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Díez-Villares S, García-Varela L, Antas SGD, Caeiro JR, Carpintero-Fernandez P, Mayán MD, Aguiar P, de la Fuente M. Quantitative PET tracking of intra-articularly administered 89Zr-peptide-decorated nanoemulsions. J Control Release 2023; 356:702-713. [PMID: 36931471 DOI: 10.1016/j.jconrel.2023.03.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 02/17/2023] [Accepted: 03/14/2023] [Indexed: 03/19/2023]
Abstract
Intra-articular (IA) administration of drugs for the treatment of diseases such as rheumatoid arthritis, osteoarthritis and psoriatic arthritis is a common strategy; however, the rapid clearance from the synovial fluid restricts their effectivity due to the limited retention time. Drug Delivery Systems (DDS) are currently being developed to increase their joint retention time. This study compares the biodistribution and retention time of a senolytic peptide (PEP), with potential application in osteoarthritis disease, and this senolytic peptide encapsulated in a DDS based on a lipid nanoemulsion (PEPNE) by using positron emission tomography (PET) imaging. To this aim, the PEP was conjugated with a chelating agent (DFO) and radiolabeled with zirconium-89 (89Zr). Then, [89Zr]-PEP was encapsulated in a novel nanoemulsion formulation, composed by vitamin E, sphingomyelin, and a lipid-PEG. Afterward, healthy rats were administered with either the [89Zr]-PEP or the [89Zr]-PEP-NE via IA injection and underwent PET scans at 0.5-, 24-, 48-, 72-, 168-, 240- and 336 h post-injection. To assess the biodistribution of both radiotracers, several volume-of-interest were manually drawn in different organs of the rat body and the %ID/organ was calculated. The [89Zr]-PEP was successfully encapsulated in the NE and their physicochemical properties were minimally affected by the radiolabeling buffer. Adequate stability of both [89Zr]-PEP and [89Zr]-PEP-NE was found in synovial fluid over 72 h. Quantitative data from PET images revealed a significantly higher [89Zr]-PEP-NE retention in the injected knee than with [89Zr]-PEP in all follow-up PET scans. The [89Zr]-PEP %ID/organ values in the liver and kidney were significantly higher than those from [89Zr]-PEP-NE, which might indicate a faster elimination of the [89Zr]-PEP. Therefore, the study highlights the higher retention time on the target site of the [89Zr]-PEP-NE which may improve the therapeutic effects of the peptide. Thereby, the novel nanoemulsion formulation seems to be a successful DDS for IA injection. In addition, these results represent the first study that evaluates the distribution of a PET-guided DDS after its IA administration.
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Affiliation(s)
- Sandra Díez-Villares
- Nano-Oncology and Translational Therapeutics Group, Health Research Institute of Santiago de Compostela (IDIS), SERGAS, Santiago de Compostela 15706, Spain; University of Santiago de Compostela (USC), Santiago de Compostela 15706, Spain; Biomedical Research Networking Center on Oncology (CIBERONC), Madrid 28029, Spain
| | - Lara García-Varela
- Molecular Imaging Biomarkers Group, Center for Research in Molecular Medicine and Chronic Diseases (CIMUS), University of Santiago de Compostela (USC), Santiago de Compostela 15706, Spain; Nuclear Medicine Department and Molecular Imaging Group, Health Research Institute of Santiago de Compostela (IDIS), SERGAS, Santiago de Compostela 15706, Spain
| | - Soraya Groba-de Antas
- Nano-Oncology and Translational Therapeutics Group, Health Research Institute of Santiago de Compostela (IDIS), SERGAS, Santiago de Compostela 15706, Spain; University of Santiago de Compostela (USC), Santiago de Compostela 15706, Spain; Molecular Imaging Biomarkers Group, Center for Research in Molecular Medicine and Chronic Diseases (CIMUS), University of Santiago de Compostela (USC), Santiago de Compostela 15706, Spain; Nuclear Medicine Department and Molecular Imaging Group, Health Research Institute of Santiago de Compostela (IDIS), SERGAS, Santiago de Compostela 15706, Spain
| | - José Ramón Caeiro
- Department of Orthopaedic Surgery and Traumatology, Clinical University Hospital of Santiago de Compostela (CHUS), University of Santiago de Compostela (USC), Santiago de Compostela 15706, Spain
| | - Paula Carpintero-Fernandez
- CellCOM Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Servizo Galego de Saúde (SERGAS), Universidade da Coruña (UDC), A Coruña, Spain
| | - María D Mayán
- CellCOM Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Servizo Galego de Saúde (SERGAS), Universidade da Coruña (UDC), A Coruña, Spain
| | - Pablo Aguiar
- Molecular Imaging Biomarkers Group, Center for Research in Molecular Medicine and Chronic Diseases (CIMUS), University of Santiago de Compostela (USC), Santiago de Compostela 15706, Spain; Nuclear Medicine Department and Molecular Imaging Group, Health Research Institute of Santiago de Compostela (IDIS), SERGAS, Santiago de Compostela 15706, Spain.
| | - María de la Fuente
- Nano-Oncology and Translational Therapeutics Group, Health Research Institute of Santiago de Compostela (IDIS), SERGAS, Santiago de Compostela 15706, Spain; University of Santiago de Compostela (USC), Santiago de Compostela 15706, Spain; Biomedical Research Networking Center on Oncology (CIBERONC), Madrid 28029, Spain; DIVERSA Technologies SL, Edificio Emprendia, Campus Vida Universidad de Santiago de Compostela 15782, Spain.
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Varela-Eirín M, Carpintero-Fernández P, Guitián-Caamaño A, Varela-Vázquez A, García-Yuste A, Sánchez-Temprano A, Bravo-López SB, Yañez-Cabanas J, Fonseca E, Largo R, Mobasheri A, Caeiro JR, Mayán MD. Extracellular vesicles enriched in connexin 43 promote a senescent phenotype in bone and synovial cells contributing to osteoarthritis progression. Cell Death Dis 2022; 13:681. [PMID: 35931686 PMCID: PMC9355945 DOI: 10.1038/s41419-022-05089-w] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 05/05/2022] [Accepted: 07/08/2022] [Indexed: 01/21/2023]
Abstract
The accumulation of senescent cells is a key characteristic of aging, leading to the progression of age-related diseases such as osteoarthritis (OA). Previous data from our laboratory has demonstrated that high levels of the transmembrane protein connexin 43 (Cx43) are associated with a senescent phenotype in chondrocytes from osteoarthritic cartilage. OA has been reclassified as a musculoskeletal disease characterized by the breakdown of the articular cartilage affecting the whole joint, subchondral bone, synovium, ligaments, tendons and muscles. However, the mechanisms that contribute to the spread of pathogenic factors throughout the joint tissues are still unknown. Here, we show for the first time that small extracellular vesicles (sEVs) released by human OA-derived chondrocytes contain high levels of Cx43 and induce a senescent phenotype in targeted chondrocytes, synovial and bone cells contributing to the formation of an inflammatory and degenerative joint environment by the secretion of senescence-associated secretory associated phenotype (SASP) molecules, including IL-1ß and IL-6 and MMPs. The enrichment of Cx43 changes the protein profile and activity of the secreted sEVs. Our results indicate a dual role for sEVs containing Cx43 inducing senescence and activating cellular plasticity in target cells mediated by NF-kß and the extracellular signal-regulated kinase 1/2 (ERK1/2), inducing epithelial-to-mesenchymal transition (EMT) signalling programme and contributing to the loss of the fully differentiated phenotype. Our results demonstrated that Cx43-sEVs released by OA-derived chondrocytes spread senescence, inflammation and reprogramming factors involved in wound healing failure to neighbouring tissues, contributing to the progression of the disease among cartilage, synovium, and bone and probably from one joint to another. These results highlight the importance for future studies to consider sEVs positive for Cx43 as a new biomarker of disease progression and new target to treat OA.
