References of "Reginster, Jean-Yves"
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See detailOstéoporose et Médecine Personnalisée
Reginster, Jean-Yves ULg; NEUPREZ, Audrey ULg; LECART, Marie-Paule ULg et al

in Revue Médicale de Liège (2015), 70(5-6), 321-324

Osteoporosis is at the very early stages of the implementation of personalized medicine. However, the development of FRAX®, an algorithm offering the opportunity to calculate, in an individual patient ... [more ▼]

Osteoporosis is at the very early stages of the implementation of personalized medicine. However, the development of FRAX®, an algorithm offering the opportunity to calculate, in an individual patient, his/her 10-year fracture risk improves the decision process on the appropriateness to initiate a pharmacological treatment. This algorithm helps the physician to select drugs which are active on non-vertebral fractures only in high risk patients. Taking into consideration patients’ preferences, when selecting a therapeutic option, will improve long term adherence and subsequently efficacy and efficiency of the treatments. Attempts to define the natural course of osteoporosis or the response to therapy in individual patients by assessing their genetic profile remains, so far, inconclusive. [less ▲]

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See detailComments on the discordant recommendations for the use of symptomatic slow-acting drugs in knee osteoarthritis.
Reginster, Jean-Yves ULg; Cooper, Cyrus; Hochberg, Marc et al

in Current medical research and opinion (2015), 31(5), 1041-1045

Abstract Despite the near concurrent publication by influential scientific organizations, there are important differences in interpretation of the evidence base and the conclusions derived from the recent ... [more ▼]

Abstract Despite the near concurrent publication by influential scientific organizations, there are important differences in interpretation of the evidence base and the conclusions derived from the recent Osteoarthritis Research Society International (OARSI) guidelines for the management of knee osteoarthritis, the American College of Rheumatology (ACR) (concerning also hip and hand osteoarthritis) and the algorithm recommendations by the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). This is particularly evident for the drug class of Symptomatic Slow-Acting Drugs in OsteoArthritis. In this paper, we highlight these differences and try to understand where they derive from, proposing an evidence-based interpretation. [less ▲]

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See detailA phase IV, two-armed, randomized, cross-over study comparing compliance with once-a-month administration of vitamin D3 to compliance with daily administration of a fixed-dose combination of vitamin D3 and calcium during two 6-month periods
Bruyère, Olivier ULg; DEROISY, Rita ULg; Dardenne, Nadia ULg et al

in Osteoporosis International (2015)

Summary In a randomized, cross-over study, once monthly administration of vitamin D3 was preferred over a once daily administration of a fixed-dose combination of vitamin D3 and calcium, with a better ... [more ▼]

Summary In a randomized, cross-over study, once monthly administration of vitamin D3 was preferred over a once daily administration of a fixed-dose combination of vitamin D3 and calcium, with a better compliance but without any significant difference in the increase in vitamin D levels. Introduction The aim of the present study was to compare a once-monthly administration of vitamin D3 to a daily administration of a fixed-dose combination of vitamin D3 and calcium during two treatment periods of 6 months. Methods One hundred volunteers aged 50 years old or older were randomized to receive either one drinkable ampoule containing 25,000 IU vitamin D3 (D-Cure®, SMB) once monthly (group VD) or one chewable tablet containing 1000 mg calcium carbonate+800 IU vitamin D3 (Steovit Forte®, Takeda) once daily (group VDCa) during 6 months. After the first 6 months of treatment, the groups were reversed according to the randomized cross-over design. Treatment compliance (i.e. the primary outcome), preference, acceptability and vitamin D levels and adverse events were all collected. Results For the two periods, the patients had a significantly higher compliance in the VD group than in the VDCa group (p<0.0001). During the study, 50 (56.8 %) patients preferred the VD treatment, 16 (18.2 %) patients preferred the VDCa, and for 22 (25.0 %) patients, neither treatment was preferred. At the end of the first 6 months of treatment, the mean (SD) increase of 25(OH)D was 6.57 ng/mL (8.19) in the VD group and 3.88 ng/mL (10.0) in the VDCa group (p=0.16 between groups). Conclusion In this study, a once-monthly administration of vitamin D3 was preferred over a once-daily administration of a fixed-dose combination of vitamin D3 and calcium, with a better compliance but without any significant difference in the increase in vitamin D levels. [less ▲]

