In recent years,growth hormone and insulin-like growth factors have become key regulators of bone metabolism and remodeling,crucial for maintaining healthy bone mass throughout life.Studies have shown that adult growt...In recent years,growth hormone and insulin-like growth factors have become key regulators of bone metabolism and remodeling,crucial for maintaining healthy bone mass throughout life.Studies have shown that adult growth hormone deficiency leads to alterations in bone remodeling,significantly affecting bone microarchitecture and increasing fracture risk.Although recombinant human growth hormone replacement therapy can mitigate these adverse effects,improving bone density,and reduce fracture risk,its effectiveness in treating osteoporosis,especially in adults with established growth hormone deficiency,seems limited.Bisphosphonates inhibit bone resorption by targeting farnesyl pyrophosphate synthase in osteoclasts,and clinical trials have confirmed their efficacy in improving osteoporosis.Therefore,for adult growth hormone deficiency patients with osteoporosis,the use of bisphosphonates alongside growth hormone replacement therapy is recommended.展开更多
Objective: To study the prevalence of bisphosphonate-related osteonecrosis of the jaw (BRONJ) and to determine the risk factors associated with the occurrence of this pathology. Method: An observational retrospective ...Objective: To study the prevalence of bisphosphonate-related osteonecrosis of the jaw (BRONJ) and to determine the risk factors associated with the occurrence of this pathology. Method: An observational retrospective study was conducted in the Department of Oncology, Rheumatology, and Maxillofacial Surgery of Ibn Rochd University Hospital, Casablanca. The study utilized complete medical records from 2014 to 2022 and included consultations of patients receiving bisphosphonates (BPs) in July and September 2022. Statistical analysis was performed using SPSS version 16.0. Results: Our study population comprised 104 patients, of whom 91% were women and 49% were over 65 years old. Seventy-two percent of patients had a general pathology. Among them, 64 patients were treated with zoledronate, 43 with alendronate, and the remainder with risedronate, ibandronate, and pamidronate. The most common indications for treatment were bone metastasis following breast cancer (29.8%) and osteoporotic fractures (19.2%). Sixty-seven patients received intravenous (IV) treatment;only 10.5% exhibited good oral health. Fifty percent of patients underwent dental treatment, primarily tooth extractions. Osteonecrosis of the jaw (ONJ) was diagnosed in 1.9% of patients, predominantly in stages 1 and 2. Conclusion: Second and third-generation bisphosphonates are more strongly associated with the development of ONJ. Risk factors include monthly IV administration, poor oral health, comorbidities such as diabetes, medications like corticosteroids, invasive dental procedures, and not only oncological conditions but also rare indications such as bone algodystrophy. Nevertheless, our observed prevalence of 1.9% aligns with international rates ranging from 0.8% to 12%. However, most of the studies that have been carried out have been retrospective studies with insufficient numbers of patients. Further prospective epidemiological studies based on standardized protocols with rigorous and appropriate follow-up over several years are essential to determine the exact prevalence of ONJ.展开更多
BACKGROUND Mineral bone disease is associated with chronic kidney disease and persists after kidney transplantation.Immunosuppressive treatment contributes to the patho-genesis of this disease.Bisphosphonate treatment...BACKGROUND Mineral bone disease is associated with chronic kidney disease and persists after kidney transplantation.Immunosuppressive treatment contributes to the patho-genesis of this disease.Bisphosphonate treatments have shown positive but inde-finite results.AIM To evaluate the effectiveness and safety of bisphosphonate treatment on post kidney transplantation bone mineral density(BMD).METHODS We included kidney transplant recipients(KTRs)whose BMD was measured after the operation but before the initiation of treatment and their BMD was measured at least one year later.We also evaluated the BMD of KTRs using two