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Affiliation(s)
- Marta Varela-Eirín
- grid.8073.c0000 0001 2176 8535CellCOM Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Servizo Galego de Saúde (SERGAS), Universidade da Coruña (UDC), A Coruña, Spain ,grid.4494.d0000 0000 9558 4598European Research Institute for the Biology of Ageing (ERIBA), University Medical Center Groningen (UMCG), University of Groningen (RUG), Groningen, The Netherlands
| | - Paula Carpintero-Fernández
- grid.8073.c0000 0001 2176 8535CellCOM Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Servizo Galego de Saúde (SERGAS), Universidade da Coruña (UDC), A Coruña, Spain
| | - Amanda Guitián-Caamaño
- grid.8073.c0000 0001 2176 8535CellCOM Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Servizo Galego de Saúde (SERGAS), Universidade da Coruña (UDC), A Coruña, Spain
| | - Adrián Varela-Vázquez
- grid.8073.c0000 0001 2176 8535CellCOM Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Servizo Galego de Saúde (SERGAS), Universidade da Coruña (UDC), A Coruña, Spain
| | - Alejandro García-Yuste
- grid.8073.c0000 0001 2176 8535CellCOM Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Servizo Galego de Saúde (SERGAS), Universidade da Coruña (UDC), A Coruña, Spain
| | - Agustín Sánchez-Temprano
- grid.8073.c0000 0001 2176 8535CellCOM Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Servizo Galego de Saúde (SERGAS), Universidade da Coruña (UDC), A Coruña, Spain
| | - Susana B. Bravo-López
- grid.11794.3a0000000109410645Proteomics Laboratory, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Complexo Hospitalario Universitario de Santiago de Compostela (CHUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - José Yañez-Cabanas
- grid.11794.3a0000000109410645Department of Orthopaedic Surgery and Traumatology, Complexo Hospitalario Universitario de Santiago de Compostela (CHUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Eduardo Fonseca
- grid.8073.c0000 0001 2176 8535CellCOM Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Servizo Galego de Saúde (SERGAS), Universidade da Coruña (UDC), A Coruña, Spain
| | - Raquel Largo
- grid.419651.e0000 0000 9538 1950Bone and Joint Research Unit, Rheumatology Department, IIS-Fundación Jiménez Díaz UAM, Madrid, Spain
| | - Ali Mobasheri
- grid.10858.340000 0001 0941 4873Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland ,grid.493509.2Department of Regenerative Medicine, State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania ,grid.7692.a0000000090126352Departments of Rheumatology and Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands ,grid.412615.50000 0004 1803 6239Department of Joint Surgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China ,grid.4861.b0000 0001 0805 7253World Health Organization Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, University of Liège, Liège, Belgium
| | - José Ramón Caeiro
- grid.11794.3a0000000109410645Department of Orthopaedic Surgery and Traumatology, Complexo Hospitalario Universitario de Santiago de Compostela (CHUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - María D. Mayán
- grid.8073.c0000 0001 2176 8535CellCOM Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Servizo Galego de Saúde (SERGAS), Universidade da Coruña (UDC), A Coruña, Spain
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Carpintero-Fernández P, Varela-Eirín M, García-Yuste A, López-Díaz I, Caeiro JR, Mayán MD. Osteoarthritis: Mechanistic Insights, Senescence, and Novel Therapeutic Opportunities. Bioelectricity 2022. [DOI: 10.1089/bioe.2021.0039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Affiliation(s)
- Paula Carpintero-Fernández
- CellCOM Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Servizo Galego de Saúde (SERGAS), Universidade da Coruña (UDC), A Coruña, Spain
| | - Marta Varela-Eirín
- CellCOM Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Servizo Galego de Saúde (SERGAS), Universidade da Coruña (UDC), A Coruña, Spain
- European Research Institute for the Biology of Ageing (ERIBA), University Medical Center Groningen (UMCG), University of Groningen (RUG), Groningen, The Netherlands
| | - Alejandro García-Yuste
- CellCOM Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Servizo Galego de Saúde (SERGAS), Universidade da Coruña (UDC), A Coruña, Spain
| | - Iñaki López-Díaz
- CellCOM Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Servizo Galego de Saúde (SERGAS), Universidade da Coruña (UDC), A Coruña, Spain
| | - José Ramón Caeiro
- Department of Orthopaedic Surgery and Traumatology, Complexo Hospitalario Universitario de Santiago de Compostela (CHUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - María D. Mayán
- CellCOM Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Servizo Galego de Saúde (SERGAS), Universidade da Coruña (UDC), A Coruña, Spain
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Sosa-Henríquez M, Torregrosa O, Déniz A, Saavedra P, Ortego N, Turrión A, Pérez Castrillón JL, Díaz-Curiel M, Gómez-Alonso C, Martínez G, Antonio Blázquez J, Olmos-Martínez JM, Etxebarria Í, Caeiro JR, Mora-Peña D. Multiple vertebral fractures after suspension of denosumab. A series of 56 cases. Int J Clin Pract 2021; 75:e14550. [PMID: 34145944 DOI: 10.1111/ijcp.14550] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 06/10/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Denosumab is a monoclonal antibody approved for the treatment of postmenopausal osteoporosis. The withdrawal of denosumab produces an abrupt loss of bone mineral density and may cause multiple vertebral fractures (MVF). OBJECTIVE The objective of this study is to study the clinical, biochemical, and densitometric characteristics in a large series of postmenopausal women who suffered MVF after denosumab withdrawal. Likewise, we try to identify those factors related to the presence of a greater number of vertebral fractures (VF). PATIENTS AND METHODS Fifty-six patients (54 women) who suffered MVF after receiving denosumab at least for three consecutive years and abruptly suspended it. A clinical examination was carried out. Biochemical bone remodelling markers (BBRM) and bone densitometry at the lumbar spine and proximal femur were measured. VF were diagnosed by magnetic resonance imaging MRI, X-ray, or both at dorsal and lumbar spine. RESULTS Fifty-six patients presented a total of 192 VF. 41 patients (73.2%) had not previously suffered VF. After discontinuation of the drug, a statistically significant increase in the BBRM was observed. In the multivariate analysis, only the time that denosumab was previously received was associated with the presence of a greater number of VF (P = .04). CONCLUSIONS We present the series with the largest number of patients collected to date. 56 patients accumulated 192 new VF. After the suspension of denosumab and the production of MVF, there was an increase in the serum values of the BBRM. The time of denosumab use was the only parameter associated with a greater number of fractures.
