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1,468 results on '"Fogelman I"'

221. Treatment of post-menopausal osteoporosis: beyond bisphosphonates

Author

Ishtiaq, S., Fogelman, I., and Hampson, G.

Abstract

Osteoporosis is a highly prevalent condition, characterized by compromised bone strength and fragility fractures and with an important associated socio-economic burden. Bisphosphonates are well established as the first line treatment for osteoporosis. However, while randomized control trials have in general demonstrated reasonable anti-fracture efficacy at the spine, they have shown moderate reduction in fracture incidence for non-vertebral sites. Furthermore, oral bisphosphonates are commonly associated with adverse gastrointestinal effects and both oral and parenteral bisphosphonates have been linked with osteonecrosis of the jaw and atypical femoral fracture, two rare but debilitating side effects. In addition, bisphosphonates are not recommended in patients with GFR <35 ml/min/1.73 m2. Hence, there is a clear requirement for newer agents, which are able to reduce fracture risk further, whilst overcoming the limitations of bisphosphonates. Over the past 20 years, knowledge and a deeper understanding of the various signalling pathways involved in bone remodelling has increased, enabling identification of additional targets for therapy. This review focuses on these newer therapies and includes anti-resorptive agents such as raloxifene and other selective oestrogen receptor modulators, the monoclonal antibody denosumab (which inhibits the RANKL pathway), odanacatib, a cathepsin K inhibitor and the anabolic agents, PTH analogue; PTH (1–34) and anti-sclerostin antibodies (activator of the Wnt pathway). Strontium ranelate will not be reviewed as recent reports highlight concerns surrounding its cardiovascular safety and together with an apparent increased risk of thrombosis, its future use remains uncertain. Some of these agents such as raloxifene, denosumab and teriparatide are already in clinical use whilst others are at varying stages of development. This review will provide an overview of the mechanisms of action of these therapeutic agents on the skeleton and assess their efficacy in osteoporosis and fracture prevention.

Published
2015
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232. Bone densitometry Is a valuable investigation

Author

Compston, J E, primary, Duncan, W E, additional, Stott, D M, additional, Burman, K D, additional, Change, A S, additional, Reid, D M, additional, Cooper, C, additional, Fogelman, I, additional, Eastell, R, additional, and Woolf, A, additional

Published
1994
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248. Differences in regional bone metabolism at the spine and hip: a quantitative study using F-fluoride positron emission tomography.

Author

Puri, T., Frost, M., Curran, K., Siddique, M., Moore, A., Cook, G., Marsden, P., Fogelman, I., and Blake, G.

Subjects
BONE metabolism, DEOXY sugars, RADIOPHARMACEUTICALS, TOMOGRAPHY, ACADEMIC medical centers, BLOOD testing, BLOOD circulation, BONE growth, HIP joint, RESEARCH funding, SPINE, STATISTICS, DATA analysis, QUANTITATIVE research, EQUIPMENT & supplies, POSTMENOPAUSE, DESCRIPTIVE statistics, THERAPEUTICS
Abstract

Summary: This study showed that regional bone blood flow and F-fluoride bone plasma clearance measured by positron emission tomography are three times lower at the hip than the lumbar spine. Introduction: Measurements of effective bone plasma flow ( K), bone plasma clearance ( K) and standardised uptake values (SUV) using F-fluoride positron emission tomography (F-PET) provide a useful means of studying regional bone metabolism at different sites in the skeleton. This study compares the regional F-fluoride kinetics and SUV at the hip and lumbar spine (LS). Methods: Twelve healthy postmenopausal women with no history of metabolic bone disease apart from two with untreated osteoporosis were recruited. Each subject underwent 60-min dynamic F-PET scans at the LS and proximal femur two weeks apart. K, K and SUV were measured at the LS (mean of L-L), femoral neck (FN), total hip (TH) and femoral shaft (FS). Differences between sites were assessed using the nonparametric Kruskal-Wallis test with a Bonferroni correction for multiple comparisons. Results: Values of K, K and SUV at the FN, TH and FS were three times lower than at the LS ( p = 0.003). Amongst the proximal femur sites, K and SUV were lower at the FS compared with the FN and TH, and SUV was lower at the TH compared with the FN (all p < 0.05). The volume of distribution was lower at the TH and FS compared with the LS ( p < 0.05). Conclusion: The lower values of K, K and SUV at the hip suggest that lower bone blood flow in the proximal femur is an important factor explaining the principal reason for the differences in bone fluoride kinetics between the LS and hip sites. [ABSTRACT FROM AUTHOR]

Published
2013
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