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See detailQuality of life and physical components linked to sarcopenia: The SarcoPhAge study.
Beaudart, Charlotte ULg; Reginster, Jean-Yves ULg; Petermans, Jean ULg et al

in Experimental gerontology (2015), 69

INTRODUCTION: The SarcoPhAge project is an ongoing longitudinal study following community-dwelling elderly subjects with the objective to assess some health and functional consequences of sarcopenia. The ... [more ▼]

INTRODUCTION: The SarcoPhAge project is an ongoing longitudinal study following community-dwelling elderly subjects with the objective to assess some health and functional consequences of sarcopenia. The sarcopenia diagnosis algorithm developed by the European Working Group on Sarcopenia in Older People (EWGSOP) and used in the present study needs further validation through cross-sectional and longitudinal studies. The aim of the present study is to assess, using this algorithm, the prevalence of sarcopenia and the clinical components linked to this geriatric syndrome. METHODS: Participants were community dwelling subjects aged 65years or older. To diagnose sarcopenia, we applied the definition of the EWGSOP. Muscle mass was measured by dual-energy X-ray absorptiometry, muscle strength by a hydraulic dynamometer and physical performance by the SPPB test. Large amounts of socio-demographic, anamnestic and clinical data were collected in all subjects. RESULTS OVER ONE YEAR: 534 subjects were recruited for this study (60.5% of women, mean age of 73.5+/-6.16years), among whom 73 subjects were diagnosed sarcopenic, which represents a global prevalence of 13.7%. Prevalence was 11.8% in men and 14.9% in women. Sarcopenic subjects were older; had a lower Body Mass Index, lower calf, waist, wrist and arm circumferences; presented more cognitive impairments (Mini-Mental State Examination), more comorbidities; were more often malnourished; and consumed more drugs. After adjustment for age, BMI, cognitive status, nutritional status, number of comorbidities and number of drugs, sarcopenic subjects had a worse physical health-related quality of life (SF-36) for the domain of physical functioning, were at higher risk of falls (Timed Up and Go test), were more frail (Fried), presented more often tiredness for the achievement of activities of daily living (Mobility-test), presented less fat mass and obviously less lean mass. Sarcopenic women were also more dependent for housekeeping and handling finances (Lawton scale) than non-sarcopenic ones. CONCLUSION: Sarcopenia seems to be associated with many harmful clinical components making this geriatric syndrome a real public health burden. Follow-up data of the SarcoPhAge study will be helpful to assess the outcomes of sarcopenia based on the EWGSOP diagnosis algorithm and its different proposed cut-offs. [less ▲]

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See detailCan we use bone turnover markers as targets for antiresorptive treatment in postmenopausal osteoporosis ? an analysis from two phase 3 clinical trials.
BROWN, J.P.; DAKIN, P.; HADJI, P. et al

in Arthritis and Rheumatology (2015), 67(S10), 515-517

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See detailRelationship between total hip BMD T-score and incidence of nonvertebral fracture with up to 8 years of denosumab treatment
FERRARI, S.; LIBANATI, C.; LIN, CJF. et al

in Arthritis and Rheumatology (2015), 67(s10), 487-489

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See detailMobile phone-connected wearable motion sensors to assess postoperative mobilization
APPELBOOM, G.; TAYLOR, B.E.; BRUCE, E. et al

in Journal of Medical Internet Research Mobile and Ubiquitous Health (2015), 3(3), 78

Background: Early mobilization after surgery reduces the incidence of a wide range of complications. Wearable motion sensors measure movements over time and transmit this data wirelessly, which has the ... [more ▼]