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Affiliation(s)
- Manuel Sosa-Henríquez
- University of Las Palmas de Gran Canaria, Investigation Group on Osteoporosis and Bone Mineral Metabolism, Hospital University Insular, Las Palmas de Gran Canaria, Canary Islands, Spain
| | - Oscar Torregrosa
- Internal Medicine Service, Hospital General University Elche, Elche, Alicante, Spain
| | - Alejandro Déniz
- Endocrinology Section, Hospital University Insular, Las Palmas de Gran Canaria, Spain
| | - Pedro Saavedra
- Mathematics Department, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Norberto Ortego
- Internal Medicine, Hospital University San Cecilio, Granada, Spain
| | - Ana Turrión
- Rheumatology Service, Hospital University Salamanca, Salamanca, Spain
| | | | - Manuel Díaz-Curiel
- Internal Medicine Service, Hospital University Fundación Jiménez Díaz, Madrid, Spain
| | - Carlos Gómez-Alonso
- Internal Medicine Service, Hospital University Central Asturias, Oviedo, Spain
| | | | | | | | | | - José Ramón Caeiro
- Orthopaedic Surgery Department, University Hospital of Santiago de Compostela, La Coruña, Spain
| | - Damián Mora-Peña
- Internal Medicine Service, Hospital Virgen de la Luz, Cuenca, Spain
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Tarazona-Santabalbina FJ, Ojeda-Thies C, Figueroa Rodríguez J, Cassinello-Ogea C, Caeiro JR. Orthogeriatric Management: Improvements in Outcomes during Hospital Admission Due to Hip Fracture. Int J Environ Res Public Health 2021; 18:3049. [PMID: 33809573 PMCID: PMC7999190 DOI: 10.3390/ijerph18063049] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 03/05/2021] [Accepted: 03/12/2021] [Indexed: 12/13/2022]
Abstract
Hip fractures are an important socio-economic problem in western countries. Over the past 60 years orthogeriatric care has improved the management of older patients admitted to hospital after suffering hip fractures. Quality of care in orthogeriatric co-management units has increased, reducing adverse events during acute admission, length of stay, both in-hospital and mid-term mortality, as well as healthcare and social costs. Nevertheless, a large number of areas of controversy regarding the clinical management of older adults admitted due to hip fracture remain to be clarified. This narrative review, centered in the last 5 years, combined the search terms "hip fracture", "geriatric assessment", "second hip fracture", "surgery", "perioperative management" and "orthogeriatric care", in order to summarise the state of the art of some questions such as the optimum analgesic protocol, the best approach for treating anemia, the surgical options recommendable for each type of fracture and the efficiency of orthogeriatric co-management and functional recovery.
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Affiliation(s)
- Francisco José Tarazona-Santabalbina
- Department of Geriatric Medicine, Hospital Universitario de la Ribera, Alzira, 46600 Valencia, Spain
- CIBERFES, Centro de Investigación Biomédica en Red Fragilidad y Envejecimiento Saludable, Instituto Carlos III, 28029 Madrid, Spain
| | - Cristina Ojeda-Thies
- Department of Orthopaedic Surgery and Traumatology, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain;
| | - Jesús Figueroa Rodríguez
- Department of Physical Medicine and Rehabilitation, Complejo Hospitalario Universitario de Santiago de Compostela, 15706 Santiago de Compostela, Spain;
| | | | - José Ramón Caeiro
- Department of Orthopaedics and Traumatology, Complejo Hospitalario Universitario de Santiago de Compostela, 15706 Santiago de Compostela, Spain;
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Carpintero-Fernández P, Sánchez Temparno A, Varela Eírin A, García-Yuste A, Yáñez Cabanas J, Díez-Ulloa A, Caeiro JR, Mayan MD. Conexina 43 y senescencia celular: nuevas estrategias terapéuticas para el tratamiento de la artrosis. Rev Osteoporos Metab Miner 2020. [DOI: 10.4321/s1889-836x2020000400008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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7
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Varela-Eirín M, Carpintero-Fernández P, Sánchez-Temprano A, Varela-Vázquez A, Paíno CL, Casado-Díaz A, Continente AC, Mato V, Fonseca E, Kandouz M, Blanco A, Caeiro JR, Mayán MD. Senolytic activity of small molecular polyphenols from olive restores chondrocyte redifferentiation and promotes a pro-regenerative environment in osteoarthritis. Aging (Albany NY) 2020; 12:15882-15905. [PMID: 32745074 PMCID: PMC7485729 DOI: 10.18632/aging.103801] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 07/13/2020] [Indexed: 12/14/2022]
Abstract
Articular cartilage and synovial tissue from patients with osteoarthritis (OA) show an overactivity of connexin43 (Cx43) and accumulation of senescent cells associated with disrupted tissue regeneration and disease progression. The aim of this study was to determine the effect of oleuropein on Cx43 and cellular senescence for tissue engineering and regenerative medicine strategies for OA treatment. Oleuropein regulates Cx43 promoter activity and enhances the propensity of hMSCs to differentiate into chondrocytes and bone cells, reducing adipogenesis. This small molecule reduce Cx43 levels and decrease Twist-1 activity in osteoarthritic chondrocytes (OACs), leading to redifferentiation, restoring the synthesis of cartilage ECM components (Col2A1 and proteoglycans), and reducing the inflammatory and catabolic factors mediated by NF-kB (IL-1ß, IL-6, COX-2 and MMP-3), in addition to lowering cellular senescence in OACs, synovial and bone cells. Our in vitro results demonstrate the use of olive-derived polyphenols, such as oleuropein, as potentially effective therapeutic agents to improve chondrogenesis of hMSCs, to induce chondrocyte re-differentiation in OACs and clearing out senescent cells in joint tissues in order to prevent or stop the progression of the disease.
