Social support and health-related quality of life in hip and knee osteoarthritis
Ethgen, Olivier ; Vanparijs, Philippe ; 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 ▲]Detailed reference viewed: 37 (4 ULg)
Chondromodulation en 2003: reve ou realite?
in Revue Médicale de la Suisse Romande (2004), 124(2), 85-7
The use of drugs for the treatment of osteoarthritis, with a view to obtain a long-term symptomatic as well as structural benefit, is still in a preliminary state. Nowadays, matricial precursors, such as ... [more ▼]
The use of drugs for the treatment of osteoarthritis, with a view to obtain a long-term symptomatic as well as structural benefit, is still in a preliminary state. Nowadays, matricial precursors, such as glucosamine sulfate, are an interesting approach in this indication. They have demonstrated a symptomatic efficacy comparable to that of N.S.A.I.D., with significantly reduced side-effects. Glucosamine sulfate also appears to positively interfere with the structural evolution of osteoarthritis by preventing joint space narrowing which characterizes the evolution of the disease. Encouraging results have also been obtained with chondroitin sulfate and diacerein. As for other molecules, new studies should be undertaken to confirm the results already obtained. [less ▲]Detailed reference viewed: 14 (2 ULg)
Reduction in PINP, a marker of bone metabolism, with raloxifene treatment and its relationship with vertebral fracture risk
Reginster, Jean-Yves ; ; Zegels, Brigitte 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 ▲]Detailed reference viewed: 29 (5 ULg)
The effects of strontium ranelate on the risk of vertebral fracture in women with postmenopausal osteoporosis
; ; et al
in New England Journal of Medicine (2004), 350(5), 459-468
BACKGROUND: Osteoporotic structural damage and bone fragility result from reduced bone formation and increased bone resorption. In a phase 2 clinical trial, strontium ranelate, an orally active drug that ... [more ▼]
BACKGROUND: Osteoporotic structural damage and bone fragility result from reduced bone formation and increased bone resorption. In a phase 2 clinical trial, strontium ranelate, an orally active drug that dissociates bone remodeling by increasing bone formation and decreasing bone resorption, has been shown to reduce the risk of vertebral fractures and to increase bone mineral density. METHODS: To evaluate the efficacy of strontium ranelate in preventing vertebral fractures in a phase 3 trial, we randomly assigned 1649 postmenopausal women with osteoporosis (low bone mineral density) and at least one vertebral fracture to receive 2 g of oral strontium ranelate per day or placebo for three years. We gave calcium and vitamin D supplements to both groups before and during the study. Vertebral radiographs were obtained annually, and measurements of bone mineral density were performed every six months. RESULTS: New vertebral fractures occurred in fewer patients in the strontium ranelate group than in the placebo group, with a risk reduction of 49 percent in the first year of treatment and 41 percent during the three-year study period (relative risk, 0.59; 95 percent confidence interval, 0.48 to 0.73). Strontium ranelate increased bone mineral density at month 36 by 14.4 percent at the lumbar spine and 8.3 percent at the femoral neck (P<0.001 for both comparisons). There were no significant differences between the groups in the incidence of serious adverse events. CONCLUSIONS: Treatment of postmenopausal osteoporosis with strontium ranelate leads to early and sustained reductions in the risk of vertebral fractures. [less ▲]Detailed reference viewed: 24 (3 ULg)
Validation and comparative evaluation of the osteoporosis self-assessment tool (OST) in a Caucasian population from Belgium
; ; 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 ▲]Detailed reference viewed: 45 (10 ULg)
Formations organisées dans le cadre de la « Fonction de référent hospitalier pour la continuité des soins ». Hôpitaux disposant de lits Sp. Exercice 2003.
; Gosset, Christiane ; Dejace, Alain et al
Report (2004)Detailed reference viewed: 11 (0 ULg)
Formations organisées dans le cadre de la « Fonction de référent hospitalier pour la continuité des soins ». Hôpitaux psychiatriques. Exercice 2003.