Background: Early mobilization after surgery reduces the incidence of a wide range of complications. Wearable motion sensors measure movements over time and transmit this data wirelessly, which has the potential to monitor patient recovery and encourages patients to engage in their own rehabilitation. Objective: We sought to determine the ability of off-the-shelf activity sensors to remotely monitor patient postoperative mobility. Methods: Consecutive subjects were recruited under the Department of Neurosurgery at Columbia University. Patients were enrolled during physical therapy sessions. The total number of steps counted by the two blinded researchers was compared to the steps recorded on four activity sensors positioned at different body locations. Results: A total of 148 motion data points were generated. The start time, end time, and duration of each walking session were accurately recorded by the devices and were remotely available for the researchers to analyze. The sensor accuracy was significantly greater when placed over the ankles than over the hips (P<.001). Our multivariate analysis showed that step length was an independent predictor of sensor accuracy. On linear regression, there was a modest positive correlation between increasing step length and increased ankle sensor accuracy (r=.640, r2=.397) that reached statistical significance on the multivariate model (P=.03). Increased gait speed also correlated with increased ankle sensor accuracy, although less strongly (r=.444, r2=.197). We did not note an effect of unilateral weakness on the accuracy of left- versus right-sided sensors. Accuracy was also affected by several specific measures of a patient’s level of physical assistance, for which we generated a model to mathematically adjust for systematic underestimation as well as disease severity. Conclusions: We provide one of the first assessments of the accuracy and utility of widely available and wirelessly connected activity sensors in a postoperative patient population. Our results show that activity sensors are able to provide invaluable information about a patient’s mobility status and can transmit this data wirelessly, although there is a systematic underestimation bias in more debilitated patients. [less ▲]

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See detailAesthetic discomfort in hand osteoarthritis: results from the LIège Hand Osteoarthritis Cohort (LIHOC)
Neuprez, Audrey ULg; Bruyère, Olivier ULg; MAHEU, E. et al

in Arthritis Research & Therapy (2015), 17

Introduction: The primary complaint of patients with hand osteoarthritis (OA) is frequently the inelegant appearance of their hands. Only one study has been conducted to assess the magnitude of and ... [more ▼]

Introduction: The primary complaint of patients with hand osteoarthritis (OA) is frequently the inelegant appearance of their hands. Only one study has been conducted to assess the magnitude of and identify the determinants of aesthetic discomfort in hand OA. Methods: The LIège Hand Osteoarthritis Cohort is a prospective cohort of 203 patients diagnosed with hand OA. At baseline, these patients rated their aesthetic discomfort on a 100-mm visual analogue scale (VAS) and used a Likert scale (range 0–7) to quantify the magnitude of their aesthetic damage. Results: The median value of the aesthetic discomfort VAS was 35.0 [interquartile range (Q1–Q3) 6.0–59.0]. The median damage was rated 3.0 (Q1–Q3 1.0–4.0), corresponding to a moderate level. Both were significantly (p < 0.02) associated with the female gender, the duration of hand OA, the radiological severity of OA (Verbruggen–Veys and Kellgren–Lawrence scales) and pain, disability, or stiffness [Australian Canadian Osteoarthritis Hand Index (AUSCAN) and Functional Index for Hand Osteoarthritis ]. After a stepwise analysis, the parameters correlated to the aesthetic discomfort were the presence of erosive joints (p = 0.0048), the AUSCAN score (p < 0.0001), the number of joints with severe radiological damage (p = 0.023), and gender (p = 0.0009). For aesthetic damage, the parameters associated were AUSCAN score (p < 0.0001), duration of hand OA >10 years (p = 0.001), and presence of erosive joints (p < 0.0001). Compared with patients with low aesthetic discomfort (VAS ≤33 mm), those with the highest discomfort (VAS ≥66 mm) had more erosive OA (p = 0.014), a higher Verbruggen and Veys score (p = 0.0039), and a higher AUSCAN score (p < 0.001). Conclusions: Aesthetic discomfort and damage are significant complaints in patients with hand OA. The determinants of the magnitude of these are gender, radiological severity, duration of hand OA, presence of erosive joints, and impact on pain, function, and stiffness as assessed with the AUSCAN. [less ▲]

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See detailRecommendations for an update of the 2010 European regulatory guideline on clinical investigation of medical products used in the treatment of osteoarthritis and reflections about related clinically relevant outcomes: expert consensus statement.
Reginster, Jean-Yves ULg; REITER-NIESERT, S.; Bruyère, Olivier ULg et al

in Osteoarthritis and Cartilage (2015), 23

Objective: The European Society on Clinical and Economic aspects of Osteoporosis and Osteoarthritis (ESCEO) organised a working group to evaluate the need for updating the current European guideline on ... [more ▼]

