Projects In Knowledge - Osteoporosis

Osteoporosis — Osteoporosis: A Focus on Fracture Prevention

Although current osteoporosis therapies are effective in reducing the risk of fracture and increasing bone mineral density, all have some issues that limit their use. The GI side effects of oral bisphosphonates may preclude their use in some patients, while agents requiring intravenous or subcutaneous administration may pose problems with compliance for others. Recent advances in understanding bone remodeling and the pathophysiology of osteoporosis have led to the identification of novel therapeutic targets and the development of new emerging agents. Three experts in the field – Dolores M. Shoback, MD, Paul D. Miller, MD, and E. Michael Lewiecki, MD – discuss these important advances and their implications for the treatment of patients at risk of fracture and bone loss....more

E. Lewiecki, MD, FACP, FACE

Osteoporosis — Update on Osteoporosis for the Rheumatologist

Rheumatologists see many patients who are at risk for secondary bone loss resulting from corticosteroid treatment and other factors, not only postmenopausal/elderly patients at risk for primary osteoporosis. In this webcast designed specifically for rheumatologists, four experts in the field discuss the pathophysiology of bone loss, the identification and diagnosis of patients at risk for primary and secondary osteoporosis, current and emerging treatment and prevention strategies for reducing fracture risk, and the challenges in managing osteoporosis patients. ...more

J. Adachi, MD, FRCPC

Osteoporosis — Experts Responding to Your Questions: Video Q&A

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N. Lane, MD

P. Miller, MD

D. Shoback, MD

Osteoporosis — Controversies in Targeted Therapy: Management of Recurrent Ovarian Cancer

Agents targeting the vascular endothelial growth factor (VEGF) pathway have become standard therapies in the treatment of a wide variety of solid tumors. Several of these agents, such as bevacizumab, sorafenib, and sunitinib, are now being explored in the treatment of ovarian cancer. In addition, new agents directed against nonvascular targets involved in the pathophysiology of ovarian cancer have shown promise in preliminary trials. Join Dr. Bradley J. Monk as he leads a discussion with two other experts in the field, Dr. Robert Burger and Dr. Robert Coleman, as they evaluate the benefits and risks of these exciting drugs in the treatment of ovarian cancer....more

B. Monk, MD, FACOG, FACS

Osteoporosis — Monitoring

Patients may not respond to osteoporosis therapy for a variety of reasons, including poor adherence and undiagnosed secondary medical conditions. Monitoring enables the clinician to identify those patients who are continuing to lose bone mass while on therapy and address the factors compromising response. In this chapter, Dr. E. Michael Lewiecki describes the rationale and specifics of effective monitoring....more

E. Lewiecki, MD, FACP, FACE

Osteoporosis — Management of the Postfracture Patient

Join Dr. Cheryl L. Lambing for Chapter 5 of the Osteoporosis Living Medical Textbook™ as she outlines postfracture management for patients with osteoporosis-related fractures. Whether of the wrist, hip, or spine, all fractures represent an increased risk for disability and future fracture. Know the steps of the recovery process for your patients with fractures: acute treatment, medical evaluation, and rehabilitation....more

C. Lambing, MD

Osteoporosis — Expert Insight Into: Efficacy and Safety of Balloon Kyphoplasty Compared with Nonsurgical Care for Vertebral Compression Fracture: A Randomized Controlled Trial

Most patients with painful vertebral compression fractures forego the risks of conventional open surgical repair and receive supportive care during an extensive recovery period. Balloon kyphoplasty was developed as a minimally invasive treatment for compression vertebral fractures. Dr. Cheryl L. Lambing reviews findings from a randomized trial that compared the efficacy and safety of balloon kyphoplasty and nonsurgical care for improving the quality of life of patients with acute painful vertebral compression fractures. ...more

C. Lambing, MD

Osteoporosis — Expert Insight Into: Vitamin D Deficiency is Associated with Worse Cognitive Performance and Lower Bone Density in Older African Americans

Recent studies have demonstrated several non-skeletal effects of vitamin D deficiency, including cognitive function and physical performance decrements, prompting an examination of the impact of vitamin D deficiency on these parameters in older African Americans. Dr. E. Michael Lewiecki presents the results of a recent trial comparing the association between vitamin D status and cognitive function, physical performance, and bone mineral density in older African American and European American individuals, and discusses the implications of these findings in treating older patients. ...more

E. Lewiecki, MD, FACP, FACE

Osteoporosis — Treatment of Osteoporosis

Effective osteoporosis treatment plans include a bone-active agent as well as a number of nutritional, environmental, and lifestyle modifications. Together, these pharmacologic and nonpharmacologic interventions help to build or maintain bone mass and prevent fracture. Join Drs. Paul D. Miller and Jeri W. Nieves for chapter 4 of the Osteoporosis Living Medical Textbook™ as they survey the pharmacologic and nonpharmacologic intervention options to assist clinicians in individualizing treatment plans uniquely suited to the needs of each patient....more

P. Miller, MD

J. Nieves, PhD

Osteoporosis — Expert Insight Into: IV Bisphosphonate Therapy and Clinical Fractures and Mortality After Hip Fracture

One source underlying the high rate of morbidity and mortality subsequent to hip fracture is the occurrence of new osteoporotic fractures. Pharmacologic therapy for osteoporosis, while underutilized, should reduce the rate of new osteoporotic fractures. Join Dr. Cheryl Lambing to learn about the results from the international multicenter HORIZON trial which highlighted the safety and efficacy of annual intravenous infusions of zoledronic acid in the reduction of morbidity and mortality after hip fracture....more

C. Lambing, MD

Osteoporosis — Case Study: Management of Poor Response to Bisphosphonate Therapy

In this newsletter, Dr. E. Michael Lewiecki presents the case of a 58-year-old postmenopausal woman newly diagnosed with osteoporosis who has initiated bisphosphonate therapy. Through this case, Dr. Lewiecki illustrates the importance of monitoring treatment response by outlining the essential components involved, the ins and outs of interpreting DXA BMD results correctly, and what to assess or re-evaluate when treatment response is suboptimal....more

E. Lewiecki, MD, FACP, FACE

Osteoporosis — Selecting Pharmacologic Therapy

Selecting the right pharmacologic agent to treat or prevent osteoporosis for an individual patient requires a thorough knowledge of the different mechanisms of action of these agents, as well as an understanding of the efficacy and safety profile of each. In this engaging audio interview, Dr. Cheryl Lambing and Dr. E. Michael Lewiecki discuss practical considerations in the clinical use of approved agents, and present a preview of potential new therapies on the horizon. ...more

C. Lambing, MD

E. Lewiecki, MD, FACP, FACE

Osteoporosis — Expert Insight Into: Skeletal Effects of Serotonin Reuptake Inhibitors: Evidence from Clinical Studies

Dr. E. Michael Lewiecki reviews findings from a number of epidemiologic analyses that evaluated the relationship between 5-HTT, depression, pharmacologic treatment of depression, and bone health. Dr. Lewiecki provides insights about the mechanism of action for these relationships and discusses possible strategies to improve bone health for patients treated with SSRIs....more

E. Lewiecki, MD, FACP, FACE