References of "Reginster, Jean-Yves"
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See detailAccompagnement ambulatoire des patients à haut risque de réhospitalisation et/ou institutionnalisation.
Counet, Laurence ULg; de Froidmont, C.; Filée, D. et al

Report (2002)

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See detailGlucosamine and chondroitine sulfate
Reginster, Jean-Yves ULg; Kvasz, Angela ULg; Bruyère, Olivier ULg et al

in Anti Aging Medizin 2001 : Konferenz der German Society of Anti-Aging Medicine (2002)

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See detailThe use of placebo-controlled and non-inferiority trials for the evaluation of new drugs in the treatment of postmenopausal osteoporosis
Delmas, P. D.; Calvo, Gisèle ULg; Boers, M. et al

in Osteoporosis International (2002), 13(1), 1-5

Registration of new agents for the treatment of postmenopausal osteoporosis has been based over the past few years on placebo-controlled phase III trials with the incidence of patients with new vertebral ... [more ▼]

Registration of new agents for the treatment of postmenopausal osteoporosis has been based over the past few years on placebo-controlled phase III trials with the incidence of patients with new vertebral/nonvertebral fractures as the most usual primary endpoint. The use of a placebo in diseases where an active treatment is available has been a matter of debate following the update of the Declaration of Helsinki by the World Medical Association which questioned this trial design. Current regulatory recommendations within the European Union suggest that placebo-controlled trials are still the best option when assessing the efficacy and safety of new drugs intended for the treatment of postmenopausal osteoporosis. This suggestion seems to be in apparent contradiction with the current content of the Declaration of Helsinki. This paper addresses the ethics and feasibility of placebo-controlled trials in the treatment of postmenopausal osteoporosis, in the light of available therapeutic options, and discusses possible alternative approaches in those patients where placebo treatment could be deemed to be unethical. It is concluded that placebo-controlled trials remain the most efficient design to establish the efficacy and safety of a new agent for the treatment of postmenopausal osteoporosis. Such trials are feasible and ethically acceptable in patients with osteoporosis but without prevalent vertebral fractures. Conversely, in patients with prevalent vertebral fractures, placebo-controlled trials are ethically questionable and non-inferiority trials are more appropriate. A relative margin of non inferiority of 20-30% is suggested, to be discussed on a case by case basis. [less ▲]

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See detailRadiologic features poorly predict clinical outcomes in knee osteoarthritis.
Bruyère, Olivier ULg; Honore, Aline; Rovati, Lucio C et al

in Scandinavian Journal of Rheumatology (2002), 31(1), 13-6

OBJECTIVES: To assess the impact of radiographic severity and progression on pain and disability. METHODS: Measurements of mean joint space width (JSW), narrowest join space (NJS) point and assessment of ... [more ▼]

OBJECTIVES: To assess the impact of radiographic severity and progression on pain and disability. METHODS: Measurements of mean joint space width (JSW), narrowest join space (NJS) point and assessment of symptoms by the WOMAC questionnaire were performed at baseline and after three years in 212 subjects over 50 years with primary knee OA. RESULTS: At baseline, JSW and NJS were not significantly correlated with the scores recorded for the WOMAC global index or its pain, stiffness or function subscales. A statistically significant correlation was observed between the joint space narrowing over three years and the changes observed in the pain subscale of the WOMAC during the same period. The three-year changes in the global WOMAC index in patients within the lowest and the highest quartiles of mean joint space width at baseline showed, in both cases, a statistically (p<0.05) significant favorable difference between patients treated with glucosamine sulphate and those having received placebo. CONCLUSION: Radiographic and clinical progressions of the disease are significantly associated but the clinical relevance of the association is questionable. [less ▲]

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See detailRegulation by reactive oxygen species of interleukin-1beta, nitric oxide and prostaglandin E(2) production by human chondrocytes.
Mathy, Marianne ULg; Deby, Ginette ULg; Reginster, Jean-Yves ULg et al

in Osteoarthritis and Cartilage (2002), 10(7), 547-55

OBJECTIVES: To determine the effects of two drugs, N-monomethyl-L-arginine (L-NMMA) and N-acetylcysteine (NAC), on interleukin-1beta (IL-1beta), nitric oxide (NO) and prostaglandin E(2) (PGE(2 ... [more ▼]

