Bone diseases

Findings from two studies suggest that more attention may need to be given to the prevention of osteoporotic fractures among women with systemic sclerosis.

The risk for hip fracture is higher during a treatment break from risedronate than it is during a break from alendronate, study findings indicate.

Findings from a meta-analysis suggest that bisphosphonate therapy for osteoporosis is most likely to benefit postmenopausal women who have a life expectancy of more than 12 months.

In patients with rheumatoid arthritis, low-dose glucocorticoids are associated with an increased risk for vertebral fracture, but not with overall or non-vertebral fractures, show findings from a UK-based retrospective cohort study.

Less than half of patients with polymyalgia rheumatica are prescribed medications for osteoporosis, despite clinical guidelines recommending bone protection for those on long-term glucocorticoid treatment, research suggests.

Romosozumab and other sclerostin inhibitors may increase cardiovascular risk, suggests evidence from a meta-analysis of randomized trials and a study of genetic variants that mimic pharmacologic inhibition of sclerostin.

Individuals with systemic sclerosis have lower bone mineral density and a higher risk for vertebral fracture than those without the disease, indicate findings from a meta-analysis.

The cathepsin K inhibitor odanacatib reduces the incidence of fracture in postmenopausal women with osteoporosis, but at the cost of an increased risk for cardiovascular events, indicate findings from the LOFT trial.

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Findings from a meta-analysis published in JAMA Internal Medicine indicate that drug treatments for osteoporosis, particularly bisphosphonates, are not associated with a significant reduction in overall mortality risk.

US research shows that the use of opioids, selective serotonin reuptake inhibitors, or glucocorticoids may increase the risk for all types of osteoporotic fracture in patients with rheumatoid arthritis.

Malachi McKenna explains the risks of long-term bisphosphonate therapy in patients with osteoporosis, and the rationale for a drug holiday. He also compares bisphosphonates with denosumab, and explains why denosumab should not be followed by a drug holiday.

Balasubramanian A et al. Osteoporos Int 2018. doi: 10.1007/s00198-018-4732-1

The use of vitamin D supplements for maintaining or improving musculoskeletal health is not warranted, suggest the findings of an updated systematic review and meta-analysis.

Treatment with zoledronate once every 18 months significantly reduces the risk for nonvertebral or vertebral fragility fractures, compared with placebo, in postmenopausal women with osteopenia, study findings indicate.