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Affiliation(s)
- Marta Varela-Eirín
- CellCOM Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Servizo Galego de Saúde (SERGAS), Universidade da Coruña (UDC), Xubias de Arriba, A Coruña, Spain
| | - Paula Carpintero-Fernández
- CellCOM Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Servizo Galego de Saúde (SERGAS), Universidade da Coruña (UDC), Xubias de Arriba, A Coruña, Spain
| | - Agustín Sánchez-Temprano
- CellCOM Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Servizo Galego de Saúde (SERGAS), Universidade da Coruña (UDC), Xubias de Arriba, A Coruña, Spain
| | - Adrián Varela-Vázquez
- CellCOM Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Servizo Galego de Saúde (SERGAS), Universidade da Coruña (UDC), Xubias de Arriba, A Coruña, Spain
| | - Carlos Luis Paíno
- Neurobiology-Research Service, Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, Spain
| | - Antonio Casado-Díaz
- UGC Endocrinology and Nutrition, Maimónides Biomedical Research Institute of Córdoba (IMIBIC), Hospital Universitario Reina Sofía - CIBERFES, Universidad de Córdoba, Córdoba, Spain
| | - Alfonso Calañas Continente
- UGC Endocrinology and Nutrition, Maimónides Biomedical Research Institute of Córdoba (IMIBIC), Hospital Universitario Reina Sofía - CIBERFES, Universidad de Córdoba, Córdoba, Spain
| | - Virginia Mato
- Centre for Medical Informatics and Radiological Diagnosis, Universidade da Coruña, A Coruña, Spain
| | - Eduardo Fonseca
- CellCOM Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Servizo Galego de Saúde (SERGAS), Universidade da Coruña (UDC), Xubias de Arriba, A Coruña, Spain
| | - Mustapha Kandouz
- Department of Pathology, School of Medicine, Wayne State University, Detroit, MI 48202, USA
| | - Alfonso Blanco
- Flow Cytometry Core Technologies, UCD Conway Institute, University College Dublin, Dublin, Ireland
| | - José Ramón Caeiro
- Department of Orthopaedic Surgery and Traumatology, Complexo Hospitalario Universitario de Santiago de Compostela (CHUS), Universidade de Santiago de Compostela (USC), Choupana s/n, Santiago de Compostela, Spain
| | - María D Mayán
- CellCOM Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Servizo Galego de Saúde (SERGAS), Universidade da Coruña (UDC), Xubias de Arriba, A Coruña, Spain
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Varela-Eirín M, Varela-Vázquez A, Blanco A, Caeiro JR, Mayán MD. Regulación de la plasticidad celular y senescencia en condrocitos articulares: conexina 43 como diana terapéutica para el tratamiento de la artrosis. Rev Osteoporos Metab Miner 2019. [DOI: 10.4321/s1889-836x2019000200003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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9
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Ojeda-Thies C, Sáez-López P, Currie CT, Tarazona-Santalbina FJ, Alarcón T, Muñoz-Pascual A, Pareja T, Gómez-Campelo P, Montero-Fernández N, Mora-Fernández J, Larrainzar-Garijo R, Gil-Garay E, Etxebarría-Foronda I, Caeiro JR, Díez-Pérez A, Prieto-Alhambra D, Navarro-Castellanos L, Otero-Puime A, González-Montalvo JI. Spanish National Hip Fracture Registry (RNFC): analysis of its first annual report and international comparison with other established registries. Osteoporos Int 2019; 30:1243-1254. [PMID: 30904929 DOI: 10.1007/s00198-019-04939-2] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 03/11/2019] [Indexed: 01/28/2023]
Abstract
UNLABELLED Hip fracture registries have helped improve quality of care and reduce variability, and several audits exist worldwide. The results of the Spanish National Hip Fracture Registry are presented and compared with 13 other national registries, highlighting similarities and differences to define areas of improvement, particularly surgical delay and early mobilization. INTRODUCTION Hip fracture audits have been useful for monitoring current practice and defining areas in need of improvement. Most established registries are from Northern Europe. We present the results from the first annual report of the Spanish Hip Fracture Registry (RNFC) and compare them with other publically available audit reports. METHOD Comparison of the results from Spain with the most recent reports from another ten established hip fracture registries highlights the differences in audit characteristics, casemix, management, and outcomes. RESULTS Of the patients treated in 54 hospitals, 7.208 were included in the registry between January and October 2017. Compared with other registries, the RNFC included patients ≥ 75 years old; in general, they were older, more likely to be female, had a worse prefracture ambulation status, and were more likely to have extracapsular fractures. A larger proportion was treated with intramedullary nails than in other countries, and spinal anesthesia was most commonly used. With a mean of 75.7 h, Spain had by far the longest surgical delay, and the lowest proportion of patients mobilized on the first postoperative day (58.5%). Consequently, development of pressure ulcers was high, but length of stay, mortality, and discharge to home remained in the range of other audits. CONCLUSIONS National hip fracture registries have proved effective in changing clinical practice and our understanding of patients with this condition. Such registries tend to be based on an internationally recognized common dataset which would make comparisons between national registries possible, but variations such as age inclusion criteria and follow-up are becoming evident across the world. This variation should be avoided if we are to maximize the comparability of registry results and help different countries learn from each other's practice. The results reported in the Spanish RNFC, compared with those of other countries, highlight the differences between countries and detect areas of improvement, particularly surgical delay and early mobilization.
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Affiliation(s)
- C Ojeda-Thies
- Department of Traumatology and Orthopaedic Surgery, Hospital Universitari 12 de Octubre, Avda. Córdoba s/n, 28041, Madrid, Spain.