OBJECTIVES: To determine the effects of two drugs, N-monomethyl-L-arginine (L-NMMA) and N-acetylcysteine (NAC), on interleukin-1beta (IL-1beta), nitric oxide (NO) and prostaglandin E(2) (PGE(2)) production by human chondrocytes. The effect of aceclofenac (ACECLO), a non-steroidal antiinflammatory drug (NSAID), was also examined. METHODS: Human chondrocytes were enzymatically isolated from osteoarthritic knee cartilage and then maintained in culture in suspension for 48h in the absence or in the presence of lipopolysaccharide (LPS) (10 microg/ml), L-NMMA (0.5mM), NAC (1mM) or ACECLO (6.10(-6)M). IL-1beta and PGE(2) productions were quantified by specific immunoassays. Nitrite was measured in the culture supernatants by a spectrophotometric method based upon the Griess reaction. Cyclooxygenase-2 (COX-2), inducible NO synthase (iNOS) and IL-1beta gene expressions were quantified by transcription of mRNA followed by real time and quantitative polymerase chain reaction. COX-2 protein expression was analysed by Western blot. RESULTS: LPS markedly increased the expression of IL-1beta, iNOS and COX-2 genes. In parallel, NO(2) and PGE(2) amounts found in the culture supernatants were significantly enhanced whereas IL-1beta was immunologically undetectable. The addition of L-NMMA (0.5mM) fully blocked LPS-induced NO production but greatly increased PGE(2) production, suggesting a negative effect of NO on PGE(2) synthesis. Inversely, NO production was stimulated by NAC while PGE(2) production was not affected. Interestingly, NAC increased the IL-1beta and iNOS mRNA levels but did not significantly modify COX-2 mRNA expression. L-NMMA did not significantly affect the expression of IL-1beta, iNOS and COX-2. The amount of COX-2 protein did not change in the presence of the antioxidants. Finally, ACECLO fully blocked the production of PGE(2) by chondrocytes without affecting the levels of COX-2 mRNA. CONCLUSIONS: The stimulation of IL-1beta, NO and PGE(2) production by LPS is differentially controlled by reactive oxygen species (ROS). In fact, L-NMMA and NAC have different mechanisms of action on the regulation of NO and PGE(2) productions. L-NMMA fully inhibits NO but increases PGE(2) production whereas NAC up-regulates NO but does not modify PGE(2) synthesis. The stimulating effect of L-NMMA on PGE(2) production is not controlled at the transcriptional level. These findings suggest that antioxidant therapy could have different effects according to the oxygen radical species targeted. [less ▲]

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See detailEtude pilote pour le developpement d'un registre de l'infarctus du myocarde en region liegeoise (Belgique)
Paul, I.; Bilge, A.; Bolly, F. et al

in Revue d'Epidémiologie et de Santé Publique (2001), 49(5), 423-9

BACKGROUND: In 1998, a permanent registry of myocardial infarction was developed in the Liege area (Belgium) to provide updated, exhaustive and validated data on the morbidity and mortality from ... [more ▼]

BACKGROUND: In 1998, a permanent registry of myocardial infarction was developed in the Liege area (Belgium) to provide updated, exhaustive and validated data on the morbidity and mortality from cardiovascular causes, to define the patients' profile, to identify myocardial infarction therapeutic strategies and to complete and make comparisons with data collected in other parts of the country through methodologically identical registers. METHODS: All acute coronary events lethal or non lethal among individuals from both genders aged from 25 to 69 years and living in the area were registered according to the methodology developed for the MONICA project (Multinational Monitoring of Trends and Determinants in Cardiovascular Diseases) of WHO. The three main selected data sources were: death certificates, general practitioners and cardiologists, hospitals. The events were categorised according to symptoms, cardiac enzymes, electrocardiogram, history of chronic ischaemic heart disease and necropsy findings. RESULTS: The coronary-event rates were 283/100,000 in men and 102/100,000 in women. The case fatality rate, 28 days after the onset of the symptoms, was 30.6% for men and 36.2% for women, and 77.5% of deaths occurred in the first 24 hours after the onset of the symptoms. CONCLUSION: The development of a myocardial infarction register at a regional level requires the involvement of all health professionals dealing with that pathology. Such register has valuable public health interests, providing exhaustive and validated data on the pathology and its evolution as well as useful information for improving therapeutic strategies and developing adapted preventive measures. [less ▲]

