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Liu W, Nicol L, Orwoll E. Current and Developing Pharmacologic Agents for Improving Skeletal Health in Adults with Osteogenesis Imperfecta. Calcif Tissue Int 2024:10.1007/s00223-024-01188-2. [PMID: 38472351 DOI: 10.1007/s00223-024-01188-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 01/24/2024] [Indexed: 03/14/2024]
Abstract
Osteogenesis imperfecta (OI) is a genetic disorder characterized by increased bone fragility largely caused by defects in structure, synthesis, or post-translational processing of type I collagen. Drugs currently used to improve skeletal health in OI were initially developed to treat osteoporosis and clinical trials are ongoing to study their effectiveness in OI adults. Additionally, novel bone-protective agents are in preclinical studies and various phases of OI clinical trials. This review summarizes current knowledge on available pharmacologic agents and current drug trials involving OI participants. A PubMed online database search of all study types published in the English language using the terms "osteogenesis imperfecta," "OI," and "brittle bone disease" was performed in August 2022. Articles screened were restricted to adults. A ClinicalTrials.gov database search of all studies involving "osteogenesis imperfecta" was performed in August 2023. Although clinical trial data are limited, bisphosphonates and teriparatide may be useful in improving bone mineral density. As of yet, no clinical trials are available that adequately evaluate the usefulness of current therapies in reducing fracture risk. Several therapeutics, including teriparatide, setrusumab, anti-TGF-β antibodies, and allogeneic stem cells, are being studied in clinical trials. Preclinical studies involving Dickkopf-1 antagonists present promising data in non-OI bone disease, and could be useful in OI. Research is ongoing to improve therapeutic options for adults with OI and clinical trials involving gene-editing may be possible in the coming decade.
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Affiliation(s)
- Winnie Liu
- Department of Medicine, Division of Endocrinology, Diabetes & Clinical Nutrition, Oregon Health & Science University, Portland, OR, USA.
| | - Lindsey Nicol
- Department of Pediatrics, Division of Endocrinology, Oregon Health & Science University, Portland, OR, USA
| | - Eric Orwoll
- Department of Medicine, Bone and Mineral Unit, Oregon Health & Science University, Portland, OR, USA
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Liu W, Lee B, Nagamani SCS, Nicol L, Rauch F, Rush ET, Sutton VR, Orwoll E. Approach to the Patient: Pharmacological Therapies for Fracture Risk Reduction in Adults With Osteogenesis Imperfecta. J Clin Endocrinol Metab 2023; 108:1787-1796. [PMID: 36658750 PMCID: PMC10271227 DOI: 10.1210/clinem/dgad035] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 01/11/2023] [Accepted: 01/17/2023] [Indexed: 01/21/2023]
Abstract
CONTEXT Osteogenesis imperfecta (OI) is a genetic disorder characterized by increased bone fragility largely caused by defects in structure, synthesis, or post-translational processing of type I collagen. The effectiveness of medications used for fracture reduction in adults with OI is understudied and practice recommendations are not well established. Drugs currently used to improve skeletal health in OI were initially developed to treat osteoporosis. Oral and intravenous bisphosphonates have been shown to improve bone mineral density (BMD) in adults with OI and are commonly used; however, conclusive data confirming fracture protection are lacking. Similarly, teriparatide appears to increase BMD, an effect that seems to be limited to individuals with type I OI. The role of denosumab, abaloparatide, romosozumab, and estradiol/testosterone in adult OI have not been systematically studied. Anti-sclerostin agents and transforming growth factor-beta antagonists are under investigation in clinical trials. OBJECTIVE This review summarizes current knowledge on pharmacologic treatment options for reducing fracture risk in adults with OI. METHODS A PubMed online database search of all study types published in the English language using the terms "osteogenesis imperfecta," "OI," and "brittle bone disease" was performed in June 2022. Articles screened were restricted to adults. Additional sources were identified through manual searches of reference lists. CONCLUSION Fracture rates are elevated in adults with OI. Although clinical trial data are limited, bisphosphonates and teriparatide may be useful in improving BMD. Further research is needed to develop medications for adults with OI that will lead to definite fracture rate reduction.
