References of "Bruyère, Olivier"
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See detailRole of Biochemical Markers of Bone Turnover as Prognostic Indicator of Successful Osteoporosis Therapy
Reginster, Jean-Yves ULg; Collette, Julien ULg; Neuprez, Audrey et al

in BONE (2008), 42

Most of the currently available anti-osteoporosis medications promptly and significantly influence the rate of bone turnover. Biochemical markers of bone turnover now provide a high sensitivity to change ... [more ▼]

Most of the currently available anti-osteoporosis medications promptly and significantly influence the rate of bone turnover. Biochemical markers of bone turnover now provide a high sensitivity to change, allowing the detection of these bone turnover changes within a couple of weeks. Since the anti-fracture efficacy of inhibitors of bone resorption or stimulators of bone formation appears to be largely independent of baseline bone turnover, biochemical markers do not appear to play a significant role in the selection of one particular drug, for an individual patient. However, there are consistent data showing that short-term changes in biochemical markers of bone turnover may be significant predictors of future changes in bone mineral density or fracture reduction, hence suggesting that bone turnover markers play a significant role in the monitoring of anti-osteoporosis therapy. [less ▲]

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See detailTotal Joint Replacement after Glucosamine Sulphate Treatment in Knee Osteoarthritis: Results of a Mean 8-Year Observation of Patients from Two Previous 3-Year, Randomised, Placebo-Controlled Trials
Bruyère, Olivier ULg; Pavelka, K.; Rovati, L. C. et al

in Osteoarthritis and Cartilage (2008), 16(2), 254-60

OBJECTIVE: To assess the incidence of Total Joint Replacement (TJR) during the long-term follow-up of patients with knee osteoarthritis (OA) formerly receiving treatment with glucosamine sulphate or ... [more ▼]

OBJECTIVE: To assess the incidence of Total Joint Replacement (TJR) during the long-term follow-up of patients with knee osteoarthritis (OA) formerly receiving treatment with glucosamine sulphate or placebo. METHODS: Knee OA patients participating in two previous randomised, placebo-controlled, double-blind, 3-year trials of glucosamine sulphate and receiving treatment for at least 12 months, were systematically contacted to participate in a long-term follow-up retrospective assessment of the incidence of total knee replacement. RESULTS: Out of 340 patients with at least 12 months of treatment, 275 (i.e., 81%) could be retrieved and interviewed for the present evaluation: 131 formerly on placebo and 144 on glucosamine sulphate. There were no differences in baseline disease characteristics between groups or with the patients lost to follow-up. The mean duration of follow-up was approximately 5 years after trial termination and treatment discontinuation, making up a total of 2178 patient-years of observation (including treatment and follow-up). Total knee replacement had occurred in over twice as many patients from the placebo group, 19/131 (14.5%), than in those formerly receiving glucosamine sulphate, 9/144 (6.3%) (P=0.024, chi-square test), with a Relative Risk that was therefore 0.43 (95% confidence interval (CI): 0.20-0.92), i.e., a 57% decrease compared with placebo. The Kaplan Meier/Log-Rank test survival analysis confirmed a significantly decreased (P=0.026) cumulative incidence of total knee replacements in patients who had received glucosamine sulphate. A pharmacoeconomic analysis in a subgroup of subjects suggested that patients formerly on glucosamine sulphate had recurred to less symptomatic medications and use of other health resources than those from the placebo group during the last year of follow-up. CONCLUSIONS: Treatment of knee OA with glucosamine sulphate for at least 12 months and up to 3 years may prevent TJR in an average follow-up of 5 years after drug discontinuation. [less ▲]

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See detailLe traitement de l'ostéoporose de la femme jeune
Bruyère, Olivier ULg

Conference (2008, January 26)

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See detailVitamin D status and response to antiosteoporotic therapy.
Bruyère, Olivier ULg; Reginster, Jean-Yves ULg

in Women's Health (2008), 4(5), 445-7

Evaluation of: Adami S, Giannini S, Bianchi G et al.: Vitamin D status and response to treatment in post-menopausal osteoporosis. Osteoporos. Int. (2008) (Epub ahead of print). All recent osteoporosis ... [more ▼]