Objective: The European Society on Clinical and Economic aspects of Osteoporosis and Osteoarthritis (ESCEO) organised a working group to evaluate the need for updating the current European guideline on clinical investigation of drugs used in the treatment of osteoarthritis (OA). Design: Areas of potential attention were identified and the need for modifications, update or clarification was examined. Proposals were then developed based on literature reviews and through a consensus process. Results: It was agreed that the current guideline overall still reflects the current knowledge in OA, although two possible modifications were identified. The first relates to the number and timing of measurements required as primary endpoints during clinical trials of symptom-relieving drugs, either drugs with rapid onset of action or slow acting drugs. The suggested modifications are intended to take into consideration the time related clinical need and expected time response to these drugs e i.e., a more early effect for the first category in addition to the maintenance of effect, a more continuous benefit over the long-term for the latter e in the timing of assessments. Secondly, values above which a benefit over placebo should be considered clinically relevant were considered. Based on literature reviews, the most consensual values were determined for primary endpoints of both symptom-relieving drugs (i.e., pain intensity on a visual analogue scale (VAS)) and disease-modifying drugs (i.e., radiographic joint-space narrowing). [less ▲]

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See detailFurther reductions in nonvertebral fracture rate with long-term denosumab treatment in the FREEDOM open-label extension and influence of hip bone mineral density after 3 years.
FERRARI, S.; ADACHI, J.D.; LUPPUNER, K. et al

in Osteoporosis International (2015), 26

Limited data exist on the efficacy of long-term therapies for osteoporosis. In osteoporotic postmenopausal women receiving denosumab for 7 years, nonvertebral fracture rates significantly decreased in ... [more ▼]

Limited data exist on the efficacy of long-term therapies for osteoporosis. In osteoporotic postmenopausal women receiving denosumab for 7 years, nonvertebral fracture rates significantly decreased in years 4–7 versus years 1–3. This is the first demonstration of a further benefit on fracture outcomes with long-term therapy for osteoporosis. Introduction This study aimed to evaluate whether denosumab treatment continued beyond 3 years is associated with a further reduction in nonvertebral fracture rates. Methods Participants who completed the 3-year placebocontrolled Fracture REduction Evaluation of Denosumab in Osteoporosis every 6 Months (FREEDOM) study were invited to participate in an open-label extension. The present analysis includes 4,074 postmenopausal women with osteoporosis (n=2,343 long-term; n=1,731 cross-over) who enrolled in the extension, missed ≤1 dose during their first 3 years of denosumab treatment, and continued into the fourth year of treatment. Comparison of nonvertebral fracture rates during years 1–3 of denosumab with that of the fourth year and with the rate during years 4–7 was evaluated. Results For the combined group, the nonvertebral fracture rate per 100 participant-years was 2.15 for the first 3 years of denosumab treatment (referent) and 1.36 in the fourth year (rate ratio [RR]=0.64; 95 % confidence interval (CI)=0.48 to 0.85, p=0.003). Comparable findings were observed in the groups separately and when nonvertebral fracture rates during years 1–3 were compared to years 4–7 in the longterm group (RR=0.79; 95 % CI=0.62 to 1.00, p=0.046). Fracture rate reductions in year 4 were most prominent in subjects with persisting low hip bone mineral density (BMD). Conclusions Denosumab treatment beyond 3 years was associated with a further reduction in nonvertebral fracture rate that persisted through 7 years of continuous denosumab administration. The degree to which denosumab further reduces nonvertebral fracture risk appears influenced by the hip bone density achieved with initial therapy [less ▲]

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See detailDevelopment of a self-administrated quality of life questionnaire for sarcopenia in elderly subjects: the SarQol
Beaudart, Charlotte ULg; Biver, Emmanuel; Reginster, Jean-Yves ULg et al

in Age & Ageing (2015), 44

BACKGROUND: the impact of sarcopenia on quality of life is currently assessed by generic tools. However, these tools may not detect subtle effects of this specific condition on quality of life. OBJECTIVE ... [more ▼]

