Identificador persistente para citar o vincular este elemento: http://hdl.handle.net/10553/50721
Título: Risk factors for prediction of inadequate response to antiresorptives
Autores/as: Díez-Pérez, Adolfo
Olmos, Jose M.
Nogués, Xavier
Sosa, Manuel 
Díaz-Curiel, Manuel
Pérez-Castrillón, Jose Luis
Pérez-Cano, Ramon
Muñoz-Torres, Manuel
Torrijos, Antonio
Jodar, Esteban
Del Rio, Luis
Caeiro-Rey, Jose R.
Farrerons, Jordi
Vila, Joan
Arnaud, Claude
González-Macías, Jesus
Clasificación UNESCO: 32 Ciencias médicas
3205 Medicina interna
Palabras clave: Bone-Mineral Density
Vertebral Fracture Risk
Postmenopausal Women
Osteoporosis Therapy
Bisphosphonate Therapy, et al.
Fecha de publicación: 2012
Publicación seriada: Journal of Bone and Mineral Research 
Resumen: Some patients sustain fractures while on antiresorptives. Whether this represents an inadequate response (IR) to treatment or a chance event has not been elucidated. We performed a study to identify which patients are more likely to fracture while on treatment. This is a multicentric, cross-sectional study of postmenopausal women on antiresorptives for osteoporosis in 12 Spanish hospitals, classified as adequate responders (ARs) if on treatment with antiresorptives for 5 years with no incident fractures or inadequate responders (IRs) if an incident fracture occurred between 1 and 5 years on treatment. Poor compliance, secondary osteoporosis, and previous anti-osteoporosis treatment other than the assessed were exclusion criteria. Clinical, demographic, analytical, dual-energy X-ray absorptiometry (DXA) variables, and proximal femur structure analysis (Ima(TM)) and structural/fractal analyses of distal radius were performed. A total of 179 women (76 IRs; mean (SD): age 68.2 (9.0) years; 103 ARs, age 68.5 (7.9) years) were included. History of prior fracture (p=0.005), two or more falls in the previous year (p=0.032), low lumbar spine bone mineral density (BMD) (p=0.02), 25 hydroxyvitamin D (p=0.017), and hip ImaTx fracture load index (p=0.004) were associated with IR. In the logistic regression models a fracture before treatment (odds ratio [OR], 3.60; 95% confidence interval [CI], 1.47-8.82; p=0.005) and levels of 25 hydroxyvitamin D below 20 ng/mL (OR, 3.89; 95% CI, 1.55-9.77; p=0.004) significantly increased risk for IR, while increased ImaTx fracture load (OR, 0.96; 95% CI, 0.93-0.99; p = 0.006; per every 100 units) was protective, although the latter became not significant when all three variables were fitted into the model. Therefore, we can infer that severity of the disease, with microarchitectural and structure deterioration, as shown by previous fracture and hip analysis, and low levels of 25 hydroxy vitamin D carry higher risk of inadequate response to antiresorptives. More potent regimes should be developed and adequate supplementation implemented to solve this problem.
URI: http://hdl.handle.net/10553/50721
ISSN: 0884-0431
DOI: 10.1002/jbmr.1496
Fuente: Journal of Bone and Mineral Research[ISSN 0884-0431],v. 27, p. 817-824 (Abril 2012)
Colección:Artículos
Vista completa

Citas SCOPUSTM   

52
actualizado el 24-mar-2024

Citas de WEB OF SCIENCETM
Citations

46
actualizado el 25-feb-2024

Visitas

59
actualizado el 27-ene-2024

Google ScholarTM

Verifica

Altmetric


Comparte



Exporta metadatos



Los elementos en ULPGC accedaCRIS están protegidos por derechos de autor con todos los derechos reservados, a menos que se indique lo contrario.