11 research outputs found
Efficacy and safety of daily risedronate in the treatment of corticosteroid-induced osteoporosis in men and women: a randomized trial
No full textPrevention of glucocorticoid osteoporosis: a consensus document of the Dutch Society for Rheumatology
No full textPrevention of glucocorticoid osteoporosis: a consensus document of the Dutch Society for Rheumatology
No full textRonde tafel bijeenkomst: preventie en behandeling van glucocorticosteroid geinduceerde osteoporose
No full textRonde tafel bijeenkomst: preventie en behandeling van glucocorticosteroid geinduceerde osteoporose
No full textCalculations of provincial environmental costs with RIM+. A pilot study for Limburg
No full textDe resultaten werden beschreven van een haalbaarheidsstudie met als doel om na te gaan of het RIM+ (Reken en informatiesysteem Milieuhygiene) dat nu door het RIVM wordt gebruikt voor het doorrekenen van nationale milieukosten, ook geschikt is voor het maken van provinciale milieukostenberekeningen. Hiertoe zijn voor een provincie (Limburg) de benodigde gegevens verzameld en ingevoerd in RIM+, waarna milieukosten met RIM+ zijn berekend. Resultaat van de pilot is dat het inderdaad mogelijk is provinciale milieukosten te berekenen met het RIM+. De uitkomsten zijn wat methodiek, soort resultaten en kwaliteit betreft vergelijkbaar met de kostenberekeningen die TME in 1994 voor de provincies heeft uitgevoerd. Tijdens de pilot is een aantal knelpunten onderkend, waarmee in een eventuele vervolgfase rekening moet worden gehouden. Behalve met het model RIM+ hebben deze knelpunten betrekking op de organisatie van provinciale kostenberekeningen en de methodiek en databehoefte van een provinciaal kostenmodel. Drie opties voor een provinciaal milieukostenmodel worden geevalueerd. Uiteindelijk wordt een voorstel gepresenteerd, dat zoveel mogelijk de positieve punten van de verschillende opties combineert.As a first step in the cooperation between provinces and RIVM in developing a model for calculations of environmental costs, a pilot study was carried out to calculate the environmental costs to the Dutch province of Limburg using the model RIM+. This model, already used by RIVM for calculations of environmental costs on a national level, had to be partly adapted. The pilot shows that it is indeed possible to use RIM+ for provincial cost calculations. In carrying out the pilot, insight was gained into detailed desires and requirements related to input, output, methods and organisational aspects. Based on the results three options for the future are evaluated, in an advice for future actions.provincie LimburgDG
Efficacy and safety of daily risedronate in the treatment of corticosteroid-induced osteoporosis in men and women: A randomized trial
No full textLong-term use of high-dose corticosteroids often results in bone loss, which may lead to osteoporosis-related fractures. This was a multicenter, double-blind study in which 290 ambulatory men and women receiving high-dose oral corticosteroid therapy (prednisone greater than or equal to 7.5 mg/day or equivalent) for 6 or more months were randomized to receive placebo, risedronate 2.5 mg/day, or risedronate 5 mg/day for 12 months. All patients received calcium 1 g and vitamin D 400 IU daily. The primary endpoint was lumbar spine bone mineral density (BMD) at month 12, Additional measurements included BMD at the femoral neck and trochanter and the incidence of vertebral fractures, Overall, there were statistically significant treatment effects on BMD at 12 months at the lumbar spine (p < 0.001), femoral neck (p = 0.004), and trochanter (p = 0.010), Risedronate 5 mg increased BMD at 12 months by a mean (SEM) of 2.9% (0.49%) at the lumbar spine, 1.8% (0.46%) at the femoral neck, and 2.4% (0.54%) at the trochanter, whereas BMD was maintained only in the control group, Although not powered to show fracture efficacy, we observed a reduction in the incidence of vertebral fractures of 70% in the combined risedronate treatment groups, relative to placebo (p = 0.042), Risedronate was well tolerated, had a good safety profile, and was not associated with gastrointestinal adverse events. We conclude that risedronate increases BMD and potentially reduces the incidence of vertebral fractures in patients,vith corticosteroid-induced osteoporosis
Prevalence of vertebral deformities and symptomatic vertebral fractures in corticosteroid treated patients with rheumatoid arthritis