| | - P Sáez-López
- Instituto de Investigación del Hospital La Paz, IdiPAZ, Madrid, Spain
- Hospital Universitario Fundación Alcorcón, Madrid, Spain
- Head Coordinator of the Spanish National Hip Fracture Registry, Madrid, Spain
| | - C T Currie
- Fragility Fracture Network Hip Fracture Audit Special Interest Group, Zurich, Switzerland
| | - F J Tarazona-Santalbina
- Hospital Universitario de La Ribera, Alzira, Valencia, Spain
- Hamad Medical Corporation, Doha, Qatar
| | - T Alarcón
- Instituto de Investigación del Hospital La Paz, IdiPAZ, Madrid, Spain
- Hospital Universitario La Paz, Madrid, Spain
| | | | - T Pareja
- Hospital Universitario de Guadalajara, Guadalajara, Spain
| | - P Gómez-Campelo
- Instituto de Investigación del Hospital La Paz, IdiPAZ, Madrid, Spain
- Centro de Ciencias de la Salud San Rafael, Universidad Antonio de Nebrija, Madrid, Spain
| | - N Montero-Fernández
- Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - J Mora-Fernández
- Hospital Clínico Universitario San Carlos, IdISSC, Madrid, Spain
| | - R Larrainzar-Garijo
- Facultad Medicina Universidad Complutense de Madrid, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - E Gil-Garay
- Instituto de Investigación del Hospital La Paz, IdiPAZ, Madrid, Spain
- Hospital Universitario La Paz, Madrid, Spain
| | | | - J R Caeiro
- Complejo Hospitalario Universitario de Santiago, Universidad de Santiago de Compostela, Santiago De Compostela, A Coruña, Spain
| | - A Díez-Pérez
- Hospital del Mar y Universidad Autónoma de Barcelona. CIBER de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto Carlos III, Madrid, Spain
| | - D Prieto-Alhambra
- NDORMS, Grupo de Investigación GREMPAL, Idiap Jordi Gol y CIBERFes, University of Oxford, Oxford, UK
- Universitat Autònoma de Barcelona e Instituto de Salud Carlos III, Barcelona, Spain
| | | | - A Otero-Puime
- Instituto de Investigación del Hospital La Paz, IdiPAZ, Madrid, Spain
- Departamento de Medicina Preventiva y Salud Pública, Universidad Autónoma de Madrid, Madrid, Spain
| | - J I González-Montalvo
- Instituto de Investigación del Hospital La Paz, IdiPAZ, Madrid, Spain
- Hospital Universitario La Paz, Madrid, Spain
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10
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Larrainzar-Garijo R, Caeiro JR, Marco M, Giner E, Miguélez MH. Experimental validation of finite elements model in hip fracture and its clinical applicability. Rev Esp Cir Ortop Traumatol (Engl Ed) 2018; 63:146-154. [PMID: 30361127 DOI: 10.1016/j.recot.2018.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Revised: 04/26/2018] [Accepted: 05/22/2018] [Indexed: 10/28/2022] Open
Abstract
Fracture of the proximal extremity of the femur is the subject of research interest. The complexity of the bone framework and the structural inefficiency associated with ageing leave many variables yet to be understood from an experimental perspective. However, there is no clearly defined structural and biomechanical research model for hip fracture. The hypothesis of this paper is that it is possible to create a computational experimentation model that characterises the bone of the proximal extremity of the femur as a heterogeneous material from directly translating the mechanical parameters obtained from anatomical experimentation specimens. MATERIAL AND METHOD An experimental paper comparing real experimentation on cadavers and a numerical model based on finite element analysis (FEA). The variables uses were: the start point of the fracture, propagation of the fracture, progressive load and maximum load until fracture. The real mechanical parameters obtained from the anatomical specimens were translated to the computational model based on the relationship between the Hounsfield units of the high resolution CAT scan and the bone mineral density of each virtual element, whereas the propagation of the fracture was modelled by the research team's own computational design, reducing the mechanical properties of the damaged elements as the fracture line advanced. RESULTS The computational model was able to determine the start point of the fracture, with a slight tendency towards anatomical medialisation of this point compared to what happened experimentally. The degree of correlation was very high on comparing the real value of progressive deformation of the samples compared to that obtained by the computational model. Over 32 points analysed, a slope of 1.03 in lineal regression was obtained, with a relative error between the deformations of 16% and a Pearson's coefficient of R2=.99. The computational model slightly underestimated the maximum fracture load, with a relative error of approximately 10%. CONCLUSION The FEA computational model developed by this multi-disciplinary research team could be considered, as a whole, a complete FEA model of the proximal extremity of the femur with future clinical applicability since it was able to simulate and imitate the biomechanical behaviour of human femurs contrasted with a traditional experimental model made from anatomical specimens. On this basis, qualitative and quantitative interactions can be assessed which consolidate it as a powerful computational experimentation test bench for the human proximal femur.
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Affiliation(s)
- R Larrainzar-Garijo
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Infanta Leonor, Madrid, España; Departamento de Cirugía, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España.
| | - J R Caeiro
- Servicio de Cirugía Ortopédica y Traumatología, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, España
| | - M Marco
- Departamento de Ingeniería Mecánica, Universidad Carlos III, Madrid, España
| | - E Giner
- Centro de Investigación en Ingeniería Mecánica-CIIM. Dpto. de Ingeniería Mecánica y de Materiales, Universitat Politècnica de València, Valencia, España
| | - M H Miguélez
- Departamento de Ingeniería Mecánica, Universidad Carlos III, Madrid, España
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11
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Marco M, Giner E, Larraínzar-Garijo R, Caeiro JR, Miguélez MH. Erratum to: Numerical Modelling of Femur Fracture and Experimental Validation Using Bone Simulant. Ann Biomed Eng 2017; 45:2409. [PMID: 28653293 DOI: 10.1007/s10439-017-1880-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Miguel Marco
- Department of Mechanical Engineering, Universidad Carlos III de Madrid, Avda. de la Universidad 30, 28911, Leganés, Madrid, Spain.
| | - Eugenio Giner
- Department of Mechanical and Materials Engineering (CIIM), Universitat Politècnica de València Camino de Vera, 46022, Valencia, Spain
| | - Ricardo Larraínzar-Garijo
- Orthopaedics and Trauma Department, Surgery Department, Hospital Universitario Infanta Leonor, Complutense University, Madrid, Spain
| | - José Ramón Caeiro
- Orthopedic Surgery and Traumatology Service, Complejo Hospitalario Universitario de Santiago de Compostela, Rúa de Ramón Baltar, s/n, 15706, Santiago de Compostela, A Coruña, Spain
| | - María Henar Miguélez
- Department of Mechanical Engineering, Universidad Carlos III de Madrid, Avda. de la Universidad 30, 28911, Leganés, Madrid, Spain
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12
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Marco M, Giner E, Larraínzar-Garijo R, Caeiro JR, Miguélez MH. Numerical Modelling of Femur Fracture and Experimental Validation Using Bone Simulant. Ann Biomed Eng 2017. [DOI: 10.1007/s10439-017-1877-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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13
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Malouf-Sierra J, Tarantino U, García-Hernández PA, Corradini C, Overgaard S, Stepan JJ, Borris L, Lespessailles E, Frihagen F, Papavasiliou K, Petto H, Aspenberg P, Caeiro JR, Marin F. Effect of Teriparatide or Risedronate in Elderly Patients With a Recent Pertrochanteric Hip Fracture: Final Results of a 78-Week Randomized Clinical Trial. J Bone Miner Res 2017; 32:1040-1051. [PMID: 28019683 DOI: 10.1002/jbmr.3067] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 12/19/2016] [Accepted: 12/21/2016] [Indexed: 12/14/2022]
Abstract
We present final results of a study comparing teriparatide 20 μg every day (QD) with risedronate 35 mg once per week (QW) started within 2 weeks after surgery for a pertrochanteric hip fracture. Patients with BMD T-score ≤ -2.0 and 25OHD ≥9.2 ng/mL were randomized to receive 26-week double-dummy treatment plus calcium and vitamin D, followed by 52-week open-label treatment with the same assigned active drug. Primary endpoint was change from baseline in lumbar spine (LS) BMD at 78 weeks. Secondary and exploratory endpoints were change in BMD at the proximal femur, function, hip pain (Charnley score and 100 mm Visual Analog Scale [VAS]), quality of life (Short Form-36), radiology outcomes, and safety. Data were analyzed with mixed models for repeated measures (MMRM) and logistic regression. Totally, 224 patients were randomized; 171 (teriparatide: 86) contributed to the efficacy analyses (mean ± SD age: 77 ± 7.7 years, 77% females). Mean baseline LS, femoral neck (FN), and total hip (TH) T-scores were -2.16, -2.63, and -2.51, respectively. At 78 weeks, BMD increased significantly more with teriparatide compared to risedronate at the LS (+11.08% versus +6.45%; p < 0.001) and FN (+1.96% versus -1.19%; p = 0.003), with no significant between-group difference in TH BMD. Timed up-and-go (TUG) test was significantly faster with teriparatide at 6, 12, 18, and 26 weeks (differences: -3.2 to -5.9 s; p = 0.045 for overall difference). Hip pain during TUG test by 100 mm VAS was significantly lower with teriparatide at 18 weeks (adjusted difference: -11.3 mm, p = 0.033; -10.0 and -9.3 mm at 12 and 26 weeks, respectively; p = 0.079 for overall difference). Other secondary and exploratory outcomes were not different. Teriparatide group showed two new hip fractures versus seven with risedronate (p = 0.171) and more frequent hypercalcemia and hyperuricemia. In conclusion, 78-week treatment with teriparatide showed significantly greater increases in LS and FN BMD, less pain, and a faster TUG test versus risedronate. © 2016 American Society for Bone and Mineral Research.
