• Title/Summary/Keyword: Osteoporosis Therapy

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A Cost-effectiveness Analysis of the Medication for Osteoporosis (골다공증 치료약제의 비용-효과 분석)

  • 임지영;권순만
    • Health Policy and Management
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    • v.11 no.3
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    • pp.71-88
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    • 2001
  • The purpose of this study is to analyze the cost-effectiveness of four medications for treating and preventing osteoporosis -HRT therapy(conjugated equine estrogen 0.625mg for 25 days and medroxyprogesterone acetate 5mg for 01112 days), Alendronate(10mg and 5mg), Active Vitamin D(Calcitriol), and Calcium. Total costs include the direct medical cost -examination fee, consultation fee, prescription fee, fee for preparing medications, and the price of pharmaceuticals- and the indirect cost of patients such as traffic expenses and time cost. In addition, the costs of monitoring in adverse reactions are added. The effects of four medications are expressed as BMD(Bone Mineral Density) percent change measured by DEXA(Dual Energy X-ray Absorptiometry) in lumbar spine(L2-L4) and femoral neck site. A mixed model based on meta analysis provides the estimates of effectiveness, which are then appled to the hypothetical cohort consisting of postmenopausal women at the age of 50-59. HRT therapy is the most cost-effective medication at 172,433.64 won (lumbar spine site) and 546,328.28 won (femoral neck site) per BMD percent change for osteoporosis. Alendronate 10mg is more cost-effective than Alendronate 5mg as 345,971.23 won and 378,441.63 won per lumbar BMD percent change at 0.991g/$cm^2$, respectively. Alendronate 10mg is more cost-effective than Alendronate 5mg as 1,329,257.89 won and 1,467,291.23 won per femoral neck BMD percent change at 0.834g/$cm^2$, respectively.

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Combination Therapy of Conventional and Korean Medicine for Multiple Vertebral Compression Fractures Associated with Postpartum Osteoporosis: A Case Report

  • Lee, Ki-Beom;Yang, Kyu-Jin;Gi, Yu-Mi;Kim, Tae-Gyu;Jo, Hooin;Choi, Jongho
    • Journal of Acupuncture Research
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    • v.35 no.4
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    • pp.244-247
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    • 2018
  • Multiple vertebral compression fractures are a rare condition and are a serious consequence of postpartum osteoporosis. This report describes the case of a 35-year-old woman who had given birth to her first child 2 months before the onset of pain. Magnetic resonance imaging showed compression fractures of 7 vertebrae. The patient was treated with both conventional, and Korean medicine methods including acupuncture and herbal prescriptions. The patient's progress was assessed using self-reported symptoms, scale scores and laboratory test results. Her pain was gradually alleviated and biochemical inflammation marker levels improved, but her functional status remained severely impaired. Clinical practitioners who treat women in the postpartum period must be aware of osteoporosis and potential vertebral fractures and need to consider Korean medicine as an alternative therapy to help such patients.

Analysis of Women with Low Back Pain and Bone mineral density (일부 여성의 요통과 골밀도에 관한 분석)

  • Kang, Jeom-Deok
    • Journal of Korean Physical Therapy Science
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    • v.8 no.2
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    • pp.1015-1021
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    • 2001
  • Objectives: The objective of this study was to investigate analysis of women with low back pain and osteoporosis were measured for 40 normal in the women from July 20, 2000 to October 20, 2000. Methods: Bone mineral density(BMD) of lumbar spine was measured using energy absorptiometry and were correlated with age, calcium. alkaline phosphatase. bone mineral density standard T scores(p<0.05). Results: The bone mineral density of the lumbar spine decreased with aging, The bone mineral density of the lumbar spine decreased with the serum calcium and phosphate increased. The mean bone mineral density of the lumbar spine of healthy women in age($50\sim59$) was $0.83g/cm^2$, the lumbar spine of women low back pain in age($50\sim59$) was 0.75 glad. Conclusion: In the multiple regression of risk factors to bone mineral density(BMD) of lumbar spine were correlated with age, of abortion, calcium, bone mineral density standard T scores(p<0,05). In the prevention and early diagnosis and treatment of osteoporosis, the physician should consider the risk factors.

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Gender Difference in Osteoporosis Prevalence, Awareness and Treatment: Based on the Korea National Health and Nutrition Examination Survey 2008~2011 (골다공증 유병률, 인지율, 치료율 및 영향요인의 성별 비교: 국민건강영양조사 자료(2008~2011년) 활용)

