References of "Bruyère, Olivier"
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See detailBMD in men: which normative data?
Richy, Florent; Gourlay, M.; Ethgen, Olivier ULg et al

in Osteoporosis International (2004, May), 15(Suppl.1), 54

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See detailDo patients with osteoporotic hip fracture recover their initial health-related quality of life?
Ethgen, Olivier ULg; Tancredi, Annalisa ULg; Jacques, Jessica ULg et al

in Osteoporosis International (2004, May), 15(Suppl.1), 50

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See detailEvaluation of the relationship between IGF-1, IGF-BP3, BMD and age in men presenting at a multiple risk detection campaign
Hanssens, L.; Tancredi, Annalisa ULg; DeCeulaer, F. et al

in Osteoporosis International (2004, May), 15(Suppl.1), 48-49

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See detailRecommendations for the use of new methods to assess the efficacy of disease-modifying drugs in the treatment of osteoarthritis
Abadie, Eric ULg; Ethgen, Dominique ULg; Avouac, Bernard ULg et al

in Osteoarthritis and Cartilage (2004), 12(4), 263-268

Background: Recent innovations in the pharmaceutical drug discovery environment have generated new chemical entities with the potential to become disease modifying drugs for osteoarthritis (DMOAD's ... [more ▼]

Background: Recent innovations in the pharmaceutical drug discovery environment have generated new chemical entities with the potential to become disease modifying drugs for osteoarthritis (DMOAD's). Regulatory agencies acknowledge that such compounds may be granted a DMOAD indication, providing they demonstrate that they can slow down disease progression; progression would be calibrated by a surrogate for structural change, by measuring joint space narrowing (JSN) on plain X-rays with the caveat that this delayed JSN translate into a clinical benefit for the patient. Recently, new technology has been developed to detect a structural change of the OA joint earlier than conventional X-rays. Objective: The Group for the Respect of Ethics and Excellence in Science (GREES) organized a working party to assess whether these new technologies may be used as surrogates to plain x-rays for assessment of DMOADs. Methods: GREES includes academic scientists, members of regulatory authorities and representatives from the pharmaceutical industry. After an extensive search of the international literature, from 1980 to 2002, two experts meetings were organized to prepare a resource document for regulatory authorities. This document includes recommendations for a possible update of guidelines for the registration of new chemical entities in osteoarthritis. Results: Magnetic resonance imaging (MRI) is now used to measure parameters of cartilage morphology and integrity in OA patients. While some data are encouraging, correlation between short-term changes in cartilage structure observed with MRI and long-term radiographic or clinical changes are needed. Hence, the GREES suggests that MRI maybe used as an outcome in phase II studies, but that further data is needed before accepting MRI as a primary end-point in phase III clinical trials. Biochemical markers of bone and cartilage remodelling are being tested to predict OA and measure disease progression. Recently published data are promising but validation as surrogate end-points for OA disease progression requires additional study. The GREES suggests that biochemical markers remain limited to 'proof of concept' studies or as secondary end-points in phase II and III clinical trials. However, the GREES emphasizes the importance of acquiring additional information on biochemical markers in order to help better understand the mode of action of drugs to be used in OA. Regulatory agencies consider that evidence of improvement in clinical outcomes is critical for approval of DMOAD. Time to total joint replacement surgery is probably the most relevant clinical end-point for the evaluation of efficacy of a DMOAD. However, at this time, time to surgery can not be used in clinical trials because of bias by non disease-related factors like patient willingness for surgery or economic factors. At this stage, it appears that DMOAD should demonstrate a significant difference compared to placebo. Benefit should be measured by 3 co-primary end-points: JSN, pain and function. Secondary end-points should include the percentage of patients who are 'responder' (or 'failure'). The definition of a 'failure' patient would be someone with progression of JSN>0.5 mm over a period of 2-3 years or who has a significant worsening in pain and/or function, based on validated cut-off values. The definition of the clinically relevant cut-off points for pain and function must be based on data evaluating the natural history of the disease (epidemiological cohorts or placebo groups from long-term studies). These cut-offs points should reflect a high propensity, for an individual patient, to later require joint replacement. Conclusion: GREES has outlined a set of guidelines for the development of a DMOAD for OA. Although these guidelines are subject to change as new information becomes available, the information above is based on the present knowledge in the field with the addition of expert opinion. (C) 2004 OsteoArthritis Research Society International. Published by Elsevier Ltd. All rights reserved. [less ▲]