Evaluation of: Adami S, Giannini S, Bianchi G et al.: Vitamin D status and response to treatment in post-menopausal osteoporosis. Osteoporos. Int. (2008) (Epub ahead of print). All recent osteoporosis guidelines recommend that patients taking treatments for osteoporosis (i.e., bisphosphonates) should be supplemented with vitamin D and calcium. However, the bone response (i.e., bone mineral density change and fractures incidence) to bisphosphonates therapy in relation to vitamin D intake in clinical practice is unknown. In a recent retrospective study, 1515 women with postmenopausal osteoporosis under antiresorptive treatment were classified as vitamin D deficient or vitamin D repleted, according to risk factors or the level of 25 hydroxy vitamin D above or below 50 nmol/l. The change in bone mineral density remained significantly higher in vitamin D-repleted compared with vitamin D-deficient women. Moreover, the adjusted odds ratio for incident fractures in vitamin D-deficient as compared with vitamin D-repleted women was 1.77 (95% CI: 1.20-2.59; p = 0.004). [less ▲]

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See detailEvaluation of symptomatic slow-acting drugs in osteoarthritis using the GRADE system.
Bruyère, Olivier ULg; Burlet, Nansa; Delmas, Pierre D et al

in BMC Musculoskeletal Disorders (2008), 9

BACKGROUND: Symptomatic slow-acting drugs (SYSADOA) have been largely studied over the last decade. The objective of this study is to prepare a document providing recommendations for the use of SYSADOA in ... [more ▼]

BACKGROUND: Symptomatic slow-acting drugs (SYSADOA) have been largely studied over the last decade. The objective of this study is to prepare a document providing recommendations for the use of SYSADOA in osteoarthritis (OA). METHODS: The following interventions were taken into consideration: avocado/soybean unsaponifiables, chondroitin sulfate, diacereine, glucosamine sulfate, hyaluronic acid, oral calcitonin, risedronate, strontium ranelate. Recommendations were based on the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system. The GRADE system is based on a sequential assessment of the quality of evidence, followed by assessment of the balance between benefits versus downsides and subsequent judgment about the strength of recommendations. RESULTS: Chondroitin sulfate, diacereine, glucosamine sulfate, avocado/soybean unsaponifiables and hyaluronic acid have demonstrated pain reduction and physical function improvement with very low toxicity, with moderate to high quality evidence. Even if pre-clinical data and some preliminary in vivo studies have suggested that oral calcitonin and strontium ranelate could be of potential interest in OA, additional well-designed studies are needed. CONCLUSION: In the benefit/risk ratio, the use of chondroitin sulfate, diacereine, glucosamine sulfate, avocado/soybean unsaponifiables and hyaluronic acid could be of potential interest for the symptomatic management of OA. [less ▲]

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See detailEvaluation économique de la campagne de dépistage de l'ostéoporose menée en Province de Liège avec le concours de Liège Province Santé
Hiligsmann, Mickaël ULg; Bruyère, Olivier ULg; Pire, Georges et al

in Revue Médicale de Liège (2008), 63(10), 588-94

The Province of Liege has conducted an osteoporosis screening strategy for women aged 50 to 69 years. The objective of this study is to investigate the economic characteristics of the screening strategy ... [more ▼]

The Province of Liege has conducted an osteoporosis screening strategy for women aged 50 to 69 years. The objective of this study is to investigate the economic characteristics of the screening strategy and to assess its cost-effectiveness, using a Markov microsimulation model. Our analyses suggest that the osteoporosis screening strategy is efficient if the medical community and the patients fulfill the recommendations of the Province of Liege health authorities and if persistence is optimized. Therefore, bone mineral density (BMD) measurement should be performed in all individuals with positive ultrasound screening; individuals having a positive BMD diagnosis should be treated and adherence to therapy should be increased. Furthermore, to improve the efficiency of the screening strategy, we suggest to target screening on women with one or more clinical risk factors, or on women aged 65 years and older. [less ▲]

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See detailRisque à long terme de survenue d'une fracture ostéoporotique en Belgique.
Hiligsmann, Mickaël ULg; Bruyère, Olivier ULg; Reginster, Jean-Yves ULg

in Revue Médicale de Liège (2008), 63(7-8), 480-487

This work has been realised to estimate the lifetime risk of osteoporotic fracture for Belgian men and women aged 50 and 60 years. Estimates were based on a microsimulation Markov model. They take account ... [more ▼]