valid mea-surements after transplantation who received no treatment(control group).RESULTS Out of 254 KTRs,62(39 men)were included in the study.Bisphosphonates were initiated in 35 KTRs in total(20 men),1.1±2.4 years after operation and for a period of 3.9±2.3 years while 27(19 men)received no treatment.BMD improved significantly in KTRs who received bisphosphonate treatments(from-2.29±1.07 to-1.66±1.09,P<0.0001).The control group showed a non-significant decrease in BMD after 4.2±1.4 years of follow-up after surgery.Kidney function was not affected by bisphosphonate treatment.In KTRs with established osteoporosis,active treatment had a similar and significant effect on those with osteopenia or normal bone mass.CONCLUSION In this retrospective study of KTRs receiving bisphosphonate treatment,we showed that active treatment is effective in preventing bone loss irrespective of baseline BMD.展开更多
目的系统评价使用双膦酸盐药物(bisphosphonates,BPs)患者种植体早期失败率及种植术后药物相关性颌骨坏死(medication-related osteonecrosis of the jaw,MRONJ)发生率,为临床评估相关风险提供依据。方法计算机检索Cochrane Library、Wi...目的系统评价使用双膦酸盐药物(bisphosphonates,BPs)患者种植体早期失败率及种植术后药物相关性颌骨坏死(medication-related osteonecrosis of the jaw,MRONJ)发生率,为临床评估相关风险提供依据。方法计算机检索Cochrane Library、Wiley Online Library、PubMed、中国知网、万方数据知识服务平台,收集纳入各数据库建库至2022年5月发表的关于使用BPs患者种植体早期失败或种植术后发生MRONJ的临床研究。采用Stata 15.0软件对种植体早期失败率进行单组率Meta分析。结果共纳入13篇文献,其中口服BPs患者植入1182颗种植体,静脉注射BPs患者植入79颗,共计1261颗种植体。口服BPs患者合并种植体早期失败率为1.7%(95%CI:0.3%~3.9%),MRONJ发生率为0。静脉注射BPs患者种植体早期失败率为0,MRONJ发生率为5.6%。结论口服BPs患者种植体早期失败率及术后MRONJ发生率低,与健康人群基本相当。静脉使用BPs患者种植术后发生MRONJ风险较高,临床适应证选择应慎重。展开更多
BACKGROUND Mazabraud’s syndrome(MS)is a rare and slowly progressive benign disease characterized by the concurrent presence of fibrous dysplasia of bone and intramuscular myxoma,and is thought to be associated with m...BACKGROUND Mazabraud’s syndrome(MS)is a rare and slowly progressive benign disease characterized by the concurrent presence of fibrous dysplasia of bone and intramuscular myxoma,and is thought to be associated with mutations of the GNAS gene.To date,only about 100 cases of MS have been reported in the literature,but its standard treatment strategy remains unclear.CASE SUMMARY We report two cases of MS in young women who underwent different treatments based on their symptoms and disease manifestations.The first patient,aged 37,received internal fixation and intravenous bisphosphonate for a pathological fracture of the right femoral neck,excision of a right vastus medialis myxoma was subsequently performed for pain control,and asymptomatic psoas myxomas were monitored without surgery.Genetic testing confirmed a GNAS gene mutation in this patient.The second patient,aged 24,underwent right vastus intermedius muscle myxoma resection,and conservative treatment for fibrous dysplasia of the ilium.These patients were followed-up for 17 months and 3 years,respectively,and are now in a stable condition.CONCLUSION Various treatments have been selected for MS patients who suffer different symptoms.The main treatment for myxomas is surgical resection,while fibrous dysplasia is selectively treated if the patient experiences pathological fracture or severe pain.However,given the documented instances of malignant transformation of fibrous dysplasia in individuals with MS,close follow-up is necessary.展开更多
目的:分析双膦酸盐类药物对前列腺癌患者总生存期(OS)及骨转移的影响,为探讨双膦酸盐类药物改善前列腺癌预后提供依据。方法:采用计算机并配合手工检索中国知网、万方数据库、维普数据库、Web of Science、PubMed、Embase及Cochrane Lib...目的:分析双膦酸盐类药物对前列腺癌患者总生存期(OS)及骨转移的影响,为探讨双膦酸盐类药物改善前列腺癌预后提供依据。方法:采用计算机并配合手工检索中国知网、万方数据库、维普数据库、Web of Science、PubMed、Embase及Cochrane Library,搜索截止时间为2024年1月,检索文章为公开发表的关于双膦酸盐类药物辅助治疗前列腺癌的所有随机对照试验。主要观察指标包括患者OS、风险比(HR)及其95%置信区间(95%CI),次要指标为骨转移引起的骨痛和骨相关事件(SREs)等不良事件的发生率。使用Revman、Stata软件进行Meta分析。结果:共纳入10项随机对照试验。Meta分析结果显示,双膦酸盐辅助治疗组和安慰剂组之间的OS结果为阴性(HR=-0.07,95%CI:-0.21~0.07,P=0.331);SREs发生率无明显改变(OR=0.88,95%CI:0.69~1.13,Z=-0.993,P>0.05),差异均无统计学意义。结论:双膦酸盐类药物无法延缓前列腺癌患者的病情进展和延长生存期,也无法降低骨转移所致SREs等不良事件的发生率。展开更多
基金This work was supported by the Special Project of Performance Incentive and Guidance for Scientific Research Institutions of Chongqing,China (jxyn2022-5)。
