nach oben

Journal of Bone and Mineral Metabolism

Erschienen in:

18.03.2021 | Original Article

Risk factors for incident vertebral fractures in osteoporosis pharmacotherapy: a 2-year, prospective, observational study

verfasst von: Hiroshi Hagino, Yukari Uemura, Satoshi Mori, Teruki Sone, Hiroaki Ohta, Toshitaka Nakamura

Erschienen in: Journal of Bone and Mineral Metabolism | Ausgabe 4/2021

Einloggen, um Zugang zu erhalten

Abstract

Introduction

To identify predictors for incident fractures in patients on pharmaceutical treatment for osteoporosis by a secondary analysis of the Japanese Osteoporosis Intervention Trial protocol number 4 (JOINT-04), which was a 2-year, randomized, parallel-group, controlled trial of minodronate and raloxifene in women with primary osteoporosis.

Materials and Methods

This was a prospective, observational study using JOINT-04 data, in which biomarkers, such as undercarboxylated osteocalcin (ucOC), N-telopeptide of type 1 collagen, tartrate-resistant acid phosphatase 5b (TRACP-5b), bone alkaline phosphatase, homocysteine, and pentosidine in blood, and physical functions, such as the timed up and go test and one-leg standing test with eyes open (OLST), and the fall risk index, were measured. The relationships of incident morphometric vertebral fractures during the treatment period, as well as prevalent vertebral fractures, and baseline data were analyzed.

Results

The full analysis set of the JOINT-04 included 3247 patients (1623 in the minodronate group and 1624 in the raloxifene group). The hazard ratio (95% confidence interval) for incident vertebral fractures over 2 years of pharmacotherapy, adjusted for confounders, was 0.93 (0.90–0.96) for ucOC, 1.15 (1.08–1.23) for TRACP-5b, 1.02 (1.01–1.03) for pentosidine, 0.91 (0.88–0.94) for the OLST, and 1.27 (1.01–1.60) for the fall risk index, which were all independent predictors.

Conclusion

Evaluating fracture risk for patients with osteoporosis considering these potential risk factors for fracture in addition to the established risk factors may be useful when starting pharmaceutical treatment.

Nur mit Berechtigung zugänglich

Riggs BL, Melton LJ 3rd (1995) The worldwide problem of osteoporosis: insights afforded by epidemiology. Bone 17:505S-511S. https://doi.org/10.1016/8756-3282(95)00258-4CrossRefPubMed

Fujiwara S, Nakamura T, Orimo H, Hosoi T, Gorai I, Oden A, Johansson H, Kanis JA (2008) Development and application of a Japanese model of the WHO fracture risk assessment tool (FRAX). Osteoporos Int 19:429–435. https://doi.org/10.1007/s00198-007-0544-4CrossRefPubMedPubMedCentral

Dai Z, Wang R, Ang LW, Yuan JM, Koh WP (2016) Bone turnover biomarkers and risk of osteoporotic hip fracture in an Asian population. Bone 83:171–177. https://doi.org/10.1016/j.bone.2015.11.005CrossRefPubMed

Massera D, Xu S, Walker MD, Valderrabano RJ, Mukamal KJ, Ix JH, Siscovick DS, Tracy RP, Robbins JA, Biggs ML, Xue X, Kizer JR (2019) Biochemical markers of bone turnover and risk of incident hip fracture in older women: the cardiovascular health study. Osteoporos Int 30:1755–1765. https://doi.org/10.1007/s00198-019-05043-1CrossRefPubMedPubMedCentral

Schoene D, Wu SM, Mikolaizak AS, Menant JC, Smith ST, Delbaere K, Lord SR (2013) Discriminative ability and predictive validity of the timed up and go test in identifying older people who fall: systematic review and meta-analysis. J Am Geriatr Soc 61:202–208. https://doi.org/10.1111/jgs.12106CrossRefPubMed

Larsson BAM, Johansson L, Johansson H, Axelsson KF, Harvey N, Vandenput L, Magnusson P, McCloskey E, Liu E, Kanis JA, Sundh D, Lorentzon M (2020) The timed up and go test predicts fracture risk in older women independently of clinical risk factors and bone mineral density. Osteoporos Int. https://doi.org/10.1007/s00198-020-05681-wCrossRefPubMedPubMedCentral