This work has been realised to estimate the lifetime risk of osteoporotic fracture for Belgian men and women aged 50 and 60 years. Estimates were based on a microsimulation Markov model. They take account of the incidence of fracture as well as of life expectancy. Several approaches have been taken to model life expectancy. Our estimates also take account of future mortality reductions based on official estimates and secular trends in life expectancy. Lifetime risk of osteoporotic population (bone mineral density below -2.5 T-score) was also estimated. Lifetime risk of hip fracture and any major osteoporotic fracture (hip, clinical vertebral or wrist) were 20.5% and 39% respectively for women aged 60 years. Corresponding values for men were 7.9% and 14.8% and for osteoporotic women 32.3% and 53.4%. Our lifetime risk estimates re-emphasize that osteoporosis is a major public health problem and that its societal burden is likely to increase due to demographic changes. [less ▲]

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See detailCorrelation between increased bone mineral density and decreased fracture risk - Bone mineral density as a tool to monitor postmenopausal osteoporosis treatment
Bruyère, Olivier ULg; Reginster, Jean-Yves ULg

in Medicographia (2008), 30(4), 355-359

Although low bone mineral density (BMD) is predictive of fracture risk in untreated patients, there is currently debate about the extent to which the antifracture efficacy of antiosteoporotic agents is ... [more ▼]

Although low bone mineral density (BMD) is predictive of fracture risk in untreated patients, there is currently debate about the extent to which the antifracture efficacy of antiosteoporotic agents is related to BMD changes. The goal of this article is to make an overview of studies dealing with the association between BMD changes and fracture risk reduction. The percent- age of the reduction in fracture risk attributable to changes in BMD after an- tiresorptive treatments (risedronate, alendronate, and raloxifene) varies from 4% to 28%. One study with a bone-forming agent (teriparatide) found that the proportion of fracture risk reduction attributable to the increase in BMD ranged from 30% to 41%. With strontium ranelate, the changes in femoral neck and total hip BMD explained 76% and 74%, respectively, of the reduction in verte- bral fractures observed during treatment. However, study designs as well as statistical methods often differ, making the comparison between studies rather difficult. Our review indicates that the association between BMD changes and fracture risk is equivocal, but seems to be higher for strontium ranelate than that reported for its competitors. [less ▲]

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See detailLifetime absolute risk of hip and other osteoporotic fracture in Belgian women.
Hiligsmann, Mickaël ULg; Bruyère, Olivier ULg; Ethgen, Olivier ULg et al

in BONE (2008), 43(6), 991-4

OBJECTIVES: To estimate the lifetime absolute risks of hip and other osteoporotic fracture in Belgian women aged 60 years and to examine the effect of changes in baseline population fracture risk and ... [more ▼]

OBJECTIVES: To estimate the lifetime absolute risks of hip and other osteoporotic fracture in Belgian women aged 60 years and to examine the effect of changes in baseline population fracture risk and changes in life expectancy. MATERIALS AND METHODS: Estimates were performed using a Markov microsimulation model and were based on the incidence of first fracture as well as life expectancy. Baseline scenario included projected mortality rates and increasing fracture incidence by 1% per year. Alternative scenarios were performed on age, life expectancy and trends in fracture incidence. Lifetime fracture risk for osteoporotic population (T-score <or= -2.5) was also estimated. RESULTS: In the baseline scenario, lifetime absolute risks of hip fracture and of any major osteoporotic fracture (hip, clinical vertebral or wrist) were respectively 24.8% and 44.3%. Alternative scenarios showed that when assuming no change of age-specific fracture rates over time, these lifetime risks were 18.3% and 35.2%, while these values were 20.0% and 38.3% assuming no future mortality reductions. For osteoporotic women, these values were respectively 34.5% and 51.5%. CONCLUSION: We conclude that absolute lifetime fracture risks are substantial and that trends in fracture incidence and changes in life expectancy have a marked impact on absolute lifetime fracture risks. [less ▲]

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See detailStrontium ranelate: The first agent of a new therapeutic class in osteoporosis.
Neuprez, Audrey; Hiligsmann, Mickaël ULg; Scholtissen, Sophie ULg et al

in Advances in Therapy (2008), 25(12), 1235-56

Strontium ranelate is a new agent developed for the management of post-menopausal osteoporosis. It has a unique mode of action, based on an uncoupling between bone formation (increased) and bone ... [more ▼]

