Osteoporosis News

by Daniel J. Acevedo, PA-C

The American Orthopaedic Association announced it will launch an orthopedic-focused teleECHO program for its Own the Bone program in spring 2019 in conjunction with Project ECHO. The American Orthopaedic Association is the second specialty society to launch a teleECHO program.

Osteonecrosis of the jaw was a rare complication among older postmenopausal women with osteoporosis treated with denosumab for at least 3 years, despite 45% of women undergoing an invasive oral procedure while receiving treatment, according to findings published in The Journal of Clinical Endocrinology & Metabolism.

Among older adults, hip fractures are associated with a significant, persistent negative impact on health-related quality of life over 10 years, affecting levels of mobility, self-care, ambulation and pain, according to findings published in the Journal of Bone and Mineral Research.

WAIKOLOA, Hawaii — Surgeons should stop bisphosphonates in patients with bisphosphonate related femur fractures at the start of treatment and treatment options may vary, according to a presenter at Orthopedics Today Hawaii.

The Bone, Reproductive and Urologic Drugs Advisory Committee of the FDA voted 18-1 Wednesday in favor of recommending approval of a biologics license application for the monoclonal antibody romosozumab for the treatment of osteoporosis in postmenopausal women at high risk for fracture, with two of 18 “yes” votes supporting a different indication for the drug.

This installment of osteoporosis primer for PAs will focus on the modalities used to diagnosis osteoporosis. To reiterate a diagnosis of osteoporosis could be made in an adult patient aged older than 50 years who has experienced a ground level fall resulting in a fragility hip or vertebral compression fracture. Vertebral compression fractures are the most common fragility type fracture but clearly the fracture associated with the highest mortality are those of the hip. In fact, any fracture, excluding toes, fingers and skull, can be considered osteoporotic fragility type if they occur from a fall from ground level or less. However, follow-up bone density testing for these patients is indicated. These fractures cause substantial pain, disability and decreased quality of life. Besides the increased morbidity that these fractures cause, they are also expensive to the health care system resulting in 2.5 million medical visits and over 400,000 hospital admissions per year.

Pfenex this week submitted a new drug application to the FDA seeking approval for PF708, a follow-on biosimilar referencing teriparatide for the treatment of osteoporosis, according to a press release from the company.

A 75-year-old woman presents today for a preoperative evaluation prior to a left total knee replacement. She is a thin, otherwise healthy, white woman with no significant medical history aside from hypertension managed by a low-dose diuretic, diet and exercise. She does note in passing that she has gotten shorter over the years. She entered early menopause at the age of 40 years due to a total hysterectomy and was not treated with hormone replacement therapy. She does not drink or smoke. Her mother died at age 90 years, 8 months after surgery for a broken hip. You ask the patient if she has ever had a bone density test, or DXA scan, and she states that she has not.

Researchers have identified four pain susceptibility phenotypes among patients with or at risk for knee osteoarthritis, according to findings published in Arthritis & Rheumatology.