Jeong SM, Shin DW, Han K, Jung JH, Chun S, Jung HW, Son KY (2019) Timed up-and-go test is a useful predictor of fracture incidence. Bone 127:474–481. https://doi.org/10.1016/j.bone.2019.07.018CrossRefPubMed

Cawthon PM, Blackwell TL, Marshall LM, Fink HA, Kado DM, Ensrud KE, Cauley JA, Black D, Orwoll ES, Cummings SR, Schousboe JT, Osteoporotic Fractures in Men Research Group (2014) Physical performance and radiographic and clinical vertebral fractures in older men. J Bone Miner Res 29:2101–2108. https://doi.org/10.1002/jbmr.2239CrossRefPubMed

Lundin H, Saaf M, Strender LE, Nyren S, Johansson SE, Salminen H (2014) One-leg standing time and hip-fracture prediction. Osteoporos Int 25:1305–1311. https://doi.org/10.1007/s00198-013-2593-1CrossRefPubMed

10.

Uemura Y, Tanaka S, Miyazaki T, Tsukiyama M, Sone T, Taguchi A, Soen S, Mori S, Hagino H, Sugimoto T, Fukunaga M, Ohta H, Nakamura T, Orimo H, Shiraki M, Adequate Treatment of Osteoporosis Research Group (2019) Study design of multi-center, open-label randomized controlled, head-to-head trial comparing minodronic acid and raloxifene: Japanese Osteoporosis Intervention Trial (JOINT)-04. J Bone Miner Metab 37:491–495. https://doi.org/10.1007/s00774-018-0942-zCrossRefPubMed

11.

Matsumoto T, Hagino H, Shiraki M, Fukunaga M, Nakano T, Takaoka K, Morii H, Ohashi Y, Nakamura T (2009) Effect of daily oral minodronate on vertebral fractures in Japanese postmenopausal women with established osteoporosis: a randomized placebo-controlled double-blind study. Osteoporos Int 20:1429–1437. https://doi.org/10.1007/s00198-008-0816-7CrossRefPubMed

12.

Ettinger B, Black DM, Mitlak BH, Knickerbocker RK, Nickelsen T, Genant HK, Christiansen C, Delmas PD, Zanchetta JR, Stakkestad J, Gluer CC, Krueger K, Cohen FJ, Eckert S, Ensrud KE, Avioli LV, Lips P, Cummings SR (1999) Reduction of vertebral fracture risk in postmenopausal women with osteoporosis treated with raloxifene: results from a 3-year randomized clinical trial. Multiple Outcomes of Raloxifene Evaluation (MORE) investigators. JAMA 282:637–645. https://doi.org/10.1001/jama.282.7.637CrossRefPubMed

13.

Uemura Y, Sone T, Tanaka S, Miyazaki T, Tsukiyama M, Taguchi A, Soen S, Mori S, Hagino H, Sugimoto T, Fukunaga M, Ohta H, Nakamura T, Orimo H, Shiraki M, Adequate Treatment of Osteoporosis Research Group (2020) Randomized head-to-head comparison of minodronic acid and raloxifene for fracture incidence in postmenopausal Japanese women: the Japanese Osteoporosis Intervention Trial (JOINT)-04. Curr Med Res Opin. https://doi.org/10.1080/03007995.2020.1816537CrossRefPubMed

14.

Podsiadlo D, Richardson S (1991) The timed “up & go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 39:142–148. https://doi.org/10.1111/j.1532-5415.1991.tb01616.xCrossRefPubMed

15.

Michikawa T, Nishiwaki Y, Takebayashi T, Toyama Y (2009) One-leg standing test for elderly populations. J Orthop Sci 14:675–685. https://doi.org/10.1007/s00776-009-1371-6CrossRefPubMed

16.

