporosis could become more complex, particularly for general practitioners. Consequently, the successful integration of new compounds into an evidence-based concept of osteoporosis therapy requires simple and applicable tools for clinical decision making.
From "Osteoporosis: Now and the Future"
Lancet (04/09/11) Vol. 377, No. 9773, P. 1276 Rachner, Tilman D.; Khosla, Sundeep; Hofbauer, Lorenz C.
Can Vitamin D Supplements Help Prevent Osteoporosis?
Vitamin D is an element of treatment for osteoporosis, and whether it also should be administered as a precautionary measure and in what dosages is the subject of an intense debate. Last year British scientists published a review of studies that concentrated on roughly 100,000 middle-aged and elderly participants, comparing vitamin D levels in the blood with the tendency to suffer from cardiovascular diseases, type 2 diabetes, and metabolic syndrome. They learned that people with higher vitamin D levels were 50 percent as likely to suffer from type 2 diabetes and metabolic syndrome, and 33 percent as likely to have a cardiovascular disease. Helmut Schatz with the German Society of Endocrinology recommends the judicious use of vitamin D supplements, and says they are only medically advisable when additional risk factors for osteoporosis are evident, such as advanced age and risk of falling, or diminished bone density. The Washington, D.C.-based Institute of Medicine recently said that a vitamin D blood level of 20 ng/ml was sufficient for sound bones in most people, while Michael Amling with the Center for Biomechanics and Skeletal Biology in Germany thinks a level of 30 ng/ml is desirable. The Dachverband Osteologie currently advises 800 to 2,000 international units of vitamin D combined with 1,000 mg of calcium daily in osteoporosis cases. Supplements sold in health food stores and supermarkets have lower than recommended dosages overall. Experts urge people to consult a physician before taking high dosages due to potential side effects.
From "Can Vitamin D Supplements Help Prevent Osteoporosis?"
Deutsche Presse Agentur (Germany) (04/11/11) Loell, Christiane
Making Sense of Hormone Therapy After Menopause
A new government-sponsored study has found that estrogen-only therapy may be less dangerous than previously thought. The research was based on findings of the multicenter Women's Health Initiative (WHI), which was discontinued in early in 2002 after initial findings showed that the added hormones can increase breast cancer risk while doing nothing to protect the heart. But one arm of the study, in which women with hysterectomies were given estrogen-only treatment, continued. Researchers reported in the Journal of the American Medical Association that women who use estrogen for the short period around menopause do not need to worry about long-term health problems such as blood clots and strokes associated with the therapy. Three years after stopping the therapy, the risk of heart disease, stroke and blood clots among women taking the pills dropped back to the same levels as those not taking hormones. The small benefit that hormone therapy also had on preventing bone fractures, however, disappeared as well. Women who experience severe symptoms of menopause are advised to take the combination of estrogen and progestin therapy for a short period of time during and following menopause, but should not continue to take the pills in order to protect against heart disease. To lower the risk of fractures, there are other medications that are not hormone-based that can protect bone.
From "Making Sense of Hormone Therapy After Menopause"
Time (04/08/11) Park, Alice
Green Tea and Tai Chi Enhance Bone Health, Reduce Inflammation in Postmenopausal Women
Researchers are exploring the health benefits of green tea. Chwan-Li Shen, an associate professor and a researcher at the Laura W. Bush Institute for Women's Health at the Texas Tech University Health Sciences Center, says green tea contains polyphenols, which are known for their potential antioxidant activity. Dozens of observational studies have shown that people who consume the highest levels of green tea polyphenols (GTP) tend to have a lower risk of several chronic degenerative diseases like osteoporosis. It is believed that the mechanism behind this correlation may have to do with lowering chronic levels of inflammation. Shen has developed an animal model that enables her to study the effects of green tea consumption on protection against the breakdown of the bone's microarchitecture, which, in humans, can result in osteoporosis. Shen hopes that what she learns from her animal models may be applicable to postmenopausal women. Shen's most recent research focused on the potential for green tea to work synergistically with tai chi to enhance bone strength. The study of 171 postmenopausal women showed that the consumption of GTP at a level equal to about four to six cups of green tea a day, and tai chi enhanced markers of bone health after 3 and 6 months. Participants in tai chi classes also showed significant beneficial effects in quality of life in regards to their emotional and mental health. Perhaps the most remarkable result was the effect that both GTP and tai chi had on biological markers of oxidative stress, a main precursor to inflammation. The study suggests that green tea and tai chi may help reduce the underlying etiology of not only osteoporosis but of other inflammatory diseases as well.