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Affiliation(s)
- Winnie Liu
- Department of Medicine, Division of Endocrinology, Diabetes & Clinical Nutrition, Oregon Health & Science University, Portland, OR 97239, USA
| | - Brendan Lee
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA
- Texas Children's Hospital, Houston, TX 77030, USA
| | - Sandesh C S Nagamani
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA
- Texas Children's Hospital, Houston, TX 77030, USA
| | - Lindsey Nicol
- Department of Pediatrics, Division of Endocrinology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Frank Rauch
- Shriners Hospital for Children, Montreal, Quebec H3G 1A6, Canada
| | - Eric T Rush
- Children's Mercy Hospital, University of Missouri-Kansas City, Kansas City, MO 64108, USA
| | - V Reid Sutton
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA
- Texas Children's Hospital, Houston, TX 77030, USA
| | - Eric Orwoll
- Department of Medicine, Division of Endocrinology, Diabetes & Clinical Nutrition, Oregon Health & Science University, Portland, OR 97239, USA
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The Rationale for Using Neridronate in Musculoskeletal Disorders: From Metabolic Bone Diseases to Musculoskeletal Pain. Int J Mol Sci 2022; 23:ijms23136921. [PMID: 35805927 PMCID: PMC9267106 DOI: 10.3390/ijms23136921] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 06/18/2022] [Accepted: 06/20/2022] [Indexed: 02/04/2023] Open
Abstract
Neridronate or ((6-amino-1-hydroxy-1-phosphonohexyl) phosphonic acid) is an amino-bisphosphonate (BP) synthetized in Italy in 1986. Bisphosphonates are molecules with a P-C-P bond in their structure that allows strong and selectively binding to hydroxyapatite (HAP) as well as osteoclasts inhibition through different mechanisms of action. Neridronate was initially used to treat Paget disease of the bone, demonstrating effectiveness in reducing bone turnover markers as well as pain. The interesting molecular properties of neridronate foster its wide use in several other conditions, such as osteogenesis imperfecta, and osteoporosis. Thanks to the unique safety and efficacy profile, neridronate has been used in secondary osteoporosis due to genetic, rheumatic, and oncological diseases, including in pediatric patients. In the last decade, this drug has also been studied in chronic musculoskeletal pain conditions, such as algodystrophy, demonstrating effectiveness in improving extraskeletal outcomes. This review highlights historical and clinical insights about the use of neridronate for metabolic bone disorders and musculoskeletal pain conditions.
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Datta HK, Vila J, Tuck SP. Long-term evaluation of anabolic and anti-resorptive agents in adults with familial osteoporosis due to pro205ala variant of the col1a1 gene. Osteoporos Int 2021; 32:2105-2109. [PMID: 33796912 DOI: 10.1007/s00198-021-05933-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 03/18/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Osteogenesis imperfecta (OI) is a rare disorder with variable clinical presentation, commonly caused by mutations in collagen type I genes. OI affects both bone quality and density resulting in fractures and deformity. The effectiveness of bisphosphonates in the treatment of adult OI remains unclear. Small, randomised trials have shown increases in BMD, but without fracture rate reduction. AIM We report the results of BMD of a family harbouring C 613 C>G substitution in exon 8 of Col1A1 gene leading to Pro205Ala missense variant, as well as the results of long term treatment of a mother and daughter with this mutation.
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Affiliation(s)
- H K Datta
- Musculoskeletal Group, Department of Rheumatology, James Cook Blood Sciences (pathology), James Cook University Hospital, Middlesbrough, TS4 3BW, UK.
| | - J Vila
- Institute of Cellular Medicine, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
| | - S P Tuck
- Institute of Cellular Medicine, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK.
- Department of Rheumatology (S.P.T.), James Cook University Hospital, Middlesbrough, TS4 3BW, UK.