Okochi J, Toba K, Takahashi T, Matsubayashi K, Nishinaga M, Takahashi R, Ohrui T (2006) Simple screening test for risk of falls in the elderly. Geriatr Gerontol Int 6:223–227. https://doi.org/10.1111/j.1447-0594.2006.00352.xCrossRef

17.

Genant HK, Wu CY, van Kuijk C, Nevitt MC (1993) Vertebral fracture assessment using a semiquantitative technique. J Bone Miner Res 8:1137–1148. https://doi.org/10.1002/jbmr.5650080915CrossRefPubMed

18.

Klotzbuecher CM, Ross PD, Landsman PB, Abbott TA 3rd, Berger M (2000) Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. J Bone Miner Res 15:721–739. https://doi.org/10.1359/jbmr.2000.15.4.721CrossRefPubMed

19.

Nishizawa Y, Miura M, Ichimura S, Inaba M, Imanishi Y, Shiraki M, Takada J, Chaki O, Hagino H, Fukunaga M, Fujiwara S, Miki T, Yoshimura N, Ohta H, from the Japan Osteoporosis Society Bone Turnover Marker Investigation Committee (2019) Executive summary of the Japan osteoporosis society guide for the use of bone turnover markers in the diagnosis and treatment of osteoporosis (2018 edition). Clin Chim Acta 498:101–107. https://doi.org/10.1016/j.cca.2019.08.012CrossRefPubMed

20.

Dobnig H, Piswanger-Solkner JC, Obermayer-Pietsch B, Tiran A, Strele A, Maier E, Maritschnegg P, Riedmuller G, Brueck C, Fahrleitner-Pammer A (2007) Hip and nonvertebral fracture prediction in nursing home patients: role of bone ultrasound and bone marker measurements. J Clin Endocrinol Metab 92:1678–1686. https://doi.org/10.1210/jc.2006-2079CrossRefPubMed

21.

Tromp AM, Ooms ME, Popp-Snijders C, Roos JC, Lips P (2000) Predictors of fractures in elderly women. Osteoporos Int 11:134–140. https://doi.org/10.1007/PL00004174CrossRefPubMed

22.

Shiraki M, Kashiwabara S, Imai T, Tanaka S, Saito M (2019) The association of urinary pentosidine levels with the prevalence of osteoporotic fractures in postmenopausal women. J Bone Miner Metab 37:1067–1074. https://doi.org/10.1007/s00774-019-01017-9CrossRefPubMed

23.

Shiraki M, Kuroda T, Shiraki Y, Tanaka S, Higuchi T, Saito M (2011) Urinary pentosidine and plasma homocysteine levels at baseline predict future fractures in osteoporosis patients under bisphosphonate treatment. J Bone Miner Metab 29:62–70. https://doi.org/10.1007/s00774-010-0191-2CrossRefPubMed

24.

Tamaki J, Kouda K, Fujita Y, Iki M, Yura A, Miura M, Sato Y, Okamoto N, Kurumatani N (2018) Ratio of endogenous secretory receptor for advanced glycation end products to pentosidine predicts fractures in men. J Clin Endocrinol Metab 103:85–94. https://doi.org/10.1210/jc.2017-00929CrossRefPubMed

25.

Shiraki M, Yamazaki Y, Shiraki Y, Hosoi T, Tsugawa N, Okano T (2010) High level of serum undercarboxylated osteocalcin in patients with incident fractures during bisphosphonate treatment. J Bone Miner Metab 28:578–584. https://doi.org/10.1007/s00774-010-0167-2CrossRefPubMed

26.

Szulc P, Chapuy MC, Meunier PJ, Delmas PD (1996) Serum undercarboxylated osteocalcin is a marker of the risk of hip fracture: a three year follow-up study. Bone 18:487–488. https://doi.org/10.1016/8756-3282(96)00037-3CrossRefPubMed

27.

Seichi A, Hoshino Y, Doi T, Akai M, Tobimatsu Y, Kita K, Iwaya T (2014) Determination of the optimal cutoff time to use when screening elderly people for locomotive syndrome using the one-leg standing test (with eyes open). J Orthop Sci 19:620–626. https://doi.org/10.1007/s00776-014-0581-8CrossRefPubMed

28.

