The annual meeting of the American Society for Bone and Mineral Research took place Oct. 15 to 19 in Toronto and attracted approximately 5,000 participants from around the world, with more than 1,500 scientific abstracts presented. The conference highlighted the latest advances in bone and mineral research as well as new technologies and clinical treatments in bone disease and disorders of mineral metabolism.
An expert panel convened by the American Society of Bone and Mineral Research presented data on the risk of unusual femur fractures associated with bisphosphonates. The international, multi-disciplinary task force performed a review of published and unpublished data and interviewed scientists at the U.S. Food and Drug Administration and at pharmaceutical companies that sell bisphosphonates. While concerns remain regarding the risk of atypical fractures associated with long-term use of bisphosphonates, the panel said the risk appears to be relatively small.
"Atypical fractures occur in half of 1 percent of hip and thigh fractures. So, in the context of hip and thigh fracture risk, the risk is very small compared to common fractures," said task force co-chair, Elizabeth Shane, M.D., of Columbia University in New York City.
The task force reviewed 310 cases of atypical femur fractures and found that 291 patients (94 percent) had taken bisphosphonates, most for more than five years. While the risk of atypical fractures remains limited, practicing clinicians should understand the benefits of bisphosphonates for preventing common fractures and be aware that patients typically present with warning signs prior to atypical fractures.
"The benefits of bisphosphonates outweigh the potential risks, as many more common fractures can be avoided as compared to the risk of atypical fractures," Shane added. "Approximately 75 percent of patients who experienced an atypical fracture had pain in the thigh or groin. Practicing clinicians should query patients taking bisphosphonates for extended periods of time if they are experiencing pain. If patients develop persistent pain, then an X-ray should be ordered. Both sides should be X-rayed because atypical femur fractures are bilateral in about 25 percent of cases."
Overall, Shane concluded that the benefits of bisphosphonates in the prevention of common fractures outweigh the risk of atypical fractures associated with long-term use.
Two presentations and six posters at the conference focused on the efficacy of an investigational cathepsin-K inhibitor, odanacatib, in development for the treatment of osteoporosis in postmenopausal women. In one study, the investigators found that odanacatib reduced bone resorption markers and progressively increased bone mineral density (BMD) over a four-year period. The investigators extended a two-year base study of 141 postmenopausal women with low bone mass another two years to assess the efficacy and long-term safety of odanacatib compared to placebo.
Between years three and four of treatment, the investigators found an increase in BMD at the lumbar spine and hip among postmenopausal women treated with 50 mg of odanacatib weekly for four years. However, the 38 women who received odanacatib for two years during the base study and were switched to placebo for the two-year extension showed a reverse in BMD levels that returned to near baseline levels.
"The clinical and preclinical data being presented show [a] long-term increase in BMD and impact on bone formation with odanacatib therapy. We are continuing our strong and long-standing commitment to the field of osteoporosis with a large and rigorous Phase III program to evaluate the long-term efficacy and safety of odanacatib," Albert Leung, M.D., the executive director of clinical research at Merck Research Laboratories, said in a statement.
ASBMR: Osteoporosis Screening Interval Assessed
MONDAY, Oct. 18 (HealthDay News) -- Baseline bone mineral density (BMD) appears to be the most important determinant of the osteoporosis screening interval among postmenopausal women, according a study presented at the annual meeting of the American Society for Bone and Mineral Research, held from Oct. 15 to 19 in Toronto.
ASBMR: Teriparatide Improves Outcomes After Oral Surgery
MONDAY, Oct. 18 (HealthDay News) -- Teriparatide therapy of six weeks duration after periodontal surgery appears to be associated with greater resolution of osseous defects and improved clinical outcomes among patients with severe periodontal disease, according to a study published online Oct. 16 in the New England Journal of Medicine to coincide with a presentation at the annual meeting of the American Society for Bone and Mineral Research, held from Oct. 15 to 19 in Toronto.
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