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Giannini S, Poci C, Fusaro M, Egan CG, Marcocci C, Vignali E, Cetani F, Nannipieri F, Loy M, Gambino A, Adami G, Braga V, Rossini M, Arcidiacono G, Baffa V, Sella S. Effect of neridronate in osteopenic patients after heart, liver or lung transplant: a multicenter, randomized, double-blind, placebo-controlled study. Panminerva Med 2021; 63:214-223. [PMID: 34154321 DOI: 10.23736/s0031-0808.21.04401-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Transplantation (Tx) is an effective therapeutic option in patients with end-stage organ failure and osteoporosis and related fractures are a recognized complication in these patients. Aim of this study was to evaluate the efficacy of neridronate in patients with reduced bone mass after Tx of the heart, liver or lung. METHODS In this multicenter randomized double-blind controlled trial (RCT), 22 patients were treated with neridronate (25 mg i.m./month) and 17 received placebo. All patients received daily oral calcium (500 mg) and vitamin D (400 IU). Dual-energy X-ray absorptiometry (DXA) was evaluated at 0, 6 and 12 months and markers of bone turnover at 0, 3, 6, 9 and 12 months. RESULTS Thirty-nine patients (11 heart Tx, 21 liver Tx, 7 lung Tx), aged 49.3±9.1 years, with a T-score <-2.0 SD at lumbar spine or femoral level were included. In neridronate-treated patients, a significant increase in lumbar bone mineral density (BMD) was observed after 12 months vs. placebo control (0.92±0.13 g/cm2 vs. 0.84±0.08 g/cm2; P=0.005). Femur and hip BMD remained unchanged between groups. Total alkaline phosphatase, bone alkaline phosphatase and beta-cross-laps significantly decreased over the 12 months in neridronate-treated patients vs. placebo, respectively (107.4±74 U/L vs. 157.6±107.1 U/L, P=0.002; 5.7±3.3 µg/L vs. 11.7±4.3 µg/L, P<0.001 and 0.25±0.13 ng/mL vs. 0.73±0.57 ng/mL, P<0.001). No difference was observed between neridronate and placebo groups regarding safety profile. CONCLUSIONS This is the first RCT that demonstrates the efficacy of neridronate in increasing bone density and reducing bone turnover in organ Tx recipients with significant skeletal morbidity.
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Affiliation(s)
- Sandro Giannini
- Department of Medicine (DIMED), Clinica Medica Uno, University of Padua, Padua, Italy -
| | - Carlo Poci
- Department of Medicine (DIMED), Clinica Medica Uno, University of Padua, Padua, Italy
| | - Maria Fusaro
- National Research Council (CNR), Institute of Clinical Physiology (IFC), Pisa, Italy.,Department of Medicine, University of Padua, Padua, Italy
| | | | - Claudio Marcocci
- Unit of Endocrinology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Edda Vignali
- Unit of Endocrinology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Filomena Cetani
- Unit of Endocrinology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Monica Loy
- Unit of Thoracic Surgery, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Antonio Gambino
- Unit of Cardiac Surgery, Department of Cardio-Thoracic Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Giovanni Adami
- Unit of Rheumatology, Department of Medicine, University of Verona, Verona, Italy
| | - Vania Braga
- Unit of Rheumatology, Department of Medicine, University of Verona, Verona, Italy
| | - Maurizio Rossini
- Unit of Rheumatology, Department of Medicine, University of Verona, Verona, Italy
| | - Gaetano Arcidiacono
- Department of Medicine (DIMED), Clinica Medica Uno, University of Padua, Padua, Italy
| | - Valeria Baffa
- Department of Medicine (DIMED), Clinica Medica Uno, University of Padua, Padua, Italy
| | - Stefania Sella
- Department of Medicine (DIMED), Clinica Medica Uno, University of Padua, Padua, Italy
