Osteoporosis Therapy in Postmenopausal Women With High Risk of Fracture

Cappola, Anne R.; Shoback, Dolores

doi:10.1001/jama.2016.11032

Cited by 27 publications

(23 citation statements)

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“…In this study, the subjects in the OP and ON groups were chosen randomly according with the recruiting criteria, and we further recruited the normal controls also at the same age and sex ratio to keep a balance. In view of this, we should consider the relevant hormonal changes, with corresponding effects on bone metabolism, because postmenopausal women are at high risk for osteoporosis (Cappola & Shoback, 2016). Researchers have reported that prebiotics improve calcium absorption, calcium accretion in bone and BMD in adolescents as well as postmenopausal female subjects (Roberfroid et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

Diversity analysis of gut microbiota in osteoporosis and osteopenia patients

Wang

Gao

et al. 2017

PeerJ

181

150

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Some evidence suggests that bone health can be regulated by gut microbiota. To better understand this, we performed 16S ribosomal RNA sequencing to analyze the intestinal microbial diversity in primary osteoporosis (OP) patients, osteopenia (ON) patients and normal controls (NC). We observed an inverse correlation between the number of bacterial taxa and the value of bone mineral density. The diversity estimators in the OP and ON groups were increased compared with those in the NC group. Beta diversity analyses based on hierarchical clustering and principal coordinate analysis (PCoA) could discriminate the NC samples from OP and ON samples. Firmicutes, Bacteroidetes, Proteobacteria and Actinobacteria constituted the four dominant phyla in all samples. Proportion of Firmicutes was significantly higher and Bacteroidetes was significantly lower in OP samples than that in NC samples (p < 0.05), Gemmatimonadetes and Chloroflexi were significantly different between OP and NC group as well as between ON and NC group (p < 0.01). A total of 21 genera with proportions above 1% were detected and Bacteroides accounted for the largest proportion in all samples. The Blautia, Parabacteroides and Ruminococcaceae genera differed significantly between the OP and NC group (p < 0.05). Linear discriminant analysis (LDA) results showed one phylum community and seven phylum communities were enriched in ON and OP, respectively. Thirty-five genus communities, five genus communities and two genus communities were enriched in OP, ON and NC, respectively. The results of this study indicate that gut microbiota may be a critical factor in osteoporosis development, which can further help us search for novel biomarkers of gut microbiota in OP and understand the interaction between gut microbiota and bone health.

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Section: Discussionmentioning

confidence: 99%

Diversity analysis of gut microbiota in osteoporosis and osteopenia patients

Wang

Gao

et al. 2017

PeerJ

181

150

View full text Add to dashboard Cite

show abstract

“…In this study, the subjects in OP and ON groups were chosen randomly according with the recruiting criteria, and we further recruited the normal controls also at the same age and sex ratio to keep a balance. In view of this, we should consider the relevant hormonal changes, with corresponding effects on bone metabolism, because postmenopausal women are at high risk for osteoporosis (Cappola & Shoback 2016). Researchers have reported that prebiotics improve calcium absorption, calcium accretion in bone and BMD in adolescents as well as postmenopausal female subjects (Roberfroid et al 2010).…”

Section: Discussionmentioning

confidence: 99%

Peer Review #1 of "Diversity analysis of gut microbiota in osteoporosis and osteopenia patients (v0.1)"