From "Green Tea and Tai Chi Enhance Bone Health, Reduce Inflammation in Postmenopausal Women"
PhysOrg.com (04/10/11)
USPSTF Updates Screening Recommendations for Osteoporosis
The U.S. Preventive Services Task Force (USPSTF) has updated its screening recommendations for osteoporosis, now recommending that all women ages 65 and older be routinely screened for osteoporosis. USPSTF also recommends that younger women with increased risk factors for osteoporosis be screened if their fracture risk is equal to or greater than that of a 65-year-old white woman who has no additional risk factors. White women are used as the benchmark because they have a markedly higher rate of osteoporosis and fractures than other ethnic groups. Risk factors for osteoporosis include tobacco use, alcohol use, low body mass and parental history of fractures. The USPSTF also looked at whether to recommend screening men for osteoporosis but found insufficient evidence to make a recommendation at this time.
Osteoporosis screening involves a measurement of bone density, which is currently covered by Medicare. The most commonly used bone density measurement tests are dual-energy x-ray absorptiometry (DXA) of the hip and lumbar spine, as well as quantitative ultrasound of the heel, although current diagnostic and treatment criteria are based on DXA tests alone. USPSTF noted that there is a lack of evidence about how often screening should be repeated in women whose first test is negative.
From "Screening for Osteoporosis: U.S. Preventive Services Task Force Recommendation Statement"
Annals of Internal Medicine (01/17/11)
Nitroglycerin Boosts Bone Density and Bone Strength
Nitroglycerin may be an effective therapy to strengthen bones and treat osteoporosis, according to research published in the February 23 issue of the Journal of the American Medical Association. Researchers followed 243 postmenopausal women for 24 months in a single center, double-blind, placebo controlled study. The women, none of whom had osteoporosis, were randomly assigned to receive either nitroglycerin ointment or a placebo. They pasted the ointment onto their skin at bedtime. After two years, the women who were assigned to the nitroglycerin ointment group saw an increase of 7 percent in the bone mineral density in their hip bones compared to women who were given a placebo. “One of the most striking effects was the increase in cortical width or the thickness of the bone,” said the researchers. “The nitroglycerin group saw an increase of almost 25 percent in their legs and an increase of 15 percent in their arms, compared to the placebo group. This was unexpected because it’s not something you see with existing therapies.” There were some side effects of the treatment, however. About a quarter of women had headaches with nitroglycerin and did not participate in the study. Of women who were enrolled, about 5 percent stopped because of headaches.
From "Nitroglycerin Boosts Bone Density and Bone Strength"
Newswise (02/22/11)
Novel Study Confirms Strontium Ranelate's Bone-Forming Benefits
A study presented at the 2011 European Congress on Osteoporosis and Osteoarthritis reports that in postmenopausal women with postmenopausal women with osteoporosis, strontium ranelate creates significantly greater bone-forming activity than bisphosphonate alendronate. The study team says that the results are not unexpected, given that alendronate is purely an antiresorptive agent while strontium ranelate reduces bone resorption and increases bone formation. The researchers say that what is interesting is the use of before and after bone biopsies to actually see strontium ranelate's bone-forming capabilities. Until this study, there had been very limited data on paired bone biopsies in patients receiving strontium ranelate, according to study investigator Louis-Georges Ste-Marie, MD, director of the Metabolic Bone Diseases Laboratory at the Centre de recherche du CHUM, L'Hôpital Saint-Luc, in Montreal, Quebec, Canada. Ste-Marie says there is a major need for this kind of study to obtain more information on the specific mechanisms of action of the drug. Study coinvestigator Roland D. Chapurlat, MD, PhD, says that after 6 and 12 months of treatment, mineralizing surfaces had improved significantly more in women who received strontium ranelate treatments than in women who were treated with alendronate. "The bone-forming activity seen here can be attributed to strontium ranelate's unique mechanism of action, which, unlike bisphosphonates that block bone resorption and formation, combines the dual effects of increasing or maintaining bone formation and decreasing bone resorption," says Ste-Marie.