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Brizola E, Adami G, Baroncelli GI, Bedeschi MF, Berardi P, Boero S, Brandi ML, Casareto L, Castagnola E, Fraschini P, Gatti D, Giannini S, Gonfiantini MV, Landoni V, Magrelli A, Mantovani G, Michelis MB, Nasto LA, Panzeri L, Pianigiani E, Scopinaro A, Trespidi L, Vianello A, Zampino G, Sangiorgi L. Providing high-quality care remotely to patients with rare bone diseases during COVID-19 pandemic. Orphanet J Rare Dis 2020; 15:228. [PMID: 32867855 PMCID: PMC7456755 DOI: 10.1186/s13023-020-01513-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 08/19/2020] [Indexed: 01/08/2023] Open
Abstract
During the COVID-19 outbreak, the European Reference Network on Rare Bone Diseases (ERN BOND) coordination team and Italian rare bone diseases healthcare professionals created the "COVID-19 Helpline for Rare Bone Diseases" in an attempt to provide high-quality information and expertise on rare bone diseases remotely to patients and healthcare professionals. The present position statement describes the key characteristics of the Helpline initiative, along with the main aspects and topics that recurrently emerged as central for rare bone diseases patients and professionals. The main topics highlighted are general recommendations, pulmonary complications, drug treatment, trauma, pregnancy, children and elderly people, and patient associations role. The successful experience of the "COVID-19 Helpline for Rare Bone Diseases" launched in Italy could serve as a primer of gold-standard remote care for rare bone diseases for the other European countries and globally. Furthermore, similar COVID-19 helplines could be considered and applied for other rare diseases in order to implement remote patients' care.
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Affiliation(s)
- E Brizola
- Department of Rare Skeletal Disorders, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - G Adami
- Rheumatology Unit, University of Verona, Verona, Italy
| | - G I Baroncelli
- Division of Pediatrics, Department of Obstetrics, Gynecology and Pediatrics, University Hospital, Pisa, Italy
| | - M F Bedeschi
- Medical Genetic Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - P Berardi
- Italian Osteogenesis Imperfecta Association (As.It.O.I), Olgiate Molgora (LC), Italy
| | - S Boero
- Department of Paediatric Orthopaedics, IRCCS Giannina Gaslini Institute, Children's Hospital, Genoa, Italy
| | - M L Brandi
- Department of Experimental Biochemical and Clinical Sciences, University of Florence and Fondazione FIRMO, Florence, Italy
| | - L Casareto
- Department of Rare Skeletal Disorders, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - E Castagnola
- Infectious Disease Department, Giannina Gaslini Institute, IRCCS, Genoa, Italy
| | - P Fraschini
- Scientific Institute, IRCCS E. Medea, Bosisio Parini (LC), Italy
| | - D Gatti
- Rheumatology Unit, University of Verona, Verona, Italy
| | - S Giannini
- Department of Medicine, Clinica Medica 1, University of Padova and Regional Centre for Osteoporosis, Padua, Italy
| | - M V Gonfiantini
- Rare Diseases and Medical Genetics Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - V Landoni
- Valduce Hospital - Villa Beretta Rehabilitation Centre, Lecco, Italy
| | - A Magrelli
- National Center for Drug, Research and Evaluation, Istituto Superiore di Sanità, Rome, Italy
| | - G Mantovani
- Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - M B Michelis
- Department of Paediatric Orthopaedics, IRCCS Giannina Gaslini Institute, Children's Hospital, Genoa, Italy
| | - L A Nasto
- Department of Paediatric Orthopaedics, IRCCS Giannina Gaslini Institute, Children's Hospital, Genoa, Italy
| | - L Panzeri
- Italian Osteogenesis Imperfecta Association (As.It.O.I), Olgiate Molgora (LC), Italy
| | - E Pianigiani
- Department of Rare Skeletal Disorders, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - A Scopinaro
- Italian Federation of Rare Diseases Patients Associations (UNIAMO FIMR), Rome, Italy
| | - L Trespidi
- Obstetrics and Gynecologic Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - A Vianello
- Respiratory Pathophysiology Division, University of Padua, Padua, Italy
| | - G Zampino
- Rare Diseases and Birth Defects Unit, Dipartimento di Scienza della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - L Sangiorgi