BACKGROUND: the impact of sarcopenia on quality of life is currently assessed by generic tools. However, these tools may not detect subtle effects of this specific condition on quality of life. OBJECTIVE: the aim of this study was to develop a sarcopenia-specific quality of life questionnaire (SarQoL, Sarcopenia Quality of Life) designed for community-dwelling elderly subjects aged 65 years and older. SETTINGS: participants were recruited in an outpatient clinic in Liège, Belgium. SUBJECTS: sarcopenic subjects aged 65 years or older. METHODS: the study was articulated in the following four stages: (i) Item generation-based on literature review, sarcopenic subjects' opinion, experts' opinion, focus groups; (ii) Item reduction-based on sarcopenic subjects' and experts' preferences; (iii) Questionnaire generation-developed during an expert meeting; (iv) Pretest of the questionnaire-based on sarcopenic subjects' opinion. RESULTS: the final version of the questionnaire consists of 55 items translated into 22 questions rated on a 4-point Likert scale. These items are organised into seven domains of dysfunction: Physical and mental health, Locomotion, Body composition, Functionality, Activities of daily living, Leisure activities and Fears. In view of the pretest, the SarQoL is easy to complete, independently, in ∼10 min. CONCLUSIONS: the first version of the SarQoL, a specific quality of life questionnaire for sarcopenic subjects, has been developed and has been shown to be comprehensible by the target population. Investigations are now required to test the psychometric properties (internal consistency, test-retest reliability, divergent and convergent validity, discriminant validity, floor and ceiling effects) of this questionnaire. [less ▲]

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See detailReliability of muscle strength measures obtained with a hand-held dynamometer in an elderly population.
Buckinx, Fanny ULg; Croisier, Jean-Louis ULg; Reginster, Jean-Yves ULg et al

in Clinical Physiology & Functional Imaging (2015)

BACKGROUND: The objective of this study was to assess the reliability of a hand-held dynamometer for isometric strength measurements among nursing home residents. METHODS: The isometric muscle strength of ... [more ▼]

BACKGROUND: The objective of this study was to assess the reliability of a hand-held dynamometer for isometric strength measurements among nursing home residents. METHODS: The isometric muscle strength of nursing home residents was assessed for eight different muscle groups, using a hand-held dynamometer, the MicroFET2 device. Strength measurements were performed at baseline and after 4 days by the same operator and after 8 days by a second operator. Intraclass coefficients (ICC) were computed to assess the relative reliability, whereas the minimal detectable change (MDC%) was calculated to assess the absolute reliability of the test-retest of the MicroFET2 used by one single operator or by two different ones. RESULTS: Thirty nursing home residents (75.0 +/- 11.2 years, 50% of women) were enrolled in this study. ICC of the test-retest with one single operator ranged from 0.60 (0.37-0.83) for the ankle extensors to 0.85 (0.74-0.95) for the elbow flexors. When considering the test-retest with two different operators, the ICC values ranged from 0.62 (0.41-0.84) for the ankle extensors to 0.87 (0.79-0.96) for the elbow extensors. For the absolute reliability, MDC% varies from 27.64 (elbow flexors) to 81.97 (ankle extensors) when performed in intra-observer. In interobserver condition, MDC%, respectively, varies from 24.38 (elbow extensors) 67.59 (ankle extensors). CONCLUSION: Using standardized protocol and standardized instructions to patients, a high relative and moderate absolute reliability was observed for all but ankle muscle groups, making this hand-held dynamometer a potential tool for research in the elderly population. [less ▲]

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See detailDevelopment and validation of the French version of a tool assessing patient's expectations in lower limb osteoarthritis
NEUPREZ, Audrey ULg; Delcour, Jean-Pierre; Fatemi, Firouzeh et al

in Journal of Orthopaedics (2015), 12

Objective: The Hospital for Special Surgery (HSS) Hip Replacement Expectations Survey and <br />Knee Replacement Expectations Survey are validated tools developed to measure patients' <br />preoperative ... [more ▼]

