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Osteoporosis

Osteoporosis

(AAOS 2014) Older women with comorbidities are at greatest risk for revision surgery after total knee arthroplasty, a nationwide study shows. Another large analysis shows an interesting quirk about the role of osteoporosis: Bisphosphonates help, but only in some circumstances.

An expert working group says osteoporosis can be diagnosed in postmenopausal women and older men with only marginally low bone density, if they have fractured certain bones in a minor mishap, show vertebral fractures on X-ray, or have high fracture risk for other reasons.

How serious is the risk of atypical femur fracture for osteoporosis patients on bisphosphonates, and when is a "drug holiday" justified? There are no definitive studies or guidelines, but here are some strategies to consider.

New in the New England Journal: Romosozumab, whose target is sclerostin, increased BMD more than teriperatide and alendronate in a phase 2 trial involving postmenopausal women. Also, a puzzle: A rheumatic cause of abdominal pain.

The FDA has approved Duavee, the first medication to combine estrogen with bazedoxifene, for the treatment of hot flashes and the prevention of osteoporosis after menopause.

Wholesale vitamin D supplementation may not prevent osteoporosis, judges a review of clinical trials. Other news: A novel drug that directly targets IL-6 up for regulatory scrutiny, newfound mutations in Sjögren's syndrome, and why eczema itches.

Results from the Framingham Ostoporosis Study show that change in bone mineral density over baseline offers little predictive value. Also last week: More support for diet and exercise to reduce the pain of knee OA.

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