- Department of Rare Skeletal Disorders & CLIBI Laboratory, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
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Lafage-Proust MH, Courtois I. The management of osteogenesis imperfecta in adults: state of the art. Joint Bone Spine 2019; 86:589-593. [DOI: 10.1016/j.jbspin.2019.02.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2018] [Indexed: 12/16/2022]
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Pavón de Paz I, Rosado Sierra JA, Pérez Blanco C, Modroño Móstoles N, Guijarro de Armas G, Navea Aguilera C. Efectos agudos y a largo plazo del tratamiento con zolendronato en pacientes adultos con osteogénesis imperfecta. Estudio español observacional con 5 años de seguimiento. ENDOCRINOL DIAB NUTR 2019; 66:108-116. [DOI: 10.1016/j.endinu.2018.05.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 05/18/2018] [Accepted: 05/22/2018] [Indexed: 10/28/2022]
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Pavón de Paz I, Rosado Sierra JA, Pérez Blanco C, Modroño Móstoles N, Guijarro de Armas G, Navea Aguilera C. Acute and long-term effects of zoledronate in adult patients with osteogenesis imperfecta. An observational Spanish study with five years of follow-up. ENDOCRINOLOGÍA, DIABETES Y NUTRICIÓN (ENGLISH ED.) 2019. [DOI: 10.1016/j.endien.2019.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Bains JS, Carter EM, Citron KP, Boskey AL, Shapiro JR, Steiner RD, Smith PA, Bober MB, Hart T, Cuthbertson D, Krischer J, Byers PH, Pepin M, Durigova M, Glorieux FH, Rauch F, Sliepka JM, Sutton VR, Lee B, Nagamani SC, Raggio CL. A Multicenter Observational Cohort Study to Evaluate the Effects of Bisphosphonate Exposure on Bone Mineral Density and Other Health Outcomes in Osteogenesis Imperfecta. JBMR Plus 2019; 3:e10118. [PMID: 31131341 PMCID: PMC6524673 DOI: 10.1002/jbm4.10118] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 07/22/2018] [Accepted: 09/15/2018] [Indexed: 01/01/2023] Open
Abstract
Osteogenesis imperfecta (OI) is characterized by low bone mass and bone fragility. Using data from a large cohort of individuals with OI from the Osteogenesis Imperfecta Foundation's linked clinical research centers, we examined the association between exposure to bisphosphonate (BPN) treatment (past or present) and lumbar spine (LS) areal bone mineral density (aBMD), fractures, scoliosis, and mobility. From 466 individuals, we obtained 1394 participant‐age LS aBMD data points. Though all OI subtypes were examined, primary analyses were restricted to type I OI (OI‐1). Using linear regression, we constructed expected OI‐1 LS aBMD‐for‐age curves from the data from individuals who had never received BPN. LS aBMD in those who had been exposed to BPN was then compared with the computed expected aBMD. BPN exposure in preadolescent years (age <14 years) was associated with a LS aBMD that was 9% more than the expected computed values in BPN‐naïve individuals (p < 0.01); however, such association was not observed across all ages. Exposure to i.v. BPN and treatment duration >2 years correlated with LS aBMD in preadolescent individuals. BPN exposure also had a significant association with non‐aBMD clinical outcome variables. Logistic regression modeling predicted that with BPN exposure, a 1‐year increase in age would be associated with an 8.2% decrease in fracture probability for preadolescent individuals with OI‐1, compared with no decrease in individuals who had never received any BPN (p < 0.05). In preadolescent individuals with OI‐1, a 0.1 g/cm2 increase in LS aBMD was associated with a 10.6% decrease in scoliosis probability, compared with a 46.8% increase in the BPN‐naïve group (p < 0.01). For the same changes in age and LS aBMD in preadolescent individuals, BPN exposure was also associated with higher mobility scores (p < 0.01), demonstrating that BPN treatment may be associated with daily function. © 2018 The Authors. JBMR Plus Published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Jaskaran S Bains