Strontium ranelate is a new agent developed for the management of post-menopausal osteoporosis. It has a unique mode of action, based on an uncoupling between bone formation (increased) and bone resorption (decreased). To review its effectiveness we searched the MEDLINE database from 1985 to 2008, as well as databases such as the Cochrane controlled register, for citations or relevant articles. After this extensive search of the literature, a critical appraisal of the data was obtained through a consensus meeting (AN, MH, SS, OB, and J-YR). We found that strontium ranelate reduces vertebral, nonvertebral, major nonvertebral, and hip fractures over 1, 3, 4, and 5 years. Its spectrum of activity covers women with osteopenia, osteoporosis, and severe osteoporosis. Elderly subjects also show a reduction in vertebral and nonvertebral fractures. Bone mineral density may be used as a monitoring tool for strontium ranelate, since early changes are predictive of long-term fracture reduction. Biochemical markers of bone turnover reflect the uncoupling between resorption and formation. The safety profile of strontium ranelate compares favorably with the other currently marketed antiosteoporosis medications. Preliminary results suggest that strontium ranelate is able to reduce the progression of spine osteoarthritis. In conclusion, strontium ranelate has the potential to be a candidate for first-line treatment of osteopenia and osteoporosis. However, further research is needed before suggesting its widespread use in osteoarthritis. [less ▲]

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See detailAn Economic Evaluation of Quantitative Ultrasonometry as Pre-Screening Test for the Identification of Patients with Osteoporosis
Hiligsmann, Mickaël ULg; Ethgen, Olivier ULg; Bruyère, Olivier ULg et al

in Disease Management & Health Outcomes (2008), 16(6), 429-438

Background: Screening for osteoporosis has been recommended to identify patients at high risk of fracture in order to provide preventative treatment. Given the limited availability of dual-energy x-ray ... [more ▼]

Background: Screening for osteoporosis has been recommended to identify patients at high risk of fracture in order to provide preventative treatment. Given the limited availability of dual-energy x-ray absorptiometry (DXA) and health resources, quantitative ultrasonometry (QUS) has emerged as an attractive tool for the mass screening scenario. The objective of this study was to evaluate whether a screening strategy using QUS as a pre-screening tool for bone densitometry would be cost effective and, if so, at what cut-off thresholds. Methods: Decision analytic models were used to compare the cost effectiveness and cost utility of several screening strategies: DXA measurement alone and pre-screening strategies that use different QUS index cut-off thresholds. For each strategy, and for hypothetical cohorts of women, we estimated the number of DXA scans required, the number of osteoporotic patients detected and missed, the total screening cost, and the incremental cost per patient detected. A validated Markov microsimulation model with a lifetime horizon and from a healthcare perspective was also computed in order to estimate the cost per quality-adjusted life-year (QALY) gained of the alternative screening strategies combined with 5 years of alendronate therapy for women who have osteoporosis (T-score -2.5 or less). Results: The DXA strategy had the highest cost and the highest number of patients with osteoporosis detected. Pre-screening strategies using QUS reduced the number of DXA scans per patient with osteoporosis detected and the total screening cost but they also missed patients with osteoporosis as the QUS index decreased. Pre-screening strategies using QUS T-scores of 0.0, -0.5, -2.0, and -2.5 were dominated by extended dominance, as their incremental cost-effectiveness ratios (ICERs) and incremental cost-utility ratios (ICURs) were higher than that of the next more effective alternative. The cost-effectiveness and cost-utility frontiers included no screening, pre-screening using QUS T-scores of -1.0 and -1.5, and DXA measurement alone. Conclusion: These results suggest that QUS may be useful as a pre-screening tool for bone densitometry given the limited availability of DXA and health resources, and that the QUS index T-scores of -1.0 and -1.5 are the most appropriate index. [less ▲]

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See detailIbandronate in profile: drug characteristics and clinical efficacy.
Reginster, Jean-Yves ULg; Neuprez, Audrey; Bruyère, Olivier ULg

in Expert Opinion on Drug Metabolism & Toxicology (2008), 4(7), 941-51

BACKGROUND: Postmenopausal osteoporosis is a serious, chronic condition, for which nitrogen-containing bisphosphonates are now one of the treatments of choice. OBJECTIVE: To review the profile of ... [more ▼]