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Affiliation(s)
| | | | | | - Costantino Corradini
- Department of Biomedical Surgical and Dental Sciences, University of Milan, c/o 1st University Division of Orthopaedy and Traumatology, ASST Gaetano Pini, Milan, Italy
| | - Søren Overgaard
- Department of Orthopaedic Surgery and Traumatology, Odense University Hospital Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Jan J Stepan
- Institute of Rheumatology and Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Lars Borris
- Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Eric Lespessailles
- Institut de prévention et de recherche sur l'ostéoporose (IPROS), Department of Rheumatology, Centre Hospitalier Régional (CHR) d'Orléans, Orléans, France.,Imagerie Multimodale Multiéchelle et Modélisation du Tissu Osseux (I3MTO), EA 4708, Orléans University, Orléans, France
| | - Frede Frihagen
- Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
| | - Kyriakos Papavasiliou
- 3rd Orthopaedic Department, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
| | | | - Per Aspenberg
- Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - José Ramón Caeiro
- Department of Orthopaedic Surgery and Traumatology, Santiago de Compostela University Hospital, Health Research Institute, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Fernando Marin
- Eli Lilly Research Centre Ltd, Erl Wood Manor, Surrey, UK
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14
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Aspenberg P, Malouf J, Tarantino U, García-Hernández PA, Corradini C, Overgaard S, Stepan JJ, Borris L, Lespessailles E, Frihagen F, Papavasiliou K, Petto H, Caeiro JR, Marin F. Effects of Teriparatide Compared with Risedronate on Recovery After Pertrochanteric Hip Fracture: Results of a Randomized, Active-Controlled, Double-Blind Clinical Trial at 26 Weeks. J Bone Joint Surg Am 2016; 98:1868-1878. [PMID: 27852903 PMCID: PMC5551693 DOI: 10.2106/jbjs.15.01217] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Osteoporosis drugs might affect fracture-healing. We therefore studied the effects of teriparatide in comparison with risedronate on recovery after pertrochanteric hip fractures. METHODS The study was a randomized, multicenter, active-controlled, 78-week trial comparing teriparatide (20 μg/day) with risedronate (35 mg/week) initiated within 2 weeks after fixation of a low-trauma pertrochanteric hip fracture (AO/OTA 31-A1 or 31-A2). The main inclusion criteria were a bone mineral density T-score of ≤-2.0 and 25-OH-vitamin D of ≥9.2 ng/mL. During the first 26 weeks, patients received study medication with oral or injectable placebo plus calcium and vitamin D in a double-blinded fashion. Secondary (Timed Up-and-Go [TUG] test, hip pain, Short Form [SF]-36 health status, and safety) and exploratory (radiographic outcomes and ability to walk) 26-week end points are reported. RESULTS Of the 224 patients who were randomized, 171 (86 teriparatide, 85 risedronate) were included in the analysis. The mean age was 77 ± 8 years, 77% were female, and 26% had a prior history of low-trauma fracture. The teriparatide group completed the TUG test in a shorter time at 6, 12, 18, and 26 weeks (differences of -5.7, -4.4, -3.1, and -3.1 seconds, respectively; p = 0.021 for the overall difference). They also reported less pain on a visual analog scale immediately after the TUG test at 12 and 18 weeks (adjusted absolute differences of 10.6 and 11.9 mm, respectively; p < 0.05). There were no significant between-group differences in the SF-36 score, Charnley hip pain score, ability to walk, or use of walking aids during follow-up. Radiographic healing at 6, 12, and 26 weeks, mechanical failure of the implant (teriparatide, 7; risedronate, 8), loss of reduction (teriparatide, 2; risedronate, 4), and nonunion (0 cases) were not significantly different. Mild hypercalcemia and hyperuricemia were more frequent with teriparatide. CONCLUSIONS Teriparatide was associated with less pain and a shorter time to complete the TUG test between 6 and 26 weeks compared with risedronate. Other fracture-recovery outcomes were similar. The results should be interpreted with caution as these were secondary end points. LEVEL OF EVIDENCE Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Per Aspenberg
- Department of Clinical and Experimental Medicine,
Linköping University, Linköping, Sweden,E-mail address for P. Aspenberg:
| | - Jorge Malouf
- Internal Medicine, Hospital San Pablo, Barcelona,
Spain,E-mail address for J. Malouf:
| | - Umberto Tarantino
- Orthopaedic Surgery, University Tor Vergata, Rome,
Italy,E-mail address for U. Tarantino:
| | - Pedro A. García-Hernández
- Osteoporosis Center, University Hospital, Monterrey,
Mexico,E-mail address for P.A.