- Hospital for Special Surgery Dept of Orthopedic Surgery New York NY USA
| | - Erin M Carter
- Hospital for Special Surgery Dept of Orthopedic Surgery New York NY USA
| | - Kate P Citron
- Hospital for Special Surgery Dept of Orthopedic Surgery New York NY USA
| | - Adele L Boskey
- Hospital for Special Surgery Dept of Orthopedic Surgery New York NY USA
| | - Jay R Shapiro
- Department of Bone and Osteogenesis Imperfecta Kennedy Krieger Institute Baltimore MD USA
| | - Robert D Steiner
- Departments of Pediatrics and Molecular and Medical Genetics Oregon Health & Science University Portland OR USA.,University of Wisconsin School of Medicine and Public Health Madison WI USA
| | | | - Michael B Bober
- Division of Medical Genetics Alfred I. DuPont Hospital for Children Wilmington DE USA
| | - Tracy Hart
- Osteogenesis Imperfecta Foundation Gaithersburg MD USA
| | - David Cuthbertson
- College of Medicine University of South Florida, Biostatistics Tampa FL USA
| | - Jeff Krischer
- College of Medicine University of South Florida, Biostatistics Tampa FL USA
| | - Peter H Byers
- Departments of Medicine and Pathology Division of Medical Genetics University of Washington Seattle WA USA
| | - Melanie Pepin
- Departments of Medicine and Pathology Division of Medical Genetics University of Washington Seattle WA USA
| | - Michaela Durigova
- Shriners Hospital for Children-Canada and McGill University, Division of Endocrinology Montreal QC Canada
| | - Francis H Glorieux
- Shriners Hospital for Children-Canada and McGill University, Division of Endocrinology Montreal QC Canada
| | - Frank Rauch
- Shriners Hospital for Children-Canada and McGill University, Division of Endocrinology Montreal QC Canada
| | - Joseph M Sliepka
- Department of Molecular and Human Genetics Baylor College of Medicine Houston TX USA
| | - V Reid Sutton
- Department of Molecular and Human Genetics Baylor College of Medicine Houston TX USA.,Texas Children's Hospital, Human Genetics Houston TX USA
| | - Brendan Lee
- Department of Molecular and Human Genetics Baylor College of Medicine Houston TX USA.,Texas Children's Hospital, Human Genetics Houston TX USA
| | | | - Sandesh Cs Nagamani
- Department of Molecular and Human Genetics Baylor College of Medicine Houston TX USA.,Texas Children's Hospital, Human Genetics Houston TX USA
| | - Cathleen L Raggio
- Hospital for Special Surgery Dept of Orthopedic Surgery New York NY USA
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Abstract
PURPOSE OF REVIEW Here we summarize the diagnosis of osteogenesis imperfecta, discuss newly discovered genes involved in osteogenesis imperfecta, and review the management of this disease in children and adults. RECENT FINDINGS Mutations in the two genes coding for collagen type I, COL1A1 and COL1A2, are the most common cause of osteogenesis imperfecta. In the past 10 years, defects in at least 17 other genes have been identified as responsible for osteogenesis imperfecta phenotypes, with either dominant or recessive transmission. Intravenous bisphosphonate infusions are the most widely used medical treatment. This has a marked effect on vertebra in growing children and can lead to vertebral reshaping after compression fractures. However, bisphosphonates are less effective for preventing long-bone fractures. At the moment, new therapies are under investigation. SUMMARY Despite advances in the diagnosis and treatment of osteogenesis imperfecta, more research is needed. Bisphosphonate treatment decreases long-bone fracture rates, but such fractures are still frequent. New antiresorptive and anabolic agents are being investigated but efficacy and safety of these drugs, especially in children, need to be better established before they can be used in clinical practice.
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Affiliation(s)
- Telma Palomo
- aBone and Mineral Unit, Division of Endocrinology, Universidade Federal de São Paulo, Brazil bAcademic Unit of Bone Metabolism, University of Sheffield, Sheffield, United Kingdom
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