Objective: The Hospital for Special Surgery (HSS) Hip Replacement Expectations Survey and <br />Knee Replacement Expectations Survey are validated tools developed to measure patients' <br />preoperative expectations for hip and knee arthroplasty. These instruments have possible <br />uses in both daily practice and research. Our objective was to assess the test-retest reliability <br />and the construct validity of the French version of the surveys. <br />Methods: Patients scheduled for total hip (n ¼ 82) or knee replacement (n ¼ 61) aged 38e90 <br />years were included. All completed the HSS Hip or Knee Replacement Expectations Survey <br />and the Expectation WOMAC to determine concurrent validity. <br />The test-retest reliability was assessed using the intraclass coefficient correlation (ICC), <br />the Bland and Altman Method and the coefficient of variation; the internal consistency was <br />assessed by the Cronbach a coefficient. The construct validity was investigated using the <br />Pearson correlation coefficient and floor and ceiling effects by percentage frequency of <br />lowest or highest possible score achieved by respondents. <br />Results: 143 patients scheduled for hip or knee arthroplasty were included. <br />The reliability was excellent between the test and the rested total score, with an ICC of <br />0.902 (0.853e0.936) and CV of 4.06% for the French Hip Replacement Expectations Survey <br />and 0.865 (0.786e0.917) and CV of 7.7% for the French Knee Replacement Expectations <br />Survey, without bias. <br />The Cronbach a coefficient was 0.72 for hip Survey and 0.82 for knee Survey showing a <br />good internal consistency. <br />Pearson correlation coefficients of 0.45 and 0.48 between Expectations WOMAC and <br />HSS, respectively for hip Survey and knee Survey, were observed but with systematic bias. <br />The lowest possible score was not reported by any patient and only three patients <br />(3.66%) scheduled for hip arthroplasty reported the highest possible score. Conclusions: The French version of the HSS Hip or Knee Replacement Expectations Survey is <br />a reliable and valid questionnaire and compares favourably with the original English <br />version. Therefore, this new version may help French-speaking clinicians to evaluate expectations <br />before lower limb arthroplasty. [less ▲]

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See detailBaseline characteristics of the Liège Hand Osteoarthritis Cohort (LIHOC)
NEUPREZ, Audrey ULg; Bruyère, Olivier ULg; Dardenne, Nadia ULg et al

in Annals of the Rheumatic Diseases (2015), 74(Supp2), 1346

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See detailCan we identify patients with high risk of osteoarthritis progression who will respond to treatment? A focus on biomarkers ans frailty
Arden, Nigel; Richette, Pascal; Cooper, Cyrus et al

in Drugs & Aging (2015), 32

Osteoarthritis (OA), a disease affecting different patient phenotypes, appears as an optimal candidate for personalized healthcare. The aim of the discussions of the European Society for Clinical and ... [more ▼]

Osteoarthritis (OA), a disease affecting different patient phenotypes, appears as an optimal candidate for personalized healthcare. The aim of the discussions of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) working group was to explore the value of markers of different sources in defining different phenotypes of patients with OA. The ESCEO organized a series of meetings to explore the possibility of identifying patients who would most benefit from treatment for OA, on the basis of recent data and expert opinion. In the first meeting, patient phenotypes were identified according to the number of affected joints, biomechanical factors, and the presence of lesions in the subchondral bone. In the second meeting, summarized in the present article, the working group explored other markers involved in OA. Profiles of patients may be defined according to their level of pain, functional limitation, and presence of coexistent chronic conditions including frailty status. A considerable amount of data suggests that magnetic resonance imaging may also assist in delineating different phenotypes of patients with OA. Among multiple biochemical biomarkers identified, none is sufficiently validated and recognized to identify patients who should be treated. Considerable efforts are also being made to identify genetic and epigenetic factors involved in OA, but results are still limited. The many potential biomarkers that could be used as potential stratifiers are promising, but more research is needed to characterize and qualify the existing biomarkers and to identify new candidates. [less ▲]

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See detailDiabetes is a risk factor for knee osteoarthritis progression
Eymard, F; Parsons, C; Edwards, M et al

in Osteoarthritis and Cartilage (2015), 23

Purpose Recent studies have suggested that metabolic factors (obesity, diabetes, hypertension and dyslipidemia) and their clustering in metabolic syndrome (MetS) might be involved in the pathophysiology ... [more ▼]