  • Kim, Yunmi;Kim, Jung Hwan;Cho, Dong Sook
    • Journal of Korean Academy of Nursing
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    • v.45 no.2
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    • pp.293-305
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    • 2015
  • Purpose: The aim of the study was to assess and identify gender differences in factors associated with prevalence, awareness, and treatment of osteoporosis. Methods: Data for 3,071 men and 3,635 women ($age{\qeq}50$) from the Korea National Health and Nutrition Examination Survey 2008~2011 were included. Osteoporosis was defined by World Health Organization T-score criteria. Impact factors and odds ratios were analysed by gender using multivariate logistic regression. Results: Osteoporosis prevalence rates were 7.0% in men and 40.1% in women. Osteopenia rates were 45.5% and 46.0% respectively. Among respondents with osteoporosis, 7.6% men and 37.8% women were aware of their diagnosis. Also 5.7% men with osteoporosis and 22.8% women were treated. Higher prevalence was found among respondents who were older, at lower socioeconomic levels, with lower body mass index and shorter height in both genders, and among women with fracture history, and non-hormonal replacement therapy. Awareness and treatment rates for the risk groups were similar compared to the low risk controls for both genders. Fracture history increased awareness and treatment rates independently for both genders. Women with perceived poor health status and health screening had increased awareness and treatment rates, but not men. Conclusion: Results indicate that postmenopausal women have a higher prevalence of osteoporosis than men and awareness and treatment rates were higher than for men. Despite gender difference in prevalence, osteoporosis was underdiagnosed and undertreated for both genders. Specialized public education and routine health screenings according to gender could be effective strategies to increase osteoporosis awareness and treatment.

Roles of growth factors, calcitonic polypeptides and neuropeptides in bone metabolism, osteoporosis and rheumatis arthritis

  • Lee, Tae-Kyun;Kim, June-ki;Kim, Kap-Sung;Chang, Jun-Hyuk;Jeong, Ji-cheon;Nam, Kyung-Soo;Kim, Cheorl-Ho
    • The Journal of Dong Guk Oriental Medicine
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    • v.9
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    • pp.1-23
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    • 2000
  • Osteoporosis is a common disorder characterized by reduced bone mineral density, deterioration of the microarchitecture of bone tissue and increased risk of fracture. The aim of treatment of osteoporosis is to maintain and, ideally, to restore bone strength safely. In recent years the role of polypeptide growth factors in bone metabolism has begun to appear. It has been proposed that alterations in the expression or production of growth factor can modulate the proliferation and activity of bone forming cells. Thus, the role of structurally diverse peptides for the management and diagnosis of osteoporosis has attracted the attention of many investigators. This paper reviews numerous findings concerning the use of polypeptides, hormones, and growth factors, for the management of osteoporosis. Many of the compounds mentioned here are experimental prototypes of new therapeutic classes. Though it is unlikely that some of the compounds may ever be used clinically, development of safe and efficacious agents in each class will define the future course of therapy for osteoporosis.

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The Review on the Study of Osteoporosis in Oriental Medicine Journals (골다공증의 연구 경향에 대한 고찰 -한의 학술 논문 검색을 중심으로-)

  • Kim, Young-Wook;Song, Yun-kyung;Lim, Hyung-Ho
    • The Journal of Korea CHUNA Manual Medicine
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    • v.5 no.1
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    • pp.67-76
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    • 2004
  • Objectives : The purpose of this study is to research trends In the study of osteoporosis and to establish the future direction for its study. Methods: We reviewed oriental medicine papers published in last twelve years (1990-2002). Methods : We reviewed oriental medicine papers published in last twelve years (1990-2002). Results : 1. We researched 42 papers in 12 journals and patterns of study were as follows: experimental studies were 30 (71%), reviewed studies were 8(19%), clinical studies were 2 (5%) and etc were 2 (5%). 2. The experimental studies(30) were divided into papers on efficiency testing of herbal medications (22) and herbal acupuncture (7) and etc (1). 3. The reviewed studies showed that research has been carried out in the fields of cause, pathogenesis, principles for treating disease, herbal medication, herbal acupuncture, acupuncture and moxibustion, exercise to osteoporosis. 4. The clinical studies showed that the research was carried out in the fields of follow up surveys for the herbal medication efficiency testing, the relativity of osteoporosis to other diseases. 5. In consequence of researching the case reports, there was no prescription used meaningfully. Conclusions: We need more studies of osteoporosis by reaching for specific therapy.

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Effect of Biochemical Makers of Bone Metabolism by Administration of Radix Concentration in Ovariectomized Rats (골다공증 쥐에서 우슬의 농도별 투여에 따른 골대사의 생화학적 마커에 미치는 영향)

  • Kim, Eun-Jung;Kim, Young-Eok;Jang, Mee-Kyung;Kim, Young-Il;Kim, Hyung-Woo;Kim, Gye-Yeop
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.21 no.4
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    • pp.967-972
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    • 2007
  • Osteoporosis is the most prevalent metabolic bone disease and is characterized by diminished bone strength predisposing to an increased risk of fracture. We investigated the effects of the extract from Acyranthes Radix on the progress of bone loss in ovariectomized rats for 6 weeks. Female Sprague-Dawley 40 rats of 3-4 weeks, weight 200 ${\pm}$ 10g were divided into two groups including the sham operation group(8 rats) and ovariectomy group(32 rats). The dose-dependent effect of Acyranthes Radix extract on bone mineral density and biochemical testing was assessed in ovariectomized rat. Body weights were increased in all groups was higher in experimental group than sham operation group. The level of bone mineral density, GPT, and serum P concentration, ALP were increased experimental group, but a little increase in sham operation group at same period. This longitudinal study result made conclusion that Acyranthes Radix extract treatment appeared to improve the osteoporosis delaying the progression to the osteoporotic process in rats.

Prediction of medication-related osteonecrosis of the jaw (MRONJ) using automated machine learning in patients with osteoporosis associated with dental extraