2017 papers internacionales. · 1. osteoporosis international = 262 2. j bone mineral research =...
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2017Papers Internacionales.
Dr. Pedro Paulo Marín Larraín
Profesor Titular
Depto. Medicina Interna-Geriatría
Facultad de Medicina PUC
Director SCHOMM
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Búsqueda en la web 2017.--.-..-
Google = 3.330.000 citas
Google Académico = 4.850 En español = 189
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Pub Med “BONE” en 100 años.
2000
Osteoporosis 2017 = 1.832 papers
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Web of Sciences – 2017.
Osteoporosis = 1.290 citas
• Terapias = 427
• Revisiones = 116
• Diagnóstico = 189
• Editoriales = 30–Resto abstracts, etc.
http://bibliotecas.uc.cl/
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Web of Sciences - Revistas
http://bibliotecas.uc.cl/
1. Osteoporosis International = 262
2. J Bone Mineral Research = 104
3. Annals Rheumatic Disease = 55
4. Archives of Osteoporosis = 40
5. Arthritis Rheumatology = 24
6. Bone = 20
7. Annals of Internal Medicine = 17
Medicine= 16, Rheumatology= 14, JAGS = 10 Maturitas=7
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• USA = 281
• China = 211
• Japón = 93
• UK = 85
• Brasil = 30
• Argentina = 12
• México = 10
• Colombia = 2
Web of Sciences- Países.
ESCRITOS en ESPAÑOL = 5
http://bibliotecas.uc.cl/
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Web of Sciences - ACP.
• Treatment of Low Bone Density or Osteoporosis to Prevent Fractures in Men and Women: A Clinical Practice Guideline Update From the American College of Physicians.
Amir Qaseem, MD, PhD, MHA; Mary Ann Forciea, MD; Robert M. McLean, MD; and Thomas D. Denberg, MD, PhD; for the Clinical
Guidelines Committee of the American College of Physicians*
Ann Intern Med. 2017;166:818-839
28 VECES CITADO EN EL AÑO 2017
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UK clinical guideline for the prevention and treatment of osteoporosis.
The National Osteoporosis Guideline Group (NOGG)
Arch Osteopor (2017) 12: 43This article is an open access publication
CITADO 12 VECES
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Decreasing trend of hip fractures incidence in Italy between 2007and 2014: epidemiological changes due to population aging
Archives of Osteoporosis (2018) 13:23
Hospitalizaciones anuales por fracturas de caderas
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Decreasing trend of hip fractures incidence in Italybetween 2007 and 2014:
epidemiological changes due to population aging.
Archives of Osteoporosis (2018) 13:23
SUBEN Hospitalizaciones por fracturas de caderas >85 AÑOS.
HOMBRES
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Decreasing trend of hip fractures incidence in Italy between 2007and 2014: epidemiological changes due to population aging.
Archives of Osteoporosis (2018) 13:23
Hospitalizaciones anuales por fracturas de caderas
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Rapid Geriatric Assessment
of Hip Fracture.
Jesse Zanker, MBBS, Gustavo Duque, MD
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Review: Pharmacological treatment of osteoporosis in the oldest old.
• -.-.-.the fact that evidence of the antifractureefficacy of osteoporosis treatments comes mainly from randomized controlled trials in postmenopausal women with a mean age of 70–75 years.
• This review discusses the pharmacological management of osteoporosis in the oldest old (>80 years).-.-.there is currently sufficient evidence to initiate appropriate treatment in the elderly with osteoporosis and osteoporotic fractures.
Clinical Interventions in Aging 2017:12 1065–1077
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10 years Denosumab treatment in postmenopauseal women with
osteoporosis: results from the phase 3 randomized
FREEDOM trial and open label extension.
Lancet Diabetes Endocrinology 2017, 5 (7):513-523
CITADO 24 VECES
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Vertebral Fractures After Discontinuation ofDenosumab: A Post Hoc Analysis of the Randomized
Placebo-Controlled FREEDOM Trial and Its Extension.
Journal of Bone and Mineral Research, Vol. 33, February 2018, pp 190–198
• In conclusion, denosumab substantially reduces the risk of vertebral fractures, and soon after treatment discontinuation, a patient’s risk of vertebral fracture returns to the level before treatment initiation.
• Additionally, more than half of patients who sustain a vertebral fracture have multiple vertebral fractures.
• Physicians should keep careful track of the dates when a patient’s next dose of denosumab is due.
I
If a patient discontinues denosumab, particularly if she has had a vertebral fracture, the patient should promptly receive a bisphosphonate or another
antiresorptive agent to prevent the increased risk of vertebral fractures, especially multiple vertebral
fractures, that develop soon after stopping denosumab.
Denosumad reduce las fracturas vertebrales a largo plazo.
PERO al parar remedio vuelve al riesgo similar al previo.
Más de la mitad casos presenta múltiples fracturas
vertebrales.
