Program Book and Abstracts - ISCD

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158 — LONG-TERM EFFECT OF LUMBAR EPIDURAL CORTICOSTEROID INJECTIONS ON BONE MINERAL DENSITY OF THE LUMBAR SPINE Sam Suthan, Department of Medicine, Sister’s Hospital of Buffalo, Joseph M. Grisanti, M.D., Medical Director, Buffalo Rheumatology Associates, Michael W. Grisanti, M.D., Buffalo Rheumatology Assoicates, Mary Brennan, Buffalo Rheumatology Associates, Patricia Daul, R.N., CCRC, James E. Hatem, Kelly Schwab, RT, Fred MacAdam, M.D. The purpose of this study was to determine the long-term effect of lumbar epidural corticosteroid injections on bone mineral density (BMD) of the lumbar spine in a prospective manner. This is a long-term extension analysis of lumbar spine (BMD) on 34 subjects who received an epidural corticosteroid injection consisting of 80mg of repository methylprednisolone for the treatment of lumbar spondylosis or lumbar canal stenosis. All subjects received a baseline lumbar spine DXA before the epidural injection and then again 6 weeks later. This extension study assesses BMD of the lumbar spine approximately 3 years post epidural injection. The change of BMD in the study population over time was compared to the change anticipated in the NHAINES III database in age and sex matched controls. Twenty-one of the 34 subjects consented to the follow-up DEXA scan at 3 years. The results indicate that the average decrease in BMD at 3 years in our subjects was 1.79%. The anticipated decrease in BMD over 3 years in the NHAINES III database for age and sex matched controls was 2.36%. Statistical analysis using a paired two-sided T-test demonstrates the decline in BMD at the lumbar spine in subjects seen 3 years after receiving an epidural repository corticosteroid injection is not statistically different than the anticipated decline seen with normal aging. We conclude that, other than the anticipated loss of BMD due to aging, the use of an epidural corticosteroid injection did not result in additional loss of bone. 159 — IN VITRO AND IN VIVO DIFFERENCES BETWEEN BRANDED AND GENERIC WEEKLY BISPHOSPHONATE TABLETS A C Perkins, Academic Medical Physics Medical School University of Nottingham, P E Blackshaw, Academic Medical Physics Medical School University of Nottingham, UK, P D Hay, Academic Medical Physics Medical School University of Nottingham, UK, S C Lawes, Academic Medical Physics Medical School University of Nottingham, UK, C T Atherton, R J Dansereau Variation in disintegration times have been reported for generic bisphosphonates. This could be important for oral bisphosphonates where incomplete swallowing may cause serious iatrogenic complications for patients on long-term treatment. The in vitro disintegration of 26 generic alendronate tablets available in Canada, Germany, Netherlands and the UK was evaluated and compared to the branded product (Fosamax®). The swallowing of two of the generic alendronate formulations was compared to risedronate (Actonel®) tablets in 20 subjects with a mean age 62yrs. Tc- 99m labeled tablets were swallowed while monitoring using a gamma camera with subjects in both an erect and a supine (45o) position. Six of the generic alendronate tablets had rapid in vitro disintegration times (
162 — BREAKING THE BARRIERS TO BETTER HEALTH IN OSTEOPOROSIS PATIENTS Debbie Zeldow, Deputy Director, Alliance for Aging Research A survey was conducted in order to identify any gaps in communication between women age 50 to 80 and their physicians regarding osteoporosis treatment. This survey, conducted by telephone in December and January of 2004, included 752 post-menopausal women between the ages of 50 and 80 with osteoporosis, and 352 primary care and ob/gyn physicians. It examined attitudes towards living with osteoporosis, prescription medication usage, and perceptions; as well as gaps in communication between the physician and patient. A physician and patient guide were created based upon the information received in the survey. The Alliance found that many patients don t understand the significance of an osteoporosis diagnosis. Because they often show no symptoms, there is generally a low osteoporosis treatment compliance rate. 70% of physicians reported lack of persistence as a problem with osteoporosis medications. For those that do pursue treatment, most patients reported that their main reasons for taking prescription medications was their desire to remain healthy and independent, while doctors believed that fear of bone fracture was their main concern. To effectively treat osteoporosis, lines of communication between doctors and their patients need to be improved. Doctors need to talk openly with their patients about the risks of osteoporosis, and help them find the medication and regimen that best fits their lifestyle and will facilitate optimal treatment outcomes. By rethinking physician- patient communication, the patient can better understand the need to follow their physician s specified treatment, which will help physicians treat their patients to the best of their ability. 