BACKGROUND: Postmenopausal osteoporosis is a serious, chronic condition, for which nitrogen-containing bisphosphonates are now one of the treatments of choice. OBJECTIVE: To review the profile of ibandronate, a monthly oral (150 mg) or quarterly intravenous injection (3 mg) of bisphosphonate. METHODS: The literature search was limited to publications of ibandronate data. RESULTS/CONCLUSION: Ibandronate is rapidly absorbed and distributed in the bone; it is not metabolised and is excreted in urine. Clinical trial data have demonstrated the efficacy of ibandronate in reducing fracture risk, increasing bone mineral density and reducing bone turnover. These data are supported by recent meta-analyses and a large database study that have demonstrated antifracture efficacy with the ibandronate regimens used in clinical practice. Overall, ibandronate has generally been well tolerated. Therefore, ibandronate is a useful treatment for postmenopausal osteoporosis. [less ▲]

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See detailVitamin D inadequacy in French osteoporotic and osteopenic women.
De Cock, Caroline; Bruyère, Olivier ULg; Collette, Julien ULg et al

in Joint Bone Spine (2008), 75(5), 567-72

OBJECTIVE: Studies have shown that low serum vitamin D levels are associated with secondary hyperparathyroidism, which decreases bone strength and increases fracture risk, most notably after 50 years of ... [more ▼]

OBJECTIVE: Studies have shown that low serum vitamin D levels are associated with secondary hyperparathyroidism, which decreases bone strength and increases fracture risk, most notably after 50 years of age. The objective of this study was to evaluate the vitamin D status of postmenopausal women in France. METHODS: We conducted a cross-sectional observational study of 1292 menopausal women with osteoporosis or osteopenia. The age range was 52-94 years. Serum 25-OH-vitamin D was assayed in each patient. Based on data in the literature, we used four 25-OH-D cutoffs to define vitamin D deficiency: 30, 50, 75, and 80 nmol/L (<12, <20, <30, and <32 ng/ml). RESULTS: Mean serum 25-OH-D was 51.5+/-26.1 nmol/L (about 20.6+/-10.4 ng/ml). In the 343 (26.5%) patients taking supplemental vitamin D with or without supplemental calcium, the mean serum 25-OH-D level was significantly higher than in the other patients (65.0+/-26.0 ng/ml vs. 46.6+/-18.6 ng/ml; P<0.001). In the subgroup not taking vitamin D supplements, the prevalence of vitamin D deficiency was 27.3%, 54.1%, 89.9%, and 93.2% with the 30, 50, 75, and 80 nmol/L cutoffs, respectively. The mean 25-OH-D level varied across seasons (P<0.001), with the highest value being obtained in summer (53.4+/-18.7 nmol/L; about 21.3+/-7.5 ng/ml). CONCLUSION: Vitamin D deficiency is common among postmenopausal women with osteoporosis or osteopenia in France. [less ▲]

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See detailPost-fracture management of patients with hip fracture: a perspective.
Bruyère, Olivier ULg; Brandi, M.-L.; Burlet, N. et al

in Current Medical Research & Opinion (2008), 24(10), 2841-51

BACKGROUND: Hip fracture creates a worldwide morbidity, mortality and economic burden. After surgery, many patients experience long-term disability or die as a consequence of the fracture. A fracture is a ... [more ▼]

BACKGROUND: Hip fracture creates a worldwide morbidity, mortality and economic burden. After surgery, many patients experience long-term disability or die as a consequence of the fracture. A fracture is a major risk factor for a subsequent fracture, which may occur within a short interval. METHODS: A literature search on post-fracture management of patients with hip fracture was performed on the Medline database. Key experts convened to develop a consensus document. FINDINGS: Management of hip-fracture patients to optimize outcome after hospital discharge requires several stages of care co-ordinated by a multidisciplinary team from before admission through to discharge. Further studies that specifically assess prevention and post-fracture management of hip fracture are needed, as only one study to date has assessed an osteoporosis medication in patients with a recent hip fracture. Proper nutrition is vital to assist bone repair and prevent further falls, particularly in malnourished patients. Vitamin D, calcium and protein supplementation is associated with an increase in hip BMD and reduction in falls. Rehabilitation is essential to improve functional disabilities and survival rates. Fall prevention and functional recovery strategies should include patient education and training to improve balance and increase muscle strength and mobility. Appropriate management can prevent further fractures and it is critical that high-risk patients are identified and treated. To foster this process, clinical pathways have been established to support orthopaedic surgeons. CONCLUSION: Although hip fracture is generally associated with poor outcomes, appropriate management can ensure optimal recovery and survival, and should be prioritized after a hip fracture to avoid deterioration of health and prevent subsequent fracture. [less ▲]

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