文摘In recent years,growth hormone and insulin-like growth factors have become key regulators of bone metabolism and remodeling,crucial for maintaining healthy bone mass throughout life.Studies have shown that adult growth hormone deficiency leads to alterations in bone remodeling,significantly affecting bone microarchitecture and increasing fracture risk.Although recombinant human growth hormone replacement therapy can mitigate these adverse effects,improving bone density,and reduce fracture risk,its effectiveness in treating osteoporosis,especially in adults with established growth hormone deficiency,seems limited.Bisphosphonates inhibit bone resorption by targeting farnesyl pyrophosphate synthase in osteoclasts,and clinical trials have confirmed their efficacy in improving osteoporosis.Therefore,for adult growth hormone deficiency patients with osteoporosis,the use of bisphosphonates alongside growth hormone replacement therapy is recommended.
文摘Objective: To study the prevalence of bisphosphonate-related osteonecrosis of the jaw (BRONJ) and to determine the risk factors associated with the occurrence of this pathology. Method: An observational retrospective study was conducted in the Department of Oncology, Rheumatology, and Maxillofacial Surgery of Ibn Rochd University Hospital, Casablanca. The study utilized complete medical records from 2014 to 2022 and included consultations of patients receiving bisphosphonates (BPs) in July and September 2022. Statistical analysis was performed using SPSS version 16.0. Results: Our study population comprised 104 patients, of whom 91% were women and 49% were over 65 years old. Seventy-two percent of patients had a general pathology. Among them, 64 patients were treated with zoledronate, 43 with alendronate, and the remainder with risedronate, ibandronate, and pamidronate. The most common indications for treatment were bone metastasis following breast cancer (29.8%) and osteoporotic fractures (19.2%). Sixty-seven patients received intravenous (IV) treatment;only 10.5% exhibited good oral health. Fifty percent of patients underwent dental treatment, primarily tooth extractions. Osteonecrosis of the jaw (ONJ) was diagnosed in 1.9% of patients, predominantly in stages 1 and 2. Conclusion: Second and third-generation bisphosphonates are more strongly associated with the development of ONJ. Risk factors include monthly IV administration, poor oral health, comorbidities such as diabetes, medications like corticosteroids, invasive dental procedures, and not only oncological conditions but also rare indications such as bone algodystrophy. Nevertheless, our observed prevalence of 1.9% aligns with international rates ranging from 0.8% to 12%. However, most of the studies that have been carried out have been retrospective studies with insufficient numbers of patients. Further prospective epidemiological studies based on standardized protocols with rigorous and appropriate follow-up over several years are essential to determine the exact prevalence of ONJ.
文摘BACKGROUND Mineral bone disease is associated with chronic kidney disease and persists after kidney transplantation.Immunosuppressive treatment contributes to the patho-genesis of this disease.Bisphosphonate treatments have shown positive but inde-finite results.AIM To evaluate the effectiveness and safety of bisphosphonate treatment on post kidney transplantation bone mineral density(BMD).METHODS We included kidney transplant recipients(KTRs)whose BMD was measured after the operation but before the initiation of treatment and their BMD was measured at least one year later.We also evaluated the BMD of KTRs using two valid mea-surements after transplantation who received no treatment(control group).RESULTS Out of 254 KTRs,62(39 men)were included in the study.Bisphosphonates were initiated in 35 KTRs in total(20 men),1.1±2.4 years after operation and for a period of 3.9±2.3 years while 27(19 men)received no treatment.BMD improved significantly in KTRs who received bisphosphonate treatments(from-2.29±1.07 to-1.66±1.09,P<0.0001).The control group showed a non-significant decrease in BMD after 4.2±1.4 years of follow-up after surgery.Kidney function was not affected by bisphosphonate treatment.In KTRs with established osteoporosis,active treatment had a similar and significant effect on those with osteopenia or normal bone mass.CONCLUSION In this retrospective study of KTRs receiving bisphosphonate treatment,we showed that active treatment is effective in preventing bone loss irrespective of baseline BMD.
