Validity of the French hip and knee replacement expectations surveys

in Osteoporosis International (2013, April), 24(Suppl.1), 374

Case report: Traumatic injury of the spinal accessory nerve

Conference (2012, November 23)

Role of glucosamine in the treatment for osteoarthritis.

in Rheumatology International (2012), 32(10), 2959-67

Over the last 20 years, several studies have investigated the ability of glucosamine sulfate to improve the symptoms (pain and function) and to delay the structural progression of osteoarthritis. There is ... [more ▼]

Over the last 20 years, several studies have investigated the ability of glucosamine sulfate to improve the symptoms (pain and function) and to delay the structural progression of osteoarthritis. There is now a large, convergent body of evidence that glucosamine sulfate, given at a daily oral dose of 1,500 mg, is able to significantly reduce the symptoms of osteoarthritis in the lower limbs. This dose of glucosamine sulfate has also been shown, in two independent studies, to prevent the joint space narrowing observed at the femorotibial compartment in patients with mild-to-moderate knee osteoarthritis. This effect also translated into a 50 % reduction in the incidence of osteoarthritis-related surgery of the lower limbs during a 5-year period following the withdrawal of the treatment. Some discrepancies have been described between the results of studies performed with a patent-protected formulation of glucosamine sulfate distributed as a drug and those having used glucosamine preparations purchased from global suppliers, packaged, and sold over-the-counter as nutritional supplements. [less ▲]

Comparison of the proportion of patients potentially treated with an anti-osteoporotic drug using the current criteria of the Belgian national social security and the new suggested FRAX criteria

in Rheumatology International (2012)

To assess the number of anti-osteoporosis treatments that would be reimbursed by the Belgian social security if either FRAX or the current criteria were used to determine access to reimbursement. This is ... [more ▼]

To assess the number of anti-osteoporosis treatments that would be reimbursed by the Belgian social security if either FRAX or the current criteria were used to determine access to reimbursement. This is a retrospective study based on data from 1,000 women randomly selected from an outpatient hospital specialized in bone metabolism in Belgium. Proportions of potentially refunded treatments between FRAX and current criteria were compared. Out of the 1,000 women files, 890 have sufficient information to assess FRAX . In Belgium, current criteria include a bone mineral density (BMD) T score below -2.5 at the lumbar spine, the femoral neck or the total hip and/or at least a prevalent vertebral fracture. Using these criteria, 167 women (18.8 %) would have access to reimbursement. Using the criteria based on the validated Belgian FRAX tool, only 116 women (13.0 %) would have access to reimbursement, meaning that access to reimbursement based on FRAX criteria would reduce by 30 % the anti-osteoporosis drug expenses covered by the national social security. Interestingly, only 65 women out of the 116 (56.0 %) selected with the FRAX criteria were also selected with the current criteria of the national social security. A substantial proportion of individuals that would potentially receive a reimbursement for their treatment using the FRAX criteria do not have access to any refund for their treatment with the current criteria. Since patients identified with the FRAX tool are those with the highest risk profile for future fractures, reappraisals of treatment reimbursement guidelines are expected in Belgium. [less ▲]

Assessment of quality of life in patients undergoing total joint replacement for OA of the lower limb

in Annals of the Rheumatic Diseases (2012, June), 71(Suppl.3), 693

Reimbursement of drugs against osteoporosis based on FRAX® instead of the current criteria would reduce by 30% the cost (in a societal perspective) of anti-osteoporosis treatment in Belgium

in Osteoporosis International (2011, March), 22(Suppl.1), 333-334

A FRAX(R) model for the assessment of fracture probability in Belgium.

in Osteoporosis International (2011), 22(2), 453-61

A country-specific FRAX(R) model was developed from the epidemiology of fracture and death in Belgium. Fracture probabilities were identified that corresponded to currently accepted reimbursement ... [more ▼]

A country-specific FRAX(R) model was developed from the epidemiology of fracture and death in Belgium. Fracture probabilities were identified that corresponded to currently accepted reimbursement thresholds. INTRODUCTION: The objective of this study was to evaluate a Belgian version of the WHO fracture risk assessment (FRAX(R)) tool to compute 10-year probabilities of osteoporotic fracture in men and women. A particular aim was to determine fracture probabilities that corresponded to the reimbursement policy for the management of osteoporosis in Belgium and the clinical scenarios that gave equivalent fracture probabilities. METHODS: Fracture probabilities were computed from published data on the fracture and death hazards in Belgium. Probabilities took account of age, sex, the presence of clinical risk factors and femoral neck bone mineral density (BMD). Fracture probabilities were determined that were equivalent to intervention (reimbursement) thresholds currently used in Belgium. RESULTS: Fracture probability increased with age, lower BMI, decreasing BMD T-score and all clinical risk factors used alone or combined. The 10-year probabilities of a major osteoporosis-related fracture that corresponded to current reimbursement guidelines ranged from approximately 7.5% at the age of 50 years to 26% at the age of 80 years where a prior fragility fracture was used as an intervention threshold. For women at the threshold of osteoporosis (femoral neck T-score = -2.5 SD), the respective probabilities ranged from 7.4% to 15%. Several combinations of risk-factor profiles were identified that gave similar or higher fracture probabilities than those currently accepted for reimbursement in Belgium. CONCLUSIONS: The FRAX(R) tool has been used to identify possible thresholds for therapeutic intervention in Belgium, based on equivalence of risk with current guidelines. The FRAX(R) model supports a shift from the current DXA-based intervention strategy, towards a strategy based on fracture probability of a major osteoporotic fracture that in turn may improve identification of patients at increased fracture risk. The approach will need to be supported by health economic analyses. [less ▲]

Le remboursement des traitements contre l'ostéoporose basé sur l'utilisation de l'outil FRAX plutôt que sur les critères actuels permettrait de réduire de 30% le coût, dans une perspective sociétale, du traitement de l'ostéoporose en Belgique

in Revue du Rhumatisme (2010, November), 77(Suppl.3), 66-67

Strontium ranelate: a look back at its use for osteoporosis

in Expert Opinion on Pharmacotherapy (2010), 11(17), 2915-2927

Importance of the field: Osteoporosis is now considered as a major health problem in all developed and in most developing (non-African) coutries. Areas covered in this review: In the present review, we ... [more ▼]

Importance of the field: Osteoporosis is now considered as a major health problem in all developed and in most developing (non-African) coutries. Areas covered in this review: In the present review, we provide an extensive literature survey (MEDLINE, PubMed, Cochrane Controlled Register), for articles dealing with osteoporosis management and/or strontium ranelate, from 1920 to 2010. What the reader will gain: The objective is to provide an extensive, unbiased assessment of the available data allowing to place strontium ranelate in perspective, with other anti-osteoporosis treatments. Take home message: Owing to a positive benefit/risk ratio, strontium ranelate may now be considered as a first-line treatment in the management of osteoporosis. [less ▲]

A FRAX® model for the assessment of fracture probability in Belgium

in Osteoporosis International (2010, May), 21(Suppl.1), 255