; Gosset, Christiane ; Dejace, Alain et al
Report (2004)Detailed reference viewed: 6 (0 ULg)
Furanic Avocado/Soybean Unsaponifiables Prevent Osteoarthritic Subchondral Osteoblasts- Induced Cartilage Degradation
Sanchez, Christelle ; Deberg, Michelle ; et al
Poster (2004)Detailed reference viewed: 25 (5 ULg)
Type II collagen peptides for measuring cartilage degradation
Henrotin, Yves ; Deberg, Michelle ; et al
in Biorheology (2004), 41(3-4), 543-547
This paper describes two new immunoassays for a peptide of the triple helix of type II collagen (Coll 2-1) and its nitrated form (Coll 2-1 NO2). In healthy subjects aged between 20 and 65 years old, Coll ... [more ▼]
This paper describes two new immunoassays for a peptide of the triple helix of type II collagen (Coll 2-1) and its nitrated form (Coll 2-1 NO2). In healthy subjects aged between 20 and 65 years old, Coll 2-1 and Coll 2-1 NO2 levels in serum were in means 125.13+/-3.71 and 0.16+/-0.08 nmol/l, respectively. These levels did not significantly vary with age. However, up to 45 years of age, Coll 2-1 NO2 levels in women were significantly higher than in men. In patients with knee osteoarthritis (OA), Coll 2-1 in serum was found to be elevated compared to healthy controls (267.45+/-26.42 nmol/l vs 126.78+/-6.61 nmol/l). Further, we have demonstrated that an increase of the urinary levels of Coll 2-1 or Coll 2-1 NO2 over 1 year was predictive of joint space narrowing progression in OA patients. In conclusion, these preliminary results indicate that Coll 2-1 could be a predictive marker of knee OA progression. [less ▲]Detailed reference viewed: 23 (3 ULg)
Traitement de l’ostéoporose postménopausique en 2004.
Reginster, Jean-Yves ;
in L'agenda Gynécologique (2004), 36Detailed reference viewed: 7 (1 ULg)
Fractures vertébrales ostéoporotiques et raloxifène (Evista°).
in Patient Care (2004), 27Detailed reference viewed: 9 (1 ULg)
Evaluation of proposals of Belgian Social Security Institute for reimbursement of bone densitometry tests. Toward a cost-effective strategy for osteoporosis screening?
Ben Sedrine, Wafa ; Ethgen, Olivier ; et al
in Aging Clinical & Experimental Research (2004), 16(5), 413-419
BACKGROUND AND AIMS: The Belgian Social Security Institute (hereafter INAMI) proposes a list of conditions to be considered as a prerequisite for reimbursement of Bone Mineral Density (BMD) measurements ... [more ▼]
BACKGROUND AND AIMS: The Belgian Social Security Institute (hereafter INAMI) proposes a list of conditions to be considered as a prerequisite for reimbursement of Bone Mineral Density (BMD) measurements. The aim of this paper was to evaluate the diagnostic accuracy of the proposed criteria for identifying osteoporosis, and to gauge how useful they are for more rational application of densitometry tests. METHODS: 3748 Caucasian women aged at least 50 years old were recruited consecutively from an outpatient university center, from the database of which all relevant data corresponding to the INAMI list of clinical factors, as well as patients' age, weight and height, were collected. BMD measurements using dual X-ray absorptiometry were reported at the spine and hip regions. Diagnostic accuracy was evaluated through measures of sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). Additionally, from ROC analysis, benchmark values for age and body mass index were identified and then, used alone and in combination with the INAMI test, were applied to define various screening strategies. For each of them, associated costs per osteoporotic patient detected were estimated. Cost estimates refer only to the costs associated with the densitometric procedure from the perspective of the reimbursement health authorities. RESULTS: Applying INAMI criteria for detecting osteoporosis at any of the considered sites yielded sensitivity of 68.9%, specificity of 50.7%, PPV of 42.9% and NPV of 57.3%. Comparison of incremental costs per patient of the different strategies revealed that, with 67.1 Euros, the option of opening BMD coverage to women on the basis of the INAMI conditions would be more cost-effective than mass screening (90.1 Euros) or applying the age criterion alone (70.2 Euros). However, the BMI condition seems to act as a better indicator of risk than the INAMI criteria in those meeting the age condition (35.4 Euros). CONCLUSIONS: The accuracy of the INAMI proposal turns out to be quite unsatisfactory, and did not adequately cover the population at risk of osteoporosis. From a resource allocation perspective, the best strategy by far would be to recommend using concomitantly INAMI, age and BMI-selective criteria. Some adaptations could enhance the usefulness of the INAMI proposals as a selective approach for BMD referral and reimbursement. [less ▲]Detailed reference viewed: 58 (1 ULg)
Strontium ranelate reduces the risk of vertebral fractures in postmenopausal women with osteopenia
; Reginster, Jean-Yves ; et al
in Osteoporosis International (2004), 15(S1), 119-120Detailed reference viewed: 8 (4 ULg)
Strontium ranelate reduces the risk of vertebral and non-vertebral fractures in Caucasian women with post-menopausal osteoporosis.