Lundin H, Saaf M, Strender LE, Nyren S, Johansson SE, Salminen H (2017) Gait speed and one-leg standing time each add to the predictive ability of FRAX. Osteoporos Int 28:179–187. https://doi.org/10.1007/s00198-016-3818-xCrossRefPubMed

Titel: Risk factors for incident vertebral fractures in osteoporosis pharmacotherapy: a 2-year, prospective, observational study
verfasst von: Hiroshi Hagino
Yukari Uemura
Satoshi Mori
Teruki Sone
Hiroaki Ohta
Toshitaka Nakamura
Publikationsdatum: 18.03.2021
Verlag: Springer Nature Singapore
Erschienen in: Journal of Bone and Mineral Metabolism / Ausgabe 4/2021
Print ISSN: 0914-8779
Elektronische ISSN: 1435-5604
DOI: https://doi.org/10.1007/s00774-021-01208-3

Differences in subtrochanteric and diaphyseal atypical femoral fractures in a super-aging prefectural area: YamaCAFe Study

Original Article

Plasma periostin as a biomarker of osteoporosis in postmenopausal women with type 2 diabetes

Original Article

Role of irisin in effects of chronic exercise on muscle and bone in ovariectomized mice

Original Article

Aging and direct medical costs of osteoporotic fractures

Original Article

Response to the letter from Otsuka et al. Trends in the prevalence of underweight in women across generations in Japan

Letter to the Editor

PTH1-34 promotes osteoblast formation through Beclin1-dependent autophagic activation

Original Article

Kompaktes Leitlinien-Wissen Innere Medizin (Link öffnet in neuem Fenster)

Mit medbee Pocketcards schnell und sicher entscheiden.
Leitlinien-Wissen kostenlos und immer griffbereit auf ihrem Desktop, Handy oder Tablet.

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

Studie zur HIFU bei Prostatakrebs lässt viele Fragen offen

22.01.2025
Prostatakarzinom
Nachrichten

Führt eine HIFU-Ablation beim Prostatakarzinom im Vergleich mit einer radikalen Prostatektomie zu ähnlichen onkologischen, aber besseren funktionalen Ergebnissen? Interimsdaten der französischen HIFI-Studie sind uneindeutig. In einem Kommentar zur Studie werden zumindest drei allgemeine Erkenntnisse herausgearbeitet.

Leitlinienkonformes Management thermischer Verletzungen

22.01.2025
Verbrennung
Nachrichten

Thermische Verletzungen gehören zu den schwerwiegendsten Traumen und hinterlassen oft langfristige körperliche und psychische Spuren. Die aktuelle S2k-Leitlinie „Behandlung thermischer Verletzungen im Kindesalter (Verbrennung, Verbrühung)“ bietet eine strukturierte Übersicht über das empfohlene Vorgehen.

Frühe Hyperoxie nach Reanimation schlecht für die Prognose?

22.01.2025
Kardiopulmonale Reanimation
Nachrichten

Kommt es sehr früh nach einer kardiopulmonalen Reanimation zu einem Zustand der Hyperoxie, ist dies bei Patientinnen und Patienten nach einem Herzstillstand mit schlechteren funktionellen Ergebnissen assoziiert. Das zeigt eine Sekundäranalyse der TTM-2-Studie.

Infektanfälligkeit in früher Kindheit: eine bleibende Last?

22.01.2025
Pädiatrische Infektiologie
Nachrichten

Wenn Kinder in den ersten Lebensjahren immer wieder Infekte durchmachen, lässt dies Schlüsse auf die Infektneigung in der weiteren Kindheit zu.

EKG Essentials: EKG befunden mit System (Link öffnet in neuem Fenster)

In diesem CME-Kurs können Sie Ihr Wissen zur EKG-Befundung anhand von zwölf Video-Tutorials auffrischen und 10 CME-Punkte sammeln.
Praxisnah, relevant und mit vielen Tipps & Tricks vom Profi.

Jetzt 10 CME-Punkte sammeln

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Risk factors for incident vertebral fractures in osteoporosis pharmacotherapy: a 2-year, prospective, observational study