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See detailEfficacy of alphacalcidol and calcitriol in primary and corticosteroid-induced osteoporosis: a meta-analysis of their effects on bone mineral density and fracture rate
Richy, F.; Ethgen, Olivier ULg; Bruyère, Olivier ULg et al

in Osteoporosis International (2004), 15(4), 301-310

Vitamin D metabolites alphacalcidol and calcitriol (D-hormones) have been investigated for two decades, but few and conflicting results are available from high-quality randomized controlled trials. Our ... [more ▼]

Vitamin D metabolites alphacalcidol and calcitriol (D-hormones) have been investigated for two decades, but few and conflicting results are available from high-quality randomized controlled trials. Our objectives were to provide an evidence-based update quantitatively summarizing their efficacy on bone mineral density (BMD) and fracture rate. We performed a systematic research of any randomized controlled trial containing relevant data, peer review, data extraction and quality scoring blinded for authors and data sources, and comprehensive meta-analyses of the relevant data. Inclusion criteria were: randomized controlled study, calcitriol or alphacalcidol, BMD or fractures in healthy/osteopenic/osteoporotic patients exposed or not to corticosteroids (CS). Analyses were performed in a conservative fashion using professional dedicated softwares and stratified by outcome, target patients, study quality, and control-group type. Results were expressed as effect size (ES) for bone loss or relative risk (RR) for fracture while allocated to D-hormones vs control. Publication bias and robustness were investigated. Of the trials that were retrieved and subsequently reviewed, 17 papers fitted the inclusion criteria and were assessed. Quality scores ranged from 20 to 100%, the mean (standard deviation) being 72 (22)%. Calcitriol and alphacalcidol were found to have the same efficacy on all outcomes at p>0.13. We globally assessed D-hormones effects in preventing bone loss in patients not exposed to CS, and found positive effect: ES=0.39 (p<0.001). For lumbar spine, this particular effect was 0.43 (p<0.001). D-hormones significantly reduced the overall fracture rates: RR=0.52 (0.46; 0.59) and both vertebral and non-vertebral fractures: RR=0.53 (0.47; 0.60) and RR=0.34 (0.16; 0.71), respectively. No statistical difference in response was observed between results from studies on healthy and osteoporotic patients or depending on the fact that controls were allowed to calcium supplementation. Treatment with D-hormones was evaluated for maintaining spinal bone mass in five trials of patients with CS-induced osteoporosis, and provided ES=0.43 at p<0.001. Only two studies specifically addressed the effects of calcitriol on spinal fracture rate. None of them provided significant results, and the global RR did not reach the significance level as well: RR=0.33 (0.07; 1.51). Our data demonstrated efficacy for DH on bone loss and fracture prevention in patients not exposed to CS and on bone loss in patients exposed to CS, in the light of the most reliable scientific evidence. Their efficacy in reducing the number of fractures in patients exposed to CS remains to be determined. [less ▲]

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See detailSocial support and health-related quality of life in hip and knee osteoarthritis
Ethgen, Olivier ULg; Vanparijs, Philippe ULg; Delhalle, S. et al

in Quality of Life Research (2004), 13(2), 321-330

Objective: To document the association between social support and health-related quality of life (HRQoL) in hip and knee osteoarthritis (OA). Methods: A prospective survey including the SF-36 and the ... [more ▼]

Objective: To document the association between social support and health-related quality of life (HRQoL) in hip and knee osteoarthritis (OA). Methods: A prospective survey including the SF-36 and the Social Support questionnaire (SSQ) was administered to 108 hip and knee OA patients attending an outpatient physical rehabilitation and rheumatology clinic. Multiple regression analysis were performed to study the relation between social support and each dimension of the SF-36, controlling for age, sex, body mass index, number of comorbid conditions, socioeconomic status, site of survey completion and severity of OA which was gauged with the pain dimension of the WOMAC, an OA-specific health status instrument. Results: Greater social companionship transactions were associated with higher physical functioning ( standardized regression coefficients: beta = 0.26, p < 0.01), general health (β = 0.32, p < 0.001), mental health (beta = 0.25, p < 0.01), social functioning (β = 0.20, p < 0.05) and vitality ( b = 0.25, p < 0.05). Satisfaction with problem-oriented emotional support was related to better physical functioning (β = 0.22, p < 0.01), mental health (beta = 0.38, p < 0.001), role-emotional (B = 0.23, p < 0.01), social functioning (beta = 0.19, p < 0.05) and vitality ( b = 0.26, p < 0.01). Conclusion: Social support components significantly account for HRQoL. Health interventions in OA, primary dedicated to pain and physical disability, could be supplemented with social support component to enhance health outcomes. [less ▲]