From "Novel Study Confirms Strontium Ranelate's Bone-Forming Benefits"
Medscape (03/25/11) Brooks, Megan
How the Medication Review Can Help to Reduce Risk of Falls in Older Patients
During annual appointments with elderly patients, there are several things physicians can do to assess a patient's risk of falling. Patients may have several risk factors, including vision problems, age, and the use of medications associated with an increased risk of falling. An estimated one-third of adults 65 years or older will fall annually, and 50 percent of adults over 80 years will suffer a fall. Of those who fall, 30 percent will sustain moderate to severe injuries, such as hip fractures or traumatic brain injuries. Research over recent years has shown that falling is not inevitable, but rather the result of several modifiable risk factors, including medication. Medications are a well-recognized contributing factor to falls in older adults. Careful medication review is important for all patients, particularly the elderly, who tend to take more medications and have more adverse drug reactions. Reviewing and modifying medications have been shown to reduce the risk of falls, particularly when done as part of a multifactorial fall reduction plan. Possibly inappropriate or unnecessary medications prescribed to older adults has been associated with impaired muscle strength and functionality, increased healthcare costs, and an increased risk of hospitalization and death. Reviewing and modifying prescriptions can significantly decrease the risk of falls.
From "How the Medication Review Can Help to Reduce Risk of Falls in Older Patients"
Journal of the American Academy of Physician Assistants (04/01/2011) Kelly, Danielle M.; Frick, Ellen M.; Hale, LaDonna S.
Common Osteoporosis Medication Reduces Mortality Risk in the Elderly
Bisphosphonate medication commonly prescribed for osteoporosis seems to lower mortality rates among older adults, according to a study published in the Journal of Clinical Endocrinology and Metabolism. The research determined that the per-year mortality rate for bisphosphonate-taking individuals over 60 years of age was approximately five times lower than for those not on medications. The University of Washington School of Medicine says that bisphosphonates treat osteoporosis by preventing the absorption of bone minerals by specialized cells known as osteoclasts. Considering the length of time that participants outlived the initial Australian Dubbo Osteoporosis Epidemiology Study checkup in 1989, the researchers ascertained that zero treatment resulted in 3.46 deaths per 100 person-years (DPP) among women, and 4.3 DPP among men. The mortality rate of women taking bisphosphonates was 0.76 DPP, while men had a mortality rate of 0.99 DPP. The mortality rate among women was improved to 1.2 DPP by hormone therapy. The researchers assessed that calcium and vitamin D therapy only yielded a slight mortality rate reduction, in women to 3.18 DPP and in men to 3.13 DPP. Their findings indicate that bisphosphonates may have an appreciable beneficial effect on the mortality rate of adults with osteoporosis.
From "Common Osteoporosis Medication Reduces Mortality Risk in the Elderly"
EndocrineWeb (03/23/2011)
Bisphosphonate Use and the Risk of Subtrochanteric or Femoral Shaft Fractures in Older Women
A new analysis of 205,466 postmenopausal women indicates that women who take oral bisphosphonates for more than five years were found to have a 2.7-fold greater risk of subtrochanteric or femoral shaft fractures compared to those who took them for less than 100 days. The study participants all began oral bisphosphonate therapy between 2002 and 2008. They were observed until the spring of 2009, during which time 716 were hospitalized for subtrochanteric or femoral shaft fractures. These cases were matched with almost 3,600 women in the group who did not suffer the fractures. A secondary analysis found that women who took a bisphosphonate for three or more years had about a 24 percent lower risk of osteoporosis-related fractures than women who took the drugs for less than 100 days.
From "Bisphosphonate Use and the Risk of Subtrochanteric or Femoral Shaft Fractures in Older Women"
Journal of the American Medical Association (02/22/11) Vol. 305, No. 8, P. 783 Park-Wyllie, Laura Y.; Mamdami, Muhammad; Juurlink, David N.; et al.
Abstract News © Copyright 2011 INFORMATION, INC.
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