García-Hernández:
| | - Costantino Corradini
- Department of Biomedical Surgical and Dental
Sciences, University of Milan, c/o I Division of Orthopaedics and Traumatology,
A.O. Orthopaedic Institute, Milan, Italy,E-mail address for C. Corradini:
| | - Søren Overgaard
- Department of Orthopaedic Surgery and Traumatology,
Odense University Hospital, Odense, Denmark,Institute of Clinical Research, University of
Southern Denmark, Odense, Denmark,E-mail address for S. Overgaard:
| | - Jan J. Stepan
- Institute of Rheumatology and Faculty of Medicine 1,
Charles University, Prague, Czech Republic,E-mail address for J.J. Stepan:
| | - Lars Borris
- Orthopaedic Surgery, University Hospital, Aarhus,
Denmark,E-mail address for L. Borris:
| | - Eric Lespessailles
- IPROS, Department of Rheumatology, C.H.R
Orléans, Orléans, France,I3MTO, Orléans University, Orléans,
France,E-mail address for E. Lespessailles:
| | - Frede Frihagen
- Orthopaedic Surgery, Oslo University Hospital,
Oslo, Norway,E-mail address for F. Frihagen:
| | - Kyriakos Papavasiliou
- 3rd Orthopaedic Department, Aristotle University of
Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece,E-mail address for K. Papavasiliou:
| | - Helmut Petto
- Eli Lilly, Vienna, Austria,E-mail address for H. Petto:
| | - José Ramón Caeiro
- Department of Orthopaedic Surgery and Traumatology,
Santiago de Compostela University Hospital, Health Research Institute,
University of Santiago de Compostela, Santiago de Compostela, Spain,E-mail address for J. Ramón Caeiro:
| | - Fernando Marin
- Eli Lilly Research Centre, Windlesham, United
Kingdom,E-mail address for F. Marin:
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15
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Etxebarria-Foronda I, Arrospide A, Soto-Gordoa M, Caeiro JR, Abecia LC, Mar J. Regional variability in changes in the incidence of hip fracture in the Spanish population (2000-2012). Osteoporos Int 2015; 26:1491-7. [PMID: 25572051 DOI: 10.1007/s00198-014-3015-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 12/18/2014] [Indexed: 11/24/2022]
Abstract
UNLABELLED The objective is to analyse the evolution of the incidence of hip fracture in the female population of Spain from 2000 to 2012 and to establish the possible changes which may have been seen over this period of time, including the trends in the different regions of the country. INTRODUCTION Fragility-related hip fractures are considered to be the fractures of greatest significance to public health due to their high degree of morbidity and mortality. The change in their incidence, both in absolute values and when adjusted for age, is the subject of debate. The objective of this article is to describe the changes in the rates of hip fracture in Spain by autonomous community between the years 2000 and 2012. METHODS Using the data from the Spanish Minimum Basic Data Set, in which are all the recorded cases of women with a principal diagnosis of hip fracture, the incidence rates by age group and by autonomous community were obtained. Poisson distribution or negative binomial regressions were carried out to estimate the average annual change over the time period analysed. RESULTS There have been statistically significant changes in the trends of rates of incidence for all age groups of women over 65 years of age. The annual reduction was 2.2% for women of 65-74 years of age and less for those between 75 and 84. The rates of incidence for those over 85 increased annually by 0.58%. CONCLUSIONS Hip fractures continue to increase in absolute numbers, although if the rates are adjusted for age, a downward trend is seen in certain age groups. These findings have various origins, although in the absence of great changes in population structure, we believe that drug treatments for osteoporosis may play a role. There is variability in the change in incidence of hip fractures in different parts of the country. Further studies are required to be able to identify the causes.
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Martín-Fernández M, Martínez E, Díaz-Curiel M, Guede D, Caeiro JR, De la Piedra C. Effects of PTH (1-84) on bone quality in a validated model of osteoporosis due to androgenic deprivation. Aging Male 2014; 17:42-50. [PMID: 23914846 DOI: 10.3109/13685538.2013.821697] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AIM The purpose of this study was to evaluate the effect of parathyroid hormone (PTH) (1-84) in a model of male osteoporosis induced by orchidectomy in rats. METHODS Six-month-old Wistar rats were used as follows: SHAM (simulated orchidectomy), orchidectomized (ORX), ORX + PTH1 (ORX and treated with 10 µg/Kg/d of PTH 1-84) and ORX + PTH2 (ORX and treated with 50 µg/Kg/d of PTH 1-84) over 3 months, with treatment beginning three months after orchidectomy. RESULTS Orchidectomy resulted in a decreased of femoral and lumbar bone mineral density (BMD), a worsening of trabecular and cortical microarchitecture and a decrease in biomechanical properties. Both doses of PTH (1-84) partially (low dose) or totally (high dose) restored the ORX-induced changes. Serum C-telopeptide of type I collagen/5b isoenzyme of tartrate-resistant acid phosphatase (CTX/TRAP) resorption index increased after orchidectomy. Osteocalcin (bone Gla protein; BGP) levels were not affected by orchidectomy. PTH (1-84) treatment did not produce any changes in the levels of CTX/TRAP with respect to the ORX group. BGP levels increased with PTH treatment. CONCLUSION PTH (1-84) is able to restore the adverse effects of orchidectomy on bone as measured by BMD, microstructural and biomechanical properties and bone remodeling markers.
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Affiliation(s)
- Marta Martín-Fernández
- Department of Biochemical Research, Instituto de Investigación Sanitaria Fundación Jiménez Díaz , Madrid , Spain
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17
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Samama CM, Lecoules N, Kierzek G, Claessens YE, Riou B, Rosencher N, Mismetti P, Sautet A, Barrellier MT, Apartsin K, Jonas M, Caeiro JR, van der Veen AH, Roy PM. Comparison of fondaparinux with low molecular weight heparin for venous thromboembolism prevention in patients requiring rigid or semi-rigid immobilization for isolated non-surgical below-knee injury. J Thromb Haemost 2013; 11:1833-43. [PMID: 23965181 DOI: 10.1111/jth.12395] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2013] [Indexed: 01/19/2023]
Abstract
BACKGROUND In several small studies, anticoagulant therapy reduced the incidence of venous thromboembolism (VTE) in patients with isolated lower-limb injuries. OBJECTIVES To compare the efficacy and safety of fondaparinux 2.5 mg (1.5 mg in patients with a creatinine clearance between 30 and 50 mL min(-1) ) over nadroparin 2850 anti-factor Xa IU. PATIENTS AND METHODS In this international, multicenter, randomized, open-label study, patients with an isolated non-surgical unilateral below-knee injury having at least one additional major risk factor for VTE and requiring, in the Investigator's opinion, rigid or semi-rigid immobilization for 21-45 days with thromboprophylaxis up to complete mobilization received subcutaneously once-daily either fondaparinux or nadroparin. The primary efficacy outcome was the composite of VTE (symptomatic or ultrasonographically detected asymptomatic deep vein thrombosis of the lower limb or symptomatic pulmonary embolism) and death up to complete mobilization. The main safety outcome was major bleeding. RESULTS We randomized 1349 patients (mean age 46 years): 88.7% had a bone fracture, and 83.8% had a plaster cast fitted (mean duration of immobilization, 34 days). The primary efficacy outcome occurred in 15 of 584 patients (2.6%) in the fondaparinux group and 48 of 586 patients (8.2%) in the nadroparin group (odds ratio, 0.30; 95% confidence interval [CI], 0.15-0.54; P < 0.001). A single major bleed was experienced by fondaparinux-treated patients and none by nadroparin-treated patients. These results were maintained up to the end of follow-up. CONCLUSIONS Fondaparinux 2.5 mg day(-1) may be a valuable therapeutic option over nadroparin 2850 anti-FXa IU day(-1) for preventing VTE after below-knee injury requiring prolonged immobilization in patients with additional risk factors.