163 — UTILITY OF HEEL DXA IN DIAGNOSING OSTEOPOROSIS Tamara Vokes, MD, CCD, Associate Professor of Medicine, University of Chicago The current study examined how well heel DXA (PIXI, GE Medical Systems) diagnosed osteoporosis in 861 subjects (769 female) referred for central BMD measurement as part of their medical care. Osteoporosis was defined as BMD T-score at or below -2.5 at central site or presence of prevalent vertebral fractures on VFA. There was a significant (p-2.5. The primary endpoint was the relative change from baseline (%) in mean LS BMD at 1 year (intent-to-treat population). Adverse events and safety laboratory parameters were monitored continuously. All patient received calcium and vitamin D supplements. A total of 77 women received monthly ibandronate and 83 women received placebo. The subjects who received ibandronate achieved larger increases in LS BMD after 1 year compared with placebo. At 1 year, the relative mean change in LS BMD from baseline was 3.6% for women receiving ibandronate and - 0.4% for women receiving placebo (see Figure). The mean relative change in total hip BMD was 1.5% for women receiving ibandronate and -0.9% in women receiving placebo. Monthly ibandronate was well tolerated and the incidence of adverse events was similar between treatment groups. The most common treatment-related adverse events in patients receiving ibandronate were dyspepsia (5.2%), myalgia (5.2%), and influenza-like illness (5.2%). Treatment of appropriate patients with monthly ibandronate therapy may prevent PMO. 30 — 2008 Annual Meeting
Page 1 and 2: Global Assessment of Skeletal Healt
Page 3 and 4: Table of Contents Page Officers and
Page 5 and 6: CONTACT INFORMATION Address: 342 No
Page 7 and 8: ISCD Annual Meeting Education Evalu
Page 9 and 10: David Kendler, MD, CCD Grant Recipi
Page 11 and 12: 2008 Annual Meeting Award Winners I
Page 13 and 14: ISCD Acknowledgment of Abstract Rev
Page 15 and 16: Wednesday, March 12, 2008 - Friday,
Page 17 and 18: Page Page 151 IN VIVO LONGITUDINAL
Page 19 and 20: 105 — MULTI-CENTER MRI REPRODUCIB
Page 21 and 22: 113 — HIP AXIS LENGTH (HAL) IN JA
Page 23 and 24: 121 — IS UNIVERSAL STANDARDIZATIO
Page 25 and 26: 129 — THE EFFECT OF ACCURACY ERRO
Page 27 and 28: 137 — EVALUATION OF BONE MINERAL
Page 29 and 30: 146 — BONE MINERAL DENSITY IN SYS
Page 31: 154 — A SPONTANEOUS METATARSAL FR
Page 35 and 36: 171 — COMPARISON OF VITAMIN D SUP
Page 37 and 38: 179 — USAGE OF THE INTERNET TO PR
Page 39 and 40: 187 — UNCERTAINTY IN INTERPRETATI
Page 41 and 42: 195 — EFFICACY OF GH-TREATMENT ON
Page 43 and 44: Challenging Cases Poster Number: 20
Page 45 and 46: 2/25/2008 pQCT DEBATE pQCT - Radius
Page 47 and 48: 2/25/2008 ISCD Fourth Position Deve
Page 49 and 50: 2/25/2008 Case VF • 77 year old f
Page 51 and 52: Greatest utility for BTM in the ind
Page 53 and 54: SAMPLING FOR BONE TURNOVER MARKERS
Page 55 and 56: 2/25/2008 Image Resolution Varies w
Page 57 and 58: Five Dimensions Affecting OP Medica
Page 59 and 60: 2/25/2008 OSTEOPOROSIS AROUND THE W
Page 61 and 62: Mean BMD at the spine in females fr
Page 63 and 64: 2/25/2008 Osteoporosis Care Around
Page 65 and 66: 2/25/2008 Treatment of osteoporosis
Page 67 and 68: Availability of Assessment • Oste
Page 69 and 70: 7 Prepared by Nelson Watts MD 2007
Page 71 and 72: HANDOUTS Friday, March 14, 2008 The
Page 73 and 74: 2/25/2008 Evidence Based Guidelines
Page 75 and 76: 2/25/2008 Vitamin K 2 • Factor di
Page 77 and 78: Association Between Body Weight and
Page 79 and 80: Bone and Fat: Effects of Diabetes a
Page 81 and 82: Clinical Application of Fracture Ri
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ROC for hip fracture prediction at
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surveys include the following: •
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DXA in the office setting is $134;
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2/25/2008 The Relationship Between
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2/25/2008 Why Do We Scan? What Do W
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2/25/2008 Location of fractures in
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Bone Age and Its Relationship to Bo
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Glucocorticoid-Induced Osteoporosis
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2/25/2008 Disclosures - None Skelet
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2/25/2008 QCT PAST - PRESENT - FUTU
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2/25/2008 vQCT FOR IN VIVO FINITE E
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Monitoring of BMD ISCD Position •
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2/25/2008 ISCD San Francisco March
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2/25/2008 Safety of Long Term Bisph
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2/25/2008 ONJ- agreed upon definiti
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2/25/2008 NEED FOR LEGISLATIVE REME
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