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See detailReduction in PINP, a marker of bone metabolism, with raloxifene treatment and its relationship with vertebral fracture risk
Reginster, Jean-Yves ULg; Sarkar, S.; Zegels, Brigitte ULg et al

in BONE (2004), 34(2), 344-351

In the Multiple Outcomes of Raloxifene Evaluation (MORE) trial, 7705 postmenopausal women with osteoporosis, defined by low bone mineral density and/or prevalent vertebral fractures (VF), were randomized ... [more ▼]

In the Multiple Outcomes of Raloxifene Evaluation (MORE) trial, 7705 postmenopausal women with osteoporosis, defined by low bone mineral density and/or prevalent vertebral fractures (VF), were randomized to placebo or raloxifene (60 or 120 mg/day). All women received daily calcium (500 mg) and vitamin D (400-600 IU) supplements. Our previous analyses found that changes in BMD and biochemical markers of bone turnover are poorly predictive of the reduction in VF risk observed with raloxifene. This present study evaluated the effects of raloxifene on type I procollagen N-terminal propeptide (PINP), a new marker of bone turnover. Logistic regression analysis models evaluated the relationships between the changes at 1 year in PINP, serum osteocalcin (OC), bone-specific alkaline phosphatase (BSAP), and urinary excretion of type I collagen C-telopeptide fragments normalized to creatinine (CTx/Cr), and the risk of new VF at 3 years for placebo and pooled raloxifene. A subset of 967 women (mean age = 68 years) from the MORE cohort had PINP, OC, BSAP, and CTx evaluated at baseline. Both doses of raloxifene significantly decreased (P < 0.001) all biochemical markers of bone turnover from baseline. Compared to baseline, PINP levels were decreased by medians of 11.0% and 40.8% in the placebo and pooled raloxifene groups, respectively. In addition, the placebo and pooled raloxifene groups decreased serum OC by 8.5% and 31.8%, BSAP by 15.8% and 34.6%, and urinary CTx/Cr excretion by 5.6% and 46.5%, respectively, from baseline. In the pooled raloxifene group, the logistic regression relationship between 3-year VF risk and 1-year percentage change for each biochemical marker was statistically significant with PINP (slope estimate = 0.0085, P = 0.009), OC (slope estimate = 0.0068, P = 0.035), and BSAP (slope estimate = 0.0056, P = 0.039), but not with CTx/Cr (slope estimate = 0.0027, P = 0.192). Furthermore, the percent decrease in PINP at 1 year could account for 28% of the total reduction in vertebral fracture risk. In conclusion, a 1-year decrease in PINP, BSAP, or OC, but not CTx/Cr, may be predictive of the 3-year VF risk reduction with raloxifene therapy in this subset of postmenopausal women with osteoporosis. [less ▲]

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See detailValidation and comparative evaluation of the osteoporosis self-assessment tool (OST) in a Caucasian population from Belgium
Richy, F.; Gourlay, M.; Ross, P. D. et al

in QJM : Monthly Journal of the Association of Physicians (2004), 97(1), 39-46

BACKGROUND: Risk indices have been developed to identify women at risk of low bone mineral density (BMD) who should undergo BMD testing. Aim: To compare the performance of four risk indices in White ... [more ▼]