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Affiliation(s)
- C M Samama
- Department of Anesthesia and Intensive Care Medicine, Hôtel Dieu and Cochin University Hospitals, Assistance Publique- Hôpitaux de Paris (AP-HP), Paris Descartes University, Paris, France
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18
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Ibáñez L, Alcaraz MJ, Maicas N, Guede D, Caeiro JR, Motterlini R, Ferrándiz ML. Downregulation of the inflammatory response by CORM-3 results in protective effects in a model of postmenopausal arthritis. Calcif Tissue Int 2012; 91:69-80. [PMID: 22644323 DOI: 10.1007/s00223-012-9612-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2012] [Accepted: 05/02/2012] [Indexed: 10/28/2022]
Abstract
CO-releasing molecules (CORMs) are a new class of drugs able to release small amounts of CO in biological systems. We have shown previously that one of these molecules, CORM-3, exerts anti-inflammatory effects in animal models. The aim of this study was to assess the effects of CORM-3 on bone metabolism in a model of postmenopausal rheumatoid arthritis osteoporosis. Ovariectomy was followed by collagen-induced arthritis in female DBA-1/J mice. Animals showing arthritis on day 22 after immunization were then randomized into control and treatment groups. CORM-3 was administered at 10 mg/kg, intraperitoneally, once a day. Alendronate was administered at 100 μg/kg, orally, once a day. On days 36 and 50 after immunization, animals were killed and tissues analyzed. The arthritic score was significantly reduced by CORM-3 but not by alendronate treatment. Histopathological analyses indicated that both compounds reduced cellular infiltration and cartilage degradation. Local bone erosion and reduction in TNFα levels were seen for CORM-3 on day 50 and for alendronate on day 36. Serum levels of COMP, IL-6, MMP-3, CTX-I, alkaline phosphatase, and osteocalcin were decreased by both treatments, whereas TNFα levels were reduced by CORM-3 and TRAP-5b by alendronate. Micro-computed tomographic analysis showed protective effects on trabecular bone, which were more prominent for CORM-3 on day 36 and for alendronate on day 50. Our results suggest that CORMs represent a novel anti-inflammatory strategy to counteract joint bone erosion with partial protective effects on systemic bone loss in postmenopausal rheumatoid arthritis.
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Affiliation(s)
- Lidia Ibáñez
- Department of Pharmacology, University of Valencia, Av. Vicent Andres Estelles s/n, 46100, Burjassot, Valencia, Spain
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De La Piedra C, Quiroga I, Montero M, Dapia S, Caeiro JR, Rubert M, Diaz-Curiel M, Bauss F. Daily or monthly ibandronate prevents or restores deteriorations of bone mass, architecture, biomechanical properties and markers of bone turnover in androgen-deficient aged rats. Aging Male 2011; 14:220-30. [PMID: 20937008 DOI: 10.3109/13685538.2010.518176] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AIM The aim of this study was to investigate the effects of the bisphosphonate ibandronate (IBN) in a male osteoporosis animal model. METHODS Two studies were performed in 9-month-old orchidectomised (ORX) or sham-operated rats. In prevention study, subcutaneous IBN was administered daily (1 μg/kg) or monthly (28 μg/kg every 28 days) starting on day of surgery for 5 months. In treatment study, the same treatment started 6 months after ORX. After sacrifice, bone analyses by dual-energy X-ray absorptiometry, 3-dimensional micro-computed tomography, and 3-point bending were performed in femora or vertebrae. Serum tartrate-resistant acid phosphatase 5b (TRAP-5b) and aminoterminal propeptide of collagen I (PINP) were analysed for resorption and osteocalcin (BGP) for bone formation. RESULTS In both studies, ORX resulted in significant femoral and vertebral bone loss and microarchitectural deterioration after 5 months of ORX, and became more pronounced after 11 months. Biomechanical strength was also decreased. Serum levels for TRAP-5b and BGP increased while PINP levels were reduced or unchanged. Both daily and monthly IBN prevented or even restored ORX-induced changes in both studies, with the intermittent regimen showing a improvement in efficacy with respect to many of the biomechanical parameters.
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Affiliation(s)
- Concepcion De La Piedra
- Department of Biochemistry Investigation, Instituto de Investigacion Sanitaria Fundación Jimenez Diaz, Madrid, Spain.
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Cano A, Dapía S, Noguera I, Pineda B, Hermenegildo C, del Val R, Caeiro JR, García-Pérez MA. Comparative effects of 17beta-estradiol, raloxifene and genistein on bone 3D microarchitecture and volumetric bone mineral density in the ovariectomized mice. Osteoporos Int 2008; 19:793-800. [PMID: 17968609 DOI: 10.1007/s00198-007-0498-6] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2007] [Accepted: 10/10/2007] [Indexed: 12/13/2022]
Abstract
UNLABELLED This study assessed the effect of estradiol, raloxifene and genistein on the preservation of bone 3D-microarchitecture and volumetric bone mineral density (vBMD) in the ovariectomized mouse model. Our results indicated that raloxifene was more effective in preserving bone ovariectomized-induced changes, the advantage being concentrated in both bone microarchitecture and vBMD. INTRODUCTION This study assessed the effect of different estrogen receptor (ER) agonists on the preservation of bone 3D-microarchitecture and volumetric bone mineral density (vBMD) in the ovariectomized (OVX) mouse model. METHODS Twelve-week-old female C57BL/6 mice were randomly assigned to one of five groups: (1) SHAM-operated + vehicle; (2) OVX + vehicle; (3) OVX + 17beta-estradiol (5 microg/kg); (4) OVX + raloxifene (1 mg/kg); (5) OVX + genistein (25 mg/kg), during 4-weeks. Bone microarchitecture and trabecular, cortical and total vBMD of distal femur were imaged by ex vivo microcomputed tomography (micro-CT). RESULTS Ovariectomy produced a global deterioration involving both trabecular and cortical 3D-microarchitecture and vBMD. Raloxifene maintained both microarchitecture and vBMD, whereas estradiol prevented deterioration of some microstructural parameters, such as trabecular thickness (Tb.Th), trabecular bone pattern factor (Tb.Pf), and cortical periosteal perimeter (Ct.Pe.Pm), but did not completely block the loss in vBMD. Mice treated with genistein exhibited the less favourable profile in both vBMD and microstructural parameters preserving only cross-sectional bone area (B.Ar) and Ct.Pe.Pm in cortical bone. CONCLUSION Our data indicate that, at the selected doses, raloxifene was more effective in preserving bone OVX-induced changes than either estradiol or genistein, the advantage being concentrated in both bone microarchitecture and vBMD.
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Affiliation(s)
- A Cano
- Department of Pediatrics, Obstetrics and Gynecology, University of Valencia, Valencia, Spain
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Manuel Quesada J, Jódar E, Sánchez C, Pérez-López F, Díaz Curiel M, Herrera A, Carpintero P, Ramón Caeiro J, Muñoz M, Guañabens N, Sosa M, Gómez Alonso C, Saavedra J, Valdés C, Sanfélix J, Tejedor A, Aguado P, Fiter J. Declaración española sobre la Vitamina D en el manejo de la osteoporosis. ACTA ACUST UNITED AC 2007. [DOI: 10.1016/s1575-0922(07)71472-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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