Denosumab steroid induced osteoporosis

Another option for the treatment of severe granulomatosis with polyangiitis (GPA) is  rituximab (Rituxan) combined with glucocorticoids. Rituximab is a medication, given by injecting into the vein, which stops the blood vessel and organ inflammation. The patient and his/her doctor will work together to decide which treatment will be best for the patient. Those with less active disease may be treated with prednisone and methotrexate. Each medication has potential side effects, which need to be considered as part of the treatment plan.

Childhood cerebral adrenoleukodystrophy (ALD) is a severe neurologic disease that rapidly progresses to total disability and death unless treated with allogeneic hematopoietic cell transplantation (HCT), which has considerable morbidity and mortality. Gene therapy with autologous hematopoietic stem cells is emerging as a possible alternative treatment. A study of 17 boys with early-stage cerebral ALD enrolled to undergo transplantation with autologous CD34+ cells transfected with Lenti-D (a lentiviral vector containing manufactured ABCD1 complementary DNA) reported 88 percent were alive with no major functional disabilities at 24 months posttransplantation [ 14 ]. One boy died from disease progression that began during pretransplantation conditioning, and one was withdrawn from the study and died from complications of subsequent allogeneic HCT. None of the survivors had evidence of graft failure or graft-versus-host disease. These results suggest that autologous hematopoietic stem cell gene therapy may be as effective as, and safer than, HCT for treatment of early cerebral ALD. The treatment has not received regulatory approval. The clinical trial is ongoing and important uncertainties remain. (See "Adrenoleukodystrophy", section on 'Gene therapy' .)

Raquel was raised in Northeastern Oklahoma and attended the University of Tulsa. For seven years she worked at the Laureate Institute for Brain Research coordinating studies of psychiatric illnesses, including major depressive disorder and post-traumatic stress disorder. Medically based, her interests lie in metabolic bone diseases, osteoarthritis, and orthopedics. Today, Raquel works in the research department with Dr. Miller, Dr. Deol, Dr. Foran, and more. In her spare time, Raquel enjoys international travel, cooking, eating new foods, and reading books for book club with her cats, Bartleby and Theodosia.

Reid et al (2005) reported on the results of 2 double-blind, placebo-controlled clinical studies of zoledronic acid in the treatment of Paget disease of the bone.  In these studies, one 15-min infusion of 5 mg of zoledronic acid was compared to 60 days of oral risedronate (Actonel) (30 mg per day) in a total of 347 patients with Paget disease of the bone.  The primary efficacy end point was the rate of therapeutic response at 6 months, defined as a normalization of alkaline phosphatase levels or a reduction of at least 75 % in the total alkaline phosphatase excess.  At 6 months, % of patients receiving zoledronic acid achieved a therapeutic response, as compared with  % of patients receiving risedronate, a difference that was statistically significant.  The investigators reported that alkaline phosphatase levels normalized in  % of patients in the zoledronic acid group and  % of patients in the risedronate group (p < ).  Zoledronic acid was associated with a shorter median time to a first therapeutic response (64 days versus 89 days, p < ).  The investigators reported that the physical-component summary score of the Medical Outcomes Study 36-item Short-Form General Health Survey, a measure of the quality of life, increased significantly from baseline at both 3 and 6 months in the zoledronic acid group and differed significantly from those in the risedronate group at 3 months.  The investigators noted that pain scores improved in both groups.  During post-trial follow-up (median of 190 days), 21 of 82 patients in the risedronate group had a loss of therapeutic response, as compared with 1 of 113 patients in the zoledronic acid group (p < ).  The investigators concluded that a single infusion of zoledronic acid produces more rapid, more complete, and more sustained responses in Paget disease than does daily treatment with risedronate.

Denosumab steroid induced osteoporosis

denosumab steroid induced osteoporosis

Reid et al (2005) reported on the results of 2 double-blind, placebo-controlled clinical studies of zoledronic acid in the treatment of Paget disease of the bone.  In these studies, one 15-min infusion of 5 mg of zoledronic acid was compared to 60 days of oral risedronate (Actonel) (30 mg per day) in a total of 347 patients with Paget disease of the bone.  The primary efficacy end point was the rate of therapeutic response at 6 months, defined as a normalization of alkaline phosphatase levels or a reduction of at least 75 % in the total alkaline phosphatase excess.  At 6 months, % of patients receiving zoledronic acid achieved a therapeutic response, as compared with  % of patients receiving risedronate, a difference that was statistically significant.  The investigators reported that alkaline phosphatase levels normalized in  % of patients in the zoledronic acid group and  % of patients in the risedronate group (p < ).  Zoledronic acid was associated with a shorter median time to a first therapeutic response (64 days versus 89 days, p < ).  The investigators reported that the physical-component summary score of the Medical Outcomes Study 36-item Short-Form General Health Survey, a measure of the quality of life, increased significantly from baseline at both 3 and 6 months in the zoledronic acid group and differed significantly from those in the risedronate group at 3 months.  The investigators noted that pain scores improved in both groups.  During post-trial follow-up (median of 190 days), 21 of 82 patients in the risedronate group had a loss of therapeutic response, as compared with 1 of 113 patients in the zoledronic acid group (p < ).  The investigators concluded that a single infusion of zoledronic acid produces more rapid, more complete, and more sustained responses in Paget disease than does daily treatment with risedronate.

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