BACKGROUND: Risk indices have been developed to identify women at risk of low bone mineral density (BMD) who should undergo BMD testing. Aim: To compare the performance of four risk indices in White ambulatory women in Belgium. DESIGN: Epidemiological cross-sectional study. METHODS: Records were analysed for 4035 postmenopausal White women without Paget's disease or advanced osteoarthritis, seen at an out-patient osteoporosis centre between January 1996 and September 1999. Osteoporosis risk index scores were compared to bone density T-scores. The ability of each risk index to identify women with low BMD (T-score < -2.0) or osteoporosis (T < -2.5) was evaluated. RESULTS: Using an Osteoporosis Self-Assessment Tool (OST) score <2 to recommend DXA referral, sensitivity ranged from 85% at the lumbar spine to 97% at the total hip to detect BMD T-scores of <or= -2.5, and specificity ranged from 34% at the total hip to 37% at the femoral neck and lumbar spine. The negative predictive value was high at all skeletal sites (89-99%), demonstrating the usefulness of the OST to identify patients who have normal BMD and should not receive DXA testing. All risk indices performed similarly, although the OST had somewhat better sensitivity and somewhat lower specificity than the other indices at the cut-offs evaluated. Among the 11-12% of women who were classified as highest risk using OST or the Osteoporosis Index of Risk (OSIRIS), 81-85% had low bone mass and 68-74% had osteoporosis. DISCUSSION: The performance of these risk indices among women in Belgium was similar to that reported earlier for other samples in Asian countries, the US, and the Netherlands. The OST and other risk indices are effective and efficient tools to help target high-risk women for DXA testing. [less ▲]

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See detailFrom sample size to effect-size : small study effect investigation (SSEi)
Richy, F.; Ethgen, Olivier ULg; Bruyère, Olivier ULg et al

in Internet Journal of Epidemiology (2004), 1(2),

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See detailResponders to glucosamine sulfate in knee osteoarthritis
Bruyère, Olivier ULg; Pavelka, K.; Richy, F. et al

in Osteoporosis International (2004), 12(SB), 76

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See detailResponders to glucosamine sulfate in knee osteoarthritis
Bruyère, Olivier ULg; Pavelka, Karel; Richy, Florent et al

in Arthritis and Rheumatism (2004), 50(suppl.1), 29

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See detailA critical analysis of the efficacy of estrogens on spinal and non-spinal fracture reduction
REGINSTER, Jean-Yves ULg; Richy, Florent; Bruyère, Olivier ULg

in Reproduction Humaine et Hormones (2004), XVII(5), 419-423

During more than 20 years, estrogens replacement therapy (ERT) has been consistently regarded as the first choice for prevention of trabecular and cortical bone loss in postmenopausal women. However ... [more ▼]

During more than 20 years, estrogens replacement therapy (ERT) has been consistently regarded as the first choice for prevention of trabecular and cortical bone loss in postmenopausal women. However, there are more doubts upon the unequivocal demonstration of the anti-fracture efficacy of ERT, at the spine and hip. Controlled clinical trials and systematic reviews were retrieved, using Medline 1970-2002 and EMBASE 1980-2002. There is a convergent body of evidence that estrogens could significantly reduce the risk of vertebral and non-vertebral fractures, providing this treatment is started early after the menopause and pursued indefinitely. In the recent perspective of the published studies, reevaluating the non-skeletal benefits and harms of ERT in post-menopausal women, other chemical entities might be better options to be used for the specific purpose of preventing or treating post-menopausal osteoporosis. [less ▲]

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See detailOsteoarthritic patients with high cartilage turnover show increased responsiveness to the cartilage protecting effects of glucosamine sulphate
Christgau, Stephan; Henrotin, Yves ULg; Tanko, Laszlo B et al

in Clinical and Experimental Rheumatology (2004), 22(1, JAN-FEB), 36-42

Objective Glucosamine sulphate has been shown in a large double-blind, placebo-controlled clinical trial to prevent structural damage and improve clinical symptoms of osteoarthritis (OA). We investigated ... [more ▼]

Objective Glucosamine sulphate has been shown in a large double-blind, placebo-controlled clinical trial to prevent structural damage and improve clinical symptoms of osteoarthritis (OA). We investigated whether early response in a newly developed biochemical marker of collagen type II degradation (CTX-II, CartiLaps ELISA) could reflect the long-term preservation of hyaline cartilage. Methods Study subjects comprised 212 knee OA patients participating in a clinical trial of the effects of glucosamine sulphate. Disease symptoms were assessed quarterly by WOMAC scoring and X-ray analysis was performed at baseline and after 3 years. Urine samples were obtained at baseline and after 1, 2 and 3 years for measurement in the CartiLaps assay. The measurements were corrected for creatinine. Results At baseline the patients had an average concentration of urinary CTX-II of 222.4 +/- 159.5 ng/mmol creatinine. This was significantly above the CTX-II levels measured in urine samples from 415 healthy controls (169.1 +/- 92.3 ng/mmol, p < 0.0001). There was no significant difference in the CTX-II response in the placebo group and the glucosamine treated group. However, those with high cartilage turnover presented a significant decrease in CTX-II after 12-month glucosamine treatment. Thus, thee group with CTX II concentrations above normal average + ISD decreased 15.5 % after 12-month therapy. The 12 months change in CTX-II in OA patients with elevated CTX-II at baseline correlated with the change in average joint space width observed after 36 months (R = 0.43, p < 0.05). Increased baseline levels of CTX-II were associated with a worsening of the WOMAC index (p < 0.01). Conclusion The data indicate that measurement of urinary collagen type H C-telopeptide fragments enables the identification of OA patients with high cartilage turnover who at the same time are most responsive to therapy with structure modifying drugs. [less ▲]

