8605 Effective Strategies For Pregnancy And Lactation-Associated Osteoporosis: Teriparatide Use In Focus
Notice bibliographique
Résumé
Abstract Disclosure: D.S. Ali: None. A.A. Khan: Advisory Board Member; Self; Amgen Inc, Alexion, Ascendis. Grant Recipient; Self; Takeda, Amolyt, Calcilytix. Speaker; Self; Amgen Inc, Alexion. M. Brandi: Consulting Fee; Self; Aboca, Alexion, Amolyt, Bruno Farmaceutici, Calcilytix, Echolight, Kyowa Kirin, Personal Genomics, UCB. Speaker; Self; Abiogen, Alexion, Amolyt, Amorphical, Bruno Farmaceutici, CoGeDi, Echolight, Amgen Inc, Eli Lilly & Company. Background: Pregnancy and lactation-associated osteoporosis (PLO) is a rare but debilitating condition characterized by fragility fractures occurring during late pregnancy or during lactation, primarily affecting the spine. Current treatment strategies lack clear guidance on optimal management due to the absence of clinical trials. Previous treatment strategies focused on conventional measures such as the use of calcium supplements, vitamin D, back braces, and weaning from breastfeeding. Antiresorptive therapies have also been used. The use of teriparatide (TPD) in PLO has gained more attention in the past decade due to its anabolic properties and potential suitability for women of childbearing age. Methods: We searched PubMed, Google Scholar, and Medline until August 2023. Over 300 cases with PLO have been published. We included cases with a confirmed diagnosis of PLO based on clinical history and radiographic confirmation. Cases with prior fragility fractures, traumatic fractures or prior diagnosis of osteoporosis have been excluded. Results: We identified a total of 175 cases of PLO treated with either TPD alone or TPD followed by antiresorptive therapy. We also identified another cohort of 81 women where separation of those receiving TPD from other treatment was not possible. Most women in our analysis were primiparas (85.7%). The duration of TPD use ranged from 4 to 24 months. Despite the acknowledged risk of recurrent fractures in PLO, 82.8% of those treated with TPD did not sustain new fractures during a follow-up period ranging from 4 months to 9 years. Although direct treatment comparative studies are lacking, available evidence suggests that TPD treatment significantly improves bone mineral density (BMD) at the spine (33% at 24 months) and hip (18.6% at 18-24 months). Bisphosphonates, demonstrate varying degrees of BMD improvement. Bone turnover markers such as C-telopeptide cross-linked type I collagen (CTx) and osteocalcin have been studied in patients with PLO, suggesting that they may be predictive of BMD response to TPD treatment. Conclusion: This review highlights the severity of PLO and its health consequences, advocates for increased awareness and timely interventions. TPD emerges as a promising therapeutic option, offering substantial BMD responses and potentially serving as the primary choice for PLO treatment, given its safety profile and short half-life. Especially with consideration of the potential long-term effects associated with bisphosphonate use in women of childbearing age. Use of BTMs need further validation. Presentation: 6/3/2024
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».