Purpose Recent studies have suggested that metabolic factors (obesity, diabetes, hypertension and dyslipidemia) and their clustering in metabolic syndrome (MetS) might be involved in the pathophysiology of knee osteoarthritis (OA). We investigated their impact on radiographic progression by an annualised measure of the joint space narrowing (JSN) of the medial tibiofemoral compartment. Methods 559 patients older than 50 years with symptomatic knee OA were recruited for the placebo arm of the SEKOIA trial. The presence of diabetes, hypertension and dyslipidemia was determined at baseline interview. BMI was calculated, obesity was considered >30 kg/m2. MetS was defined by the sum of metabolic factors ≥3. Minimal medial tibiofemoral joint space on plain radiographs was measured by an automated method at baseline and then annually for up to 3 years. Results The mean age of patients was 62.8 [62.2-63.4] years; 392 were women. A total of 43.8% was obese, 6.6% had type 2 diabetes, 45.1% hypertension, 27.6% dyslipidemia and 13.6% MetS. Mean annualised JSN was greater for patients with type 2 diabetes than without diabetes (0.26 [-0.35 - -0.17] vs. 0.14 [-0.16 - -0.12] mm; p=0.001). This association remained significant after adjustment for sex, age, BMI, hypertension and dyslipidemia (p=0.018). In subgroup analysis, type 2 diabetes was a significant predictor of JSN in males but not females. The other metabolic factors and MetS were not associated with annualised JSN. Conclusion Type 2 diabetes was a predictor of joint space reduction in men with established knee OA. No relationships were found between MetS or other metabolic factors and radiographic progression. [less ▲]

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See detailExploring the Interest in and the Usage of the Internet Among Patients Eligible for Osteoporosis Screening.
Slomian, Justine ULg; Reginster, Jean-Yves ULg; Gaspard, Ulysse ULg et al

in Calcified tissue international (2015), 96

The aim of this study was to evaluate the interest in the Internet and its usage for health-related issues among people eligible for osteoporosis screening. Self-administered questionnaires have been ... [more ▼]

The aim of this study was to evaluate the interest in the Internet and its usage for health-related issues among people eligible for osteoporosis screening. Self-administered questionnaires have been distributed to subjects who were screened for osteoporosis and to menopausal women. 177 patients have responded to the survey (64.5 +/- 10.1 years, 88.1 % of women). There are 78.5 % of Internet users. Among them, 67.2 % said searching information about their health and 74.5 % said using the Internet for this purpose. All respondents attributed an average score, out of 10, of 5.7 +/- 2.3 regarding the reliability of information that they could find on the Internet. The use of the Internet differs significantly depending on age: those who use the Internet are younger (62.1 +/- 8.91 years) than those who do not use it (73.3 +/- 9.42 years). The socioeconomic status also has an impact on the Internet use: Internet users have a higher education, are more professionally active and have a higher net monthly household income compared to the group of non-users. Even if age and socioeconomic status appear to be determining factors in the use of the Internet for the search of health information in patients eligible for osteoporosis screening, almost 75 % of the study population use the Internet for this purpose. Action to promote health through an Internet platform must therefore take these parameters into account. [less ▲]

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See detailTrabecular bone score (TBS) as a new complementary approach for osteoporosis evaluation in clinical practice.
Harvey, N. C.; Gluer, C. C.; Binkley, N. et al

in Bone (2015), 78

Trabecular bone score (TBS) is a recently-developed analytical tool that performs novel grey-level texture measurements on lumbar spine dual X-ray absorptiometry (DXA) images, and thereby captures ... [more ▼]

Trabecular bone score (TBS) is a recently-developed analytical tool that performs novel grey-level texture measurements on lumbar spine dual X-ray absorptiometry (DXA) images, and thereby captures information relating to trabecular microarchitecture. In order for TBS to usefully add to bone mineral density (BMD) and clinical risk factors in osteoporosis risk stratification, it must be independently associated with fracture risk, readily obtainable, and ideally, present a risk which is amenable to osteoporosis treatment. This paper summarizes a review of the scientific literature performed by a Working Group of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis. Low TBS is consistently associated with an increase in both prevalent and incident fractures that is partly independent of both clinical risk factors and areal BMD (aBMD) at the lumbar spine and proximal femur. More recently, TBS has been shown to have predictive value for fracture independent of fracture probabilities using the FRAX(R) algorithm. Although TBS changes with osteoporosis treatment, the magnitude is less than that of aBMD of the spine, and it is not clear how change in TBS relates to fracture risk reduction. TBS may also have a role in the assessment of fracture risk in some causes of secondary osteoporosis (e.g. diabetes, hyperparathyroidism and glucocorticoid-induced osteoporosis). In conclusion, there is a role for TBS in fracture risk assessment in combination with both aBMD and FRAX. [less ▲]