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See detailGlucosamine sulfate reduces osteoarthritis progression in postmenopausal women with knee osteoarthritis: evidence from two 3-year studies
Bruyère, Olivier ULg; Pavelka, K.; Rovati, Lucio C et al

in Menopause (2004), 11(2), 138-143

OBJECTIVE: To investigate the effect of glucosamine sulfate on long-term symptoms and structure progression in postmenopausal women with knee osteoarthritis (OA). DESIGN: This study consisted of a ... [more ▼]

OBJECTIVE: To investigate the effect of glucosamine sulfate on long-term symptoms and structure progression in postmenopausal women with knee osteoarthritis (OA). DESIGN: This study consisted of a preplanned combination of two three-year, randomized, placebo-controlled, prospective, independent studies evaluating the effect of glucosamine sulfate on symptoms and structure modification in OA and post-hoc analysis of the results obtained in postmenopausal women with knee OA. Minimal joint space width was assessed at baseline and after 3 years from standing anteroposterior knee radiographs. Symptoms were scored by the algo-functional WOMAC index at baseline and after 3 years. All primary statistical analyses were performed in intention-to-treat, comparing joint space width and WOMAC changes between groups by ANOVA. RESULTS: Of 414 participants randomized in the two studies, 319 were postmenopausal women. At baseline, glucosamine sulfate and placebo groups were comparable for demographic and disease characteristics, both in the general population and in the postmenopausal women subset. After 3 years, postmenopausal participants in the glucosamine sulfate group showed no joint space narrowing [joint space change of +0.003 mm (95% CI, -0.09 to 0.11)], whereas participants in the placebo group experienced a narrowing of -0.33 mm (95% CI, -0.44 to -0.22; P < 0.0001 between the two groups). Percent changes after 3 years in the WOMAC index showed an improvement in the glucosamine sulfate group [-14.1% (95%, -22.2 to -5.9)] and a trend for worsening in the placebo group (5.4% (95% CI, -4.9 to 15.7) (P = 0.003 between the two groups). CONCLUSION: This analysis, focusing on a large cohort of postmenopausal women, demonstrated for the first time that a pharmacological intervention for OA has a disease-modifying effect in this particular population, the most frequently affected by knee OA. [less ▲]

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See detailTechniques Spéciales de la Personne Agée
Bruyère, Olivier ULg

Learning material (2004)

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See detailTime-dependent risk of gastrointestinal complications induced by NSAIDS use: a consensus statement using meta-analytic approach
Richy, Florent; Bruyère, Olivier ULg; Ethgen, Olivier ULg et al

in Osteoporosis International (2003, November), 14(Suppl. 7), 9

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See detailDo new methods of investigation allow faster assessment of drugs efficacy in osteoarthritis?
Abadie, Eric ULg; Avouac, B.; Bouvenot, G. et al

in Osteoporosis International (2003, November), 14(Suppl. 7), 2

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See detailEvaluation of the relationship between IGF-I, IGF-BP3, BMD and age in men presenting at a multiple risk detection campaign
Hanssens, L.; Tancredi, Annalisa ULg; De Ceulaer, F. et al

in Osteoporosis International (2003, November), 14(Suppl. 7), 90-91

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See detailRational to use OSIRIS® (osteoporosis index of risk) to prescreen for osteoporosis in the general population
Richy, Florent; Gourlay, M.; Ethgen, Olivier ULg et al

in Osteoporosis International (2003, November), 14(Suppl. 7), 67-68

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