文摘目的系统评价使用双膦酸盐药物(bisphosphonates,BPs)患者种植体早期失败率及种植术后药物相关性颌骨坏死(medication-related osteonecrosis of the jaw,MRONJ)发生率,为临床评估相关风险提供依据。方法计算机检索Cochrane Library、Wiley Online Library、PubMed、中国知网、万方数据知识服务平台,收集纳入各数据库建库至2022年5月发表的关于使用BPs患者种植体早期失败或种植术后发生MRONJ的临床研究。采用Stata 15.0软件对种植体早期失败率进行单组率Meta分析。结果共纳入13篇文献,其中口服BPs患者植入1182颗种植体,静脉注射BPs患者植入79颗,共计1261颗种植体。口服BPs患者合并种植体早期失败率为1.7%(95%CI:0.3%~3.9%),MRONJ发生率为0。静脉注射BPs患者种植体早期失败率为0,MRONJ发生率为5.6%。结论口服BPs患者种植体早期失败率及术后MRONJ发生率低,与健康人群基本相当。静脉使用BPs患者种植术后发生MRONJ风险较高,临床适应证选择应慎重。
基金Supported by National Natural Science Foundation of China,No.81702662.
文摘BACKGROUND Mazabraud’s syndrome(MS)is a rare and slowly progressive benign disease characterized by the concurrent presence of fibrous dysplasia of bone and intramuscular myxoma,and is thought to be associated with mutations of the GNAS gene.To date,only about 100 cases of MS have been reported in the literature,but its standard treatment strategy remains unclear.CASE SUMMARY We report two cases of MS in young women who underwent different treatments based on their symptoms and disease manifestations.The first patient,aged 37,received internal fixation and intravenous bisphosphonate for a pathological fracture of the right femoral neck,excision of a right vastus medialis myxoma was subsequently performed for pain control,and asymptomatic psoas myxomas were monitored without surgery.Genetic testing confirmed a GNAS gene mutation in this patient.The second patient,aged 24,underwent right vastus intermedius muscle myxoma resection,and conservative treatment for fibrous dysplasia of the ilium.These patients were followed-up for 17 months and 3 years,respectively,and are now in a stable condition.CONCLUSION Various treatments have been selected for MS patients who suffer different symptoms.The main treatment for myxomas is surgical resection,while fibrous dysplasia is selectively treated if the patient experiences pathological fracture or severe pain.However,given the documented instances of malignant transformation of fibrous dysplasia in individuals with MS,close follow-up is necessary.
文摘目的:分析双膦酸盐类药物对前列腺癌患者总生存期(OS)及骨转移的影响,为探讨双膦酸盐类药物改善前列腺癌预后提供依据。方法:采用计算机并配合手工检索中国知网、万方数据库、维普数据库、Web of Science、PubMed、Embase及Cochrane Library,搜索截止时间为2024年1月,检索文章为公开发表的关于双膦酸盐类药物辅助治疗前列腺癌的所有随机对照试验。主要观察指标包括患者OS、风险比(HR)及其95%置信区间(95%CI),次要指标为骨转移引起的骨痛和骨相关事件(SREs)等不良事件的发生率。使用Revman、Stata软件进行Meta分析。结果:共纳入10项随机对照试验。Meta分析结果显示,双膦酸盐辅助治疗组和安慰剂组之间的OS结果为阴性(HR=-0.07,95%CI:-0.21~0.07,P=0.331);SREs发生率无明显改变(OR=0.88,95%CI:0.69~1.13,Z=-0.993,P>0.05),差异均无统计学意义。结论:双膦酸盐类药物无法延缓前列腺癌患者的病情进展和延长生存期,也无法降低骨转移所致SREs等不良事件的发生率。