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See detailEvaluation of the Simple Calculated Osteoporosis Risk Estimation (Score) in a Sample of White Women from Belgium
Ben Sedrine, Wafa ULg; Devogelaer, J. P.; Kaufman, J. M. et al

in BONE (2001), 29(4), 374-80

Identifying patients at risk of developing an osteoporosis-related fracture will continue to be a challenge. The "gold standard" for osteoporosis diagnosis is bone densitometry. However, economic issues ... [more ▼]

Identifying patients at risk of developing an osteoporosis-related fracture will continue to be a challenge. The "gold standard" for osteoporosis diagnosis is bone densitometry. However, economic issues or availability of the technology may prevent its use under a mass screening scenario. A risk assessment instrument, the "simple calculated osteoporosis risk estimation" (SCORE), has been reported to appropriately identify women likely to have low (t score < or = -2 SD) bone mineral density (BMD) and who should be referred for bone densitometry. The aim of our study is to evaluate the discriminatory performance of SCORE in a random sample of postmenopausal white women from Belgium. For this purpose, we gathered medical data on 4035 consecutive patients aged > or = 45 years, either consulting spontaneously or referred for a BMD measurement to an outpatient osteoporosis center located at the University of Liege, Belgium. BMD measurements, using dual-energy X-ray absorptiometry (DXA) technology, were taken at the hip (total and neck) and lumbar spine (L2-4). At the recommended cutoff point of 6, SCORE had a sensitivity of 91.5% to detect low BMD at any of the measured sites, a specificity of 26.5%, a positive predictive value of 52.8%, and a negative predictive value of 77.7%. According to SCORE, 18% of the patients would not be recommended for densitometry. Among these, 10.9% were misclassified as they had osteoporosis (t score < or = -2.5 SD) at one or more of the sites investigated. The negative predictive errors of SCORE, when failing to detect osteoporosis, were only 1% for the total hip, 3.2% for the femoral neck, and 8.8% for the lumbar spine. We conclude that, notwithstanding the high values of sensitivity, SCORE specificity is too low to be useful as a diagnostic tool for screening patients at high risk to later develop osteoporosis. Nevertheless, from a resource allocation perspective, this instrument can be used with relative confidence to exclude patients who do not need a BMD measurement, and would therefore provide an opportunity to realize substantial cost savings in comparison to a mass screening strategy. [less ▲]

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See detailComment positionner l'acéclofénac au sein de l'arsenal thérapeutique des pathologies ostéo-articulaires chroniques ?
Reginster, Jean-Yves ULg; Paul, I.; Henrotin, Yves ULg

in Revue Médicale de Liège (2001), 56(7), 484-8

The aim of this article is to critically review the potential role of aceclofenac in the treatment of inflammatory pain and chronic osteoarticular disorder, based on its activity on the mediators of ... [more ▼]

The aim of this article is to critically review the potential role of aceclofenac in the treatment of inflammatory pain and chronic osteoarticular disorder, based on its activity on the mediators of inflammation, its effect on cartilage remodeling and on the results of clinical studies comparing aceclofenac with other NSAIDs in these disorders. Aceclofenac has an outstanding anti-inflammatory profile, involving besides a classical inhibition of prostaglandins E2, a decrease in the expression of several cytokines including interleukin 1 and tumor necrosis factor alpha. It also inhibits activated oxygen species production and influences cells adhesion. Aceclofenac and its main metabolite, 4-hydroxyaceclofenac, has positive effects on cartilage anabolism combined with modulating effect of matrix catabolism. Clinically, aceclofenac has been consistently shown to have a similar efficacy than that of widely marketed NSAIDs and a tolerance profile at least as good, if not better than the profile observed for other NSAIDs in the treatment of osteoarthritis, rheumatoid arthritis and ankylosing spondylitis. As of today, no head to head comparison between aceclofenac and coxibs have been performed, nor for efficacy neither for tolerance. The specific profile of aceclofenac makes this NSAID an interesting candidate for long-term treatment of chronic rheumatic disorders as well as for treatment of acute inflammatory episodes. [less ▲]