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Vertebral Fractures After Discontinuation ofDenosumab: A Post Hoc Analysis of the Randomized
Placebo-Controlled FREEDOM Trial and Its Extension.
Journal of Bone and Mineral Research, Vol. 33, February 2018, pp 190–198
Múltiples fracturasvertebrales
Therefore, patients who discontinue denosumab should
rapidly transition to an alternative antiresorptive treatment
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Romosozumab or Alendronate for FracturePrevention in Women with Osteoporosis.
Sept. 11, 2017, at NEJM
13 veces citado-.-.-
n=4.093 mujeres osteoporóticas con fractura vertebral PREVIARendomizado-multicéntricoRomosozumab 210mg sbc./mes - Aledronato 70mg/mensual POSeguidos por 24 meses = incidencia fracturas vertebrales y otras• ROMOSOZUMAB redujo fracturas vertebrales a los 12 y 24 meses• Redujo 19% no vertebrales y 38% de caderas
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Romosozumab or Alendronate for FracturePrevention in Women with Osteoporosis.
Sept. 11, 2017, at NEJM.org.
un año
Alendronato 70mg/semanal
3 años
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Romosozumab or Alendronate for FracturePrevention in Women with Osteoporosis.
Sept. 11, 2017, NEJM
Incidencia NUEVAS fracturas Vertebrales
12 MESES24 meses
Primera fractura NO VERTEBRAL
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Benefits and Harms of Osteoporosis Medications in Patients With Chronic Kidney Disease.
A Systematic Review and Meta-analysis
Data Sources: PubMed and the Cochrane Central Register of Controlled Trials from December 2006 through December 2016.
Conclusion: Effects of osteoporosis medications on BMD, fracture risk, and safety among patients with CKD
are not clearly established.
Ann Intern Med. 2017;166:649-658.
AUN FALTAN MAS-MEJORES ESTUDIOS
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Effect of Longer-Interval vs Standard Dosing of ZoledronicAcidon Skeletal Events in Patients With Bone Metastases
A Randomized Clinical Trial.
CONCLUSIONS AND RELEVANCE Among patients with bone metastases due to breast cancer,
prostate cancer, or multiple myeloma, the use of zoledronic acid every 12 weeks compared
with the standard dosing interval of every 4 weeks did not result in an increased risk of
skeletal events over 2 years.
JAMA. 2017;317(1):48-58.
A 2 años = Acido ZOLENDRONICO es idem cada 4 o 12 semanas
MEJOR usarlo MAS ESPACIADO
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Effect of Longer-Interval vs Standard Dosing of ZoledronicAcidon Skeletal Events in Patients With Bone Metastases
A Randomized Clinical Trial
JAMA. 2017;317(1):48-58.
Cada 12 semanas es idem
que 4 semanas
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Effects of teriparatide and risedronate on new fractures inpost-menopausal women with severe osteoporosis (VERO):
a multicentre, double-blind, double-dummy, randomisedcontrolled trial.
www.thelancet.com online November 9, 2017 http://dx.doi.org/10.1016/S0140-6736(17)32137-2
Trial “cabeza-cabeza” de dos tratamientos• 24 meses-mujeres postmenopáusicas con
fracturas vertebrales previas = Osteoporosis Severa (n=268 en cada grupo)
• End point =incidencia nuevas fracturas vertebrales por Rx.
• Mejor resultado con Teriparatide sbc. que Riserdonato 35mg/semanal.
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Effects of teriparatide and risedronate on new fractures inpost-menopausal women with severe osteoporosis (VERO):
a multicentre, double-blind, double-dummy, randomisedcontrolled trial.
www.thelancet.com online November 9, 2017 http://dx.doi.org/10.1016/S0140-6736(17)32137-2
FORTEO-R
Incidencia NUEVAS FRACTURAS vertebral
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Effects of teriparatide and risedronate on new fractures inpost-menopausal women with severe osteoporosis (VERO):
a multicentre, double-blind, double-dummy, randomisedcontrolled trial.
www.thelancet.com online November 9, 2017 http://dx.doi.org/10.1016/S0140-6736(17)32137-2
Primera fractura NO vertebral Primera fractura vertebralCLINICA
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Effects of teriparatide and risedronate on new fractures inpost-menopausal women with severe osteoporosis (VERO):
a multicentre, double-blind, double-dummy, randomisedcontrolled trial.
www.thelancet.com online November 9, 2017 http://dx.doi.org/10.1016/S0140-6736(17)32137-2
DOLOR LUMBAR
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FRAX-based intervention and assessment
thresholds in seven Latin American countries.
https://doi.org/10.1007/s00198-017-4341-4
P. Clark. Denova-Gutiérrez, Zerbini. Sanchez, Messina, J. Jaller, C. Campusano, C. H. Orces G. Riera H. Johansson J. A. Kanis
Osteoporosis Internationalhttps://doi.org/10.1007/s00198-017-4341-4
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IOF Compendium of OsteoporosisFirst Edition, October 2017
2017 International Osteoporosis Foundation