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See detailThe position of Strontium ranelate in today's management of osteoporosis
Reginster, Jean-Yves ULg; Brandi, M.L; Cannata-Andia, J. et al

in Osteoporosis International (2015), 26

Osteoporosis accounts for about 3 % of total European health-care spending. The low proportion of costs for the pharmacological prevention of osteoporotic fracture means that it is highly cost saving ... [more ▼]

Osteoporosis accounts for about 3 % of total European health-care spending. The low proportion of costs for the pharmacological prevention of osteoporotic fracture means that it is highly cost saving, especially in patient with severe osteoporosis or patients who cannot take certain osteoporosis medications due to issues of contraindications or tolerability. Following recent regulatory changes, strontium ranelate is now indicated in patients with severe osteoporosis for whom treatment with other osteoporosis treatments is not possible, and without contraindications including uncontrolled hypertension, established, current or past history of ischaemic heart disease, peripheral arterial disease, and/or cerebrovascular disease. We review here today’s evidence for the safety and efficacy of strontium ranelate. The efficacy of strontium ranelate in patients complying with the new prescribing information (i.e. severe osteoporosis without contraindications) has been explored in a multivariate analysis of clinical trial data, which concluded that the antifracture efficacy of strontiumranelate is maintained in patients with severe osteoporosis without contraindications and also demonstrated how the new target population mitigates risk. Strontium ranelate is therefore an important alternative in today’s management of osteoporosis, with a positive benefit-risk balance, provided that the revised indication and contraindications are followed and cardiovascular risk is monitored. The bone community should be reassured that there remain viable alternatives in patients in whom treatment with other agents is not possible and protection against the debilitating effects of fracture is still feasible in patients with severe osteoporosis. [less ▲]

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See detailCommentary on recent therapeutic guidelines for osteoarthritis
Cutolo, M; Berenbaum, F; Hochberg, M et al

in Seminars in Arthritis & Rheumatism (2015), 44

Background Despite availability of international evidence-based guidelines for osteoarthritis (OA) management, agreement on the different treatment modalities is lacking. Method A symposium of European ... [more ▼]

Background Despite availability of international evidence-based guidelines for osteoarthritis (OA) management, agreement on the different treatment modalities is lacking. Method A symposium of European and US OA experts was held within the framework of the Annual European Congress of Rheumatology to discuss and compare guidelines and recommendations for the treatment of knee OA and to reach a consensus for management, particularly for areas in which there is no clear consensus: non-pharmacological therapy; efficacy and safety of analgesics and non-steroidal anti-inflammatory drugs (NSAIDs); intra-articular (i.a.) hyaluronates (HA); and the role of chondroitin sulfate (CS) and/or glucosamine sulfate (GS). Results All guidelines reviewed agree that knee OA is a progressive disease of the joint whose management requires non-pharmacological and pharmacological approaches. Discrepancies between guidelines are few and mostly reflect heterogeneity of expert panels involved, geographical differences in the availability of pharmacotherapies, and heterogeneity of studies included. Panels chosen for guideline development should include experts with real clinical experience in drug use and patient management. Implementation of agreed guidelines can be thwarted by drug availability and reimbursement plans, resulting in optimal OA treatment being jeopardized, HA and symptomatic slow-acting drugs for osteoarthritis (SySADOAs) being clear examples of drugs whose availability and prescription can greatly vary geographically. In addition, primary care providers, often responsible for OA management (at least in early disease), may not adhere to clinical care guidelines, particularly for non-pharmacological OA treatment. Conclusion Harmonization of the recommendations for knee OA treatment is challenging but feasible, as shown by the step-by-step therapeutic algorithm developed by European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). More easily disseminated and implemented guidance for OA treatment in the primary care setting is key to improved management of OA. [less ▲]

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