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See detailLes mediateurs biochimiques de l'inflammation
Henrotin, Yves ULg; Deby-Dupont, G.; Reginster, Jean-Yves ULg

in Revue Médicale de Liège (2001), 56(6), 433-42

Inflammatory processes are the physiological response of the organism to different stimuli such as trauma, infections or immunological reactions. The events leading to inflammation are characterized by ... [more ▼]

Inflammatory processes are the physiological response of the organism to different stimuli such as trauma, infections or immunological reactions. The events leading to inflammation are characterized by leukocytes adhesion to the endothelium, diapedesis and migration, cells activation and tissue remodelling. These processes are initiated and regulated by a great variety of inflammatory mediators including cytokines, prostanoids, leukotrienes, neuropeptides, reactive oxygen and nitrogen species, complement components, coagulation factors and metalloproteases. This paper is devoted to the description of the major local effects of these mediators in the inflammatory reaction. [less ▲]

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See detailPharma clinics. Comment je traite.... L'arthrose. 2eme partie: Nouvelles perspectives therapeutiques
Reginster, Jean-Yves ULg; Henrotin, Yves ULg

in Revue Médicale de Liège (2001), 56(3), 135-9

Besides the management of symptoms of osteoarthritis, a lot of interest was raised for molecules aiming at slowing down the structural progression of the disease. This paper summarizes the currently ... [more ▼]

Besides the management of symptoms of osteoarthritis, a lot of interest was raised for molecules aiming at slowing down the structural progression of the disease. This paper summarizes the currently available data allowing to discuss the efficacy and tolerance of these chemical entities. [less ▲]

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See detailInfluence of Daily Calcium and Vitamin D Supplementation on Parathyroid Hormone Secretion
Reginster, Jean-Yves ULg; Zegels, Brigitte ULg; Lejeune, Emmanuelle ULg et al

in Gynecological Endocrinology : The Official Journal of the International Society of Gynecological Endocrinology (2001), 15(1), 56-62

Calcium and vitamin D supplementation have been shown to reduce secondary hyperparathyroidism and play a role in age-related osteoporosis. In order to define the optimal regimen of calcium and vitamin D ... [more ▼]

Calcium and vitamin D supplementation have been shown to reduce secondary hyperparathyroidism and play a role in age-related osteoporosis. In order to define the optimal regimen of calcium and vitamin D supplementation to produce the maximal inhibition of parathyroid hormone secretion, we compared the administration of a calcium-vitamin D supplement as a single morning dose with the administration of two divided doses at 6-hour intervals. Twelve healthy male volunteers were assigned to three investigational procedures, which were alternated at weekly intervals. After a 'blank' control procedure, when they were not exposed to any supplements, they received one of two calcium-vitamin D supplement regimens: either two doses of Orocal D3 (500 mg calcium and 400 IU vitamin D3) with a 6-hour interval between doses, or one water-soluble effervescent powder pack of Cacit vitamin D3, taken in the morning (1000 mg calcium and 880 IU vitamin D3). During the three procedures (control and the two calcium-vitamin D supplementation protocols), veinous blood was drawn every 60 minutes for up to 9 hours, for serum calcium and parathyroid hormone measurements. The order of administration of the two calcium and vitamin D supplementation regimens was allocated by randomization. No significant changes in serum calcium were observed during the study. During the first 6 hours following calcium-vitamin D supplementation, a statistically significant decrease in serum parathyroid hormone was observed with both regimens, compared with baseline and the control procedure. During this first period, no differences were observed between the two treatment regimens. However, between the 6th and the 9th hour, serum parathyroid hormone levels remained significantly decreased compared to baseline with the twice-daily Orocal D3 administration, while they returned to baseline values with the once-daily Cacit D3 preparation. During this period, the percentage decrease in serum parathyroid hormone relative to baseline was significantly greater with Orocal D3 than Cacit D3 (p = 0.0021). We therefore conclude that the twice-daily administration of 500 mg calcium and 400 IU vitamin D3 at 6-hour intervals provides a more prolonged decrease in serum parathyroid hormone levels than the administration of the same total amount of calcium and vitamin D, as a single morning dose in young healthy. [less ▲]