Vinas¹

2017

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Some evidence suggest that bone health can be regulated by gut microbiota. To better understand this, we performed 16S ribosomal RNA sequencing to analyze the intestinal microbial diversity in primary osteoporosis (OP) patients, osteopenia (ON) patients and normal controls (NC). We observed an inverse correlation between the number of bacterial taxa and the value of bone mineral density. The diversity estimators in OP and ON groups were increased compared with that in NC group. Beta diversity analyses based on hierarchical clustering and principal coordinate analysis (PCoA) could discriminate the NC samples from OP and ON samples. Firmicutes, Bacteroidetes, Proteobacteria and Actinobacteria constituted the four dominant phyla in all samples. Proportion of Firmicutes was significantly higher and Bacteroidetes was significantly lower in OP samples than that in NC samples (p < 0.05), Gemmatimonadetes and Chloroflexi were significantly different between OP and NC group as well as between ON and NC group (p < 0.01). A total of 21 genera with proportions above 1% were detected and Bacteroides accounted for the largest proportion in all samples. The Blautia, Parabacteroides and Ruminococcaceae genera differed significantly between the OP and NC group (p < 0.05). Linear discriminant analysis (LDA) results showed 1 phylum community and 7 phylum communities were enriched in ON and OP, respectively. 35 genus communities, 5 genus communities and 2 genus communities were enriched in OP, ON and NC, respectively. The results of this study indicate that gut microbiota may be a critical factor in osteoporosis development, which can further help us search for novel biomarkers of gut microbiota in OP and understand the interaction between gut microbiota and bone health.

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“…Osteoporosis is still undertreated despite many years of advances, particularly in its diagnosis, assessment of fracture risk, and development of interventions that reduce the risk of fractures [ 1 ]. There are several classes of approved osteoporosis therapies, which either inhibit osteoclast-mediated bone resorption (bisphosphonates, selective estrogen receptor modulators, and the monoclonal antibody to receptor activator of nuclear kappa-B ligand) or stimulate osteoblast-mediated bone formation (teriparatide and abaloparatide) [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Effect of abaloparatide on vertebral, nonvertebral, major osteoporotic, and clinical fractures in a subset of postmenopausal women at increased risk of fracture by FRAX probability

McCloskey

Fitzpatrick

et al. 2019

Arch Osteoporos

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Summary We evaluated the efficacy of abaloparatide in women who were at increased risk for fracture, based on CHMP recommended risk thresholds, at the Abaloparatide Comparator Trial In Vertebral Endpoints (ACTIVE) study baseline. Among patients at high risk based on FRAX probabilities, 18 months of abaloparatide significantly decreased risk for all fracture endpoints compared with placebo. Purpose Abaloparatide, a novel anabolic agent for the treatment of postmenopausal osteoporosis, significantly reduced the risk of vertebral and nonvertebral fractures in the ACTIVE study compared with placebo. In this post hoc analysis, we evaluated abaloparatide’s efficacy in a subset of women in the study at an increased risk of fracture at baseline, based on the Committee for Medicinal Products for Human Use (CHMP) recommended risk thresholds for inclusion in clinical trials. Methods Women with a baseline 10-year risk of major osteoporotic fracture ≥ 10% or hip fracture ≥ 5%, assessed using the FRAX® tool (including femoral neck bone mineral density), were included in the analysis. The proportion with one or more events of new morphometric vertebral fractures was calculated. Event rates for nonvertebral, major osteoporotic, and all clinical fractures were estimated using Kaplan-Meier analysis. Results Following 18 months of treatment, abaloparatide significantly reduced incident vertebral fractures compared with placebo (relative risk reduction = 91%; 0.5% versus 5.6%; p < 0.001). Abaloparatide treatment was also associated with significantly fewer nonvertebral, major osteoporotic, and clinical fractures compared with placebo: 2.7% versus 5.8%, p = 0.036; 1.3% versus 6.0%, p < 0.001; and 3.5% versus 8.2%, p = 0.006, respectively. The effect of abaloparatide on major osteoporotic fractures (78% reduction) was significantly greater than that seen with teriparatide (23% reduction, p = 0.007). Conclusion In a subset of postmenopausal women at increased risk of fracture as judged by CHMP guidance, abaloparatide significantly decreased the risk of all fracture endpoints compared with placebo.

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Osteoporosis Therapy in Postmenopausal Women With High Risk of Fracture

Cited by 27 publications

References 10 publications

Diversity analysis of gut microbiota in osteoporosis and osteopenia patients

Diversity analysis of gut microbiota in osteoporosis and osteopenia patients

Peer Review #1 of "Diversity analysis of gut microbiota in osteoporosis and osteopenia patients (v0.1)"

Effect of abaloparatide on vertebral, nonvertebral, major osteoporotic, and clinical fractures in a subset of postmenopausal women at increased risk of fracture by FRAX probability

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