No full textObjective. This study was designed to determine whether the prevalence of vertebral deformities in patients with rheumatoid arthritis (RA) treated with corticosteroids (Cs) is higher than in RA patients not receiving Cs therapy.Patients and methods. This multicentre cross-sectional study included 205 patients with RA who were receiving Cs orally on a daily basis and 205 patients with RA who did not receive Cs, matched for sex and age. Vertebral deformities were scored according to the Kleerekoper method.Results. Vertebral deformities were found in 52 (25%) patients on Cs and in 26 (13%) patients not on Cs. Sixteen (8%) patients in the group on Cs had experienced clinical manifestations of an acute vertebral fracture in the past vs only three patients (1.5%) among those not on Cs. The use of Cs tended to increase the risk of developing a vertebral deformity [adjusted odds ratio (OR) 1.56, 95% confidence interval (CI) 0.81-2.99] and symptomatic vertebral fracture (adjusted OR 1.42, 95% CI 0.24-8.32). Each 1-mg increase in the current daily Cs dose increased the risk of a vertebral deformity (adjusted OR 1.05, 95% CI 0.98-1.13) and of a symptomatic vertebral fracture (adjusted OR 1.05, 95% CI 0.89-1.24).Conclusion. There is a higher prevalence of vertebral deformities and clinical manifestations of vertebral fractures in patients on Cs than in those not on Cs. Our data indicate that the use of Cs and each 1-mg increase in the current daily Cs dose may increase the risk of development of a vertebral deformity and symptomatic vertebral fracture in patients with RA.</p
Prevalence of vertebral deformities and symptomatic vertebral fractures in corticosteroid treated patients with rheumatoid arthritis
No full textObjective. This study was designed to determine whether the prevalence of vertebral deformities in patients with rheumatoid arthritis (RA) treated with corticosteroids (Cs) is higher than in RA patients not receiving Cs therapy. Patients and methods. This multicentre cross-sectional study included 205 patients with RA who were receiving Cs orally on a daily basis and 205 patients with RA who did not receive Cs, matched for sex and age. Vertebral deformities were scored according to the Kleerekoper method. Results. Vertebral deformities were found in 52 (25%) patients on Cs and in 26 (13%) patients not on Cs. Sixteen (8%) patients in the group on Cs had experienced clinical manifestations of an acute vertebral fracture in the past vs only three patients (1.5%) among those not on Cs. The use of Cs tended to increase the risk of developing a vertebral deformity [adjusted odds ratio (OR) 1.56, 95% confidence interval (CI) 0.81-2.99] and symptomatic vertebral fracture (adjusted OR 1.42, 95% CI 0.24-8.32). Each 1-mg increase in the current daily Cs dose increased the risk of a vertebral deformity (adjusted OR 1.05, 95% CI 0.98-1.13) and of a symptomatic vertebral fracture (adjusted OR 1.05, 95% CI 0.89-1.24). Conclusion. There is a higher prevalence of vertebral deformities and clinical manifestations of vertebral fractures in patients on Cs than in those not on Cs. Our data indicate that the use of Cs and each 1-mg increase in the current daily Cs dose may increase the risk of development of a vertebral deformity and symptomatic vertebral fracture in patients with RA
Nuevas aportaciones al conocimiento acerca de la utilización clínica de la densitometría ósea
No full text[spa] Revisión de los factores que intervienen en la interpretación de la densitometría ósea (aparato, regiones de interés, información aportada por la técnica, curvas de referencia de normalidad poblacional) y su indicación (criterios de indicación de densitometría de diferentes organismos). Se relacionan 5 estudios con las aportaciones en relación a la interpretación de la densitometría y su indicación. En el primer estudio se evalúa la importancia de la curva de normalidad de referencia para la clasificación de personas y grupos poblacionales, comparándose, en cuello de fémur, la curva de normalidad española y la propuesta por el estudio americano NHANES III. No se observan diferencias apreciables en la clasificación de individuos, pero sí en la identificación de grupos poblacionales. En el segundo estudio se evalúa la necesidad de realizar una densitometría ósea en mujeres posmenopáusicas con una fractura vertebral clínica. Se observa que tres cuartas partes de las mujeres con fractura vertebral clínica tienen osteoporosis, y casi todo el resto tiene osteopneia. Se concluye que en este grupo de pacientes podría obviarse la realización de una densitometría ósea con fines diagnósticos en caso de dificultad de acceso a la técnica. El tercer y cuarto estudios estudian la frecuencia con que debería indicarse una densitometría ósea en consultas extrahospitalarias de Reumatología y en consultas de Atención Primaria, respectivamente, utilizando diferentes criterios. Se concluye que en ambos casos la proporción de individuos con indicación de densitometría ósea varía de forma importante según el criterio utilizado para su indicación. En el último estudio se evalúa la proporción de varones con artritis reumatoide que tienen osteoporosis según los criterios de la Organizaciçon Mundial de la Salud (aplicando a varones los criterios propuestos para mujeres posmenopáusicas) y de la International Society for Clinical Densitometry. Se concluye que la prevalencia de osteoporosis es inferior a la observada en mujeres con artritis reumatoide, sin que haya diferencias importantes entre los dos criterios utilizados