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See detailPharma clinics. Comment je traite.... L'arthrose. 1ère partie: Rappel physiopathologique et traitement symptomatique
Reginster, Jean-Yves ULg; Henrotin, Yves ULg

in Revue Médicale de Liège (2001), 56(2), 63-7

Osteoarthritis is now considered in all developed countries as a major burden for public health. During several years, the pharmacological management of osteoarthritis mainly focused on symptoms relief ... [more ▼]

Osteoarthritis is now considered in all developed countries as a major burden for public health. During several years, the pharmacological management of osteoarthritis mainly focused on symptoms relief without interaction with the long-term structural progression of this disease. Based on recently published consensus, the present article summarizes the currently available options in the symptom-modifying management of osteoarthritis. [less ▲]

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See detailEffect of High Doses of Oral Risedronate (20 Mg/Day) on Serum Parathyroid Hormone Levels and Urinary Collagen Cross-Link Excretion in Postmenopausal Women with Spinal Osteoporosis
Zegels, Brigitte ULg; Eastell, R.; Russell, R. G. et al

in BONE (2001), 28(1), 108-12

The present study describes the biological effects of risedronate, a pyridinyl bisphosphonate, on bone and assesses the safety and tolerability of risedronate when given at high doses, with or without ... [more ▼]

The present study describes the biological effects of risedronate, a pyridinyl bisphosphonate, on bone and assesses the safety and tolerability of risedronate when given at high doses, with or without calcium, to postmenopausal women with spinal osteoporosis. This single-center descriptive, double-blind, placebo-controlled, randomized, parallel group study included 32 postmenopausal white women with at least one radiographically confirmed vertebral compression fracture. Patients were randomized to one of four different dose regimen groups: (i) R-P, risedronate 20 mg/day for 14 days, followed by placebo for 42 days; (ii) R-CP-P, risedronate 20 mg/day for 14 days, followed by elemental calcium 1000 mg/day and placebo for 14 days, then by placebo for 28 days; (iii) R-CP-R-CP, risedronate 20 mg/day for 7 days, followed by elemental calcium 1000 mg/day and placebo for 21 days, then risedronate 20 mg/day for 7 days, and finally elemental calcium 1000 mg/day and placebo for 21 days; and (iv) P, placebo for 56 days. The biological response was investigated by measuring serum calcium, parathyroid hormone (PTH), and 2 h urinary pyridinoline/creatinine (Pyr/Cr) and deoxypyridinoline/creatinine (DPyr/Cr) ratios at baseline and at days 3, 7, 14, 21, 28, 35, 42, 49, 56, and 84. Overall, there were no consistent trends observed between the active group and placebo for serum calcium. In groups R-P, R-CP-P, and R-CP-R-CP, mean serum PTH levels were elevated above baseline values for the entire 56 day treatment period and remained elevated, although to a lesser extent, at the day 84 follow-up visit. The effect of calcium supplementation on PTH was variable. Urinary Pyr/Cr and DPyr/Cr ratios were decreased from baseline over the entire study period in all groups receiving risedronate. The maximum observed percent decreases from baseline for Pyr/Cr and DPyr/Cr were -46.9% and -58.8%, respectively, at day 49 in the R-CP-R-CP group. In conclusion, risedronate given orally at a dose of 20 mg/day, continuously for 7 or 14 days, resulted in the expected biological response in osteoporotic women. The time course of changes in PTH levels following cessation of dosing was unaffected by calcium supplementation. There was no evidence of a PTH-mediated rebound in bone resorption following cessation of therapy. Furthermore, based on collagen cross-link data, patients did not show an excessive reduction in bone turnover. [less ▲]

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See detailLong-term effects of glucosamine sulphate on osteoarthritis progression: a randomised, placebo-controlled clinical trial
Reginster, Jean-Yves ULg; Deroisy, Rita ULg; Rovati, Lucio C et al

in Lancet (2001), 357

BACKGROUND: Treatment of osteoarthritis is usually limited to short-term symptom control. We assessed the effects of the specific drug glucosamine sulphate on the long-term progression of osteoarthritis ... [more ▼]

BACKGROUND: Treatment of osteoarthritis is usually limited to short-term symptom control. We assessed the effects of the specific drug glucosamine sulphate on the long-term progression of osteoarthritis joint structure changes and symptoms. METHODS: We did a randomised, double-blind placebo controlled trial, in which 212 patients with knee osteoarthritis were randomly assigned 1500 mg sulphate oral glucosamine or placebo once daily for 3 years. Weightbearing, anteroposterior radiographs of each knee in full extension were taken at enrolment and after 1 and 3 years. Mean joint-space width of the medial compartment of the tibiofemoral joint was assessed by digital image analysis, whereas minimum joint-space width--ie, at the narrowest point--was measured by visual inspection with a magnifying lens. Symptoms were scored by the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index. FINDINGS: The 106 patients on placebo had a progressive joint-space narrowing, with a mean joint-space loss after 3 years of -0.31 mm (95% CI -0.48 to -0.13). There was no significant joint-space loss in the 106 patients on glucosamine sulphate: -0.06 mm (-0.22 to 0.09). Similar results were reported with minimum joint-space narrowing. As assessed by WOMAC scores, symptoms worsened slightly in patients on placebo compared with the improvement observed after treatment with glucosamine sulphate. There were no differences in safety or reasons for early withdrawal between the treatment and placebo groups. INTERPRETATION: The long-term combined structure-modifying and symptom-modifying effects of gluosamine sulphate suggest that it could be a disease modifying agent in osteoarthritis. [less ▲]

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See detailEffect of risedronate on the risk of hip fracture in elderly women. Hip Intervention Program Study Group.
McClung, M R; Geusens, P; Miller, P D et al

in New England Journal of Medicine [=NEJM] (2001), 344(5), 333-40

BACKGROUND: Risedronate increases bone mineral density in elderly women, but whether it prevents hip fracture is not known. METHODS: We studied 5445 women 70 to 79 years old who had osteoporosis ... [more ▼]

BACKGROUND: Risedronate increases bone mineral density in elderly women, but whether it prevents hip fracture is not known. METHODS: We studied 5445 women 70 to 79 years old who had osteoporosis (indicated by a T score for bone mineral density at the femoral neck that was more than 4 SD below the mean peak value in young adults [-4] or lower than -3 plus a nonskeletal risk factor for hip fracture, such as poor gait or a propensity to fall) and 3886 women at least 80 years old who had at least one nonskeletal risk factor for hip fracture or low bone mineral density at the femoral neck (T score, lower than -4 or lower than -3 plus a hip-axis length of 11.1 cm or greater). The women were randomly assigned to receive treatment with oral risedronate (2.5 or 5.0 mg daily) or placebo for three years. The primary end point was the occurrence of hip fracture. RESULTS: Overall, the incidence of hip fracture among all the women assigned to risedronate was 2.8 percent, as compared with 3.9 percent among those assigned to placebo (relative risk, 0.7; 95 percent confidence interval, 0.6 to 0.9; P=0.02). In the group of women with osteoporosis (those 70 to 79 years old), the incidence of hip fracture among those assigned to risedronate was 1.9 percent, as compared with 3.2 percent among those assigned to placebo (relative risk, 0.6; 95 percent confidence interval, 0.4 to 0.9; P=0.009). In the group of women selected primarily on the basis of nonskeletal risk factors (those at least 80 years of age), the incidence of hip fracture was 4.2 percent among those assigned to risedronate and 5.1 percent among those assigned to placebo (P=0.35). CONCLUSIONS: Risedronate significantly reduces the risk of hip fracture among elderly women with confirmed osteoporosis but not among elderly women selected primarily on the basis of risk factors other than low bone mineral density. [less ▲]

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See detailInfluence of nutraceuticals on cartilage health and integrity
Henrotin, Yves ULg; Mathy-Hartet, M; Reginster, Jean-Yves ULg

in Proceeding of the Large Breed Health Care Symposium (2001)

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See detailEvaluation of classical NSAIDS and COX-2 selective inhibitors on purified ovine enzymes and human whole blood
De Leval, X; Dogne, JM; Delange, J et al

in Annals of the Rheumatic Diseases (2001), 60(S1), 343

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