; ; et al
in Calcified Tissue International (2004), 74(S1), 37-38Detailed reference viewed: 18 (4 ULg)
Strontium ranelate: a new paradigm in the treatment of osteoporosis.
REGINSTER, Jean-Yves ; LECART, Marie-Paule ; DEROISY, Rita et al
in Expert Opinion on Investigational Drugs (2004), 13(7), 857-64
In vitro, strontium ranelate increases collagen and non-collagenic protein synthesis by mature osteoblast-enriched cells. The effects of strontium ranelate on bone formation were confirmed as the drug ... [more ▼]
In vitro, strontium ranelate increases collagen and non-collagenic protein synthesis by mature osteoblast-enriched cells. The effects of strontium ranelate on bone formation were confirmed as the drug enhanced preosteoblastic cell replication. In the isolated osteoclast, a preincubation of bone slices with strontium ranelate induced a dose-dependent inhibition of the bone resorbing activity of treated rat osteoclast. Strontium ranelate dose-dependently inhibited preosteoclast differentiation. The drug was administered in 160 early postmenopausal women, in a 24-month, double-blind, placebo-controlled, prospective randomised study. At the conclusion of the study, the percentage variation of lumbar bone mineral density (BMD) from baseline was significantly different in the group receiving strontium ranelate 1000 mg/day as compared with placebo (+5.53 versus -0.75%, respectively). Increase in total hip and neck BMD averages were 3.2 and 2.5%, respectively. The effect of strontium ranelate in postmenopausal women with established osteoporosis was assessed during a multinational, prospective, double-blind, randomised, placebo-controlled trial. Strontium ranelate (500, 1000, 2000 mg/day) or placebo were given to 353 Caucasian women with prevalent vertebral osteoporosis. At the conclusion of this 2-year study, the annual increase in lumbar BMD of the group receiving strontium ranelate 2000 mg was 7.3% (p < 0.001). A significant increase in bone alkaline phophatase (p = 0.002) over a 6-month period and a significant decrease in N-telopeptide crosslinks (p = 0.004) throughout the 2-year period were seen in the group receiving 2000 mg of strontium ranelate. During the second year of treatment, the dose of 2000 mg was associated with a 44% reduction in the number of patients experiencing a new vertebral deformity. Bone histomorphometry showed no mineralisation defects. The primary analysis of the SOTI study, evaluating the effect of strontium ranelate 2000 mg on vertebral fracture rates, revealed a 41% reduction in the relative risk of patients experiencing a first new vertebral fracture with strontium ranelate throughout the 3-year study. The TROPOS study showed a significant reduction in the risk of experiencing a first non-vertebral fracture in the group treated with strontium ranelate throughout the 3-year study. A reduction in the risk of experiencing a hip fracture was also demonstrated in the patients treated for > or = 18 months. [less ▲]Detailed reference viewed: 20 (6 ULg)
Traitement structurel de l'arthrose : le point en 2004
Reginster, Jean-Yves ; LECART, Marie-Paule ; SARLET, Nathalie
in Ortho-Rhumato (2004), 2(3), 52-54Detailed reference viewed: 10 (2 ULg)
A new paradigm in the treatment of postmenopausal osteoporosis: strontium ranelate (Protelos°)
in Medicographia (2004), 26(3), 238-243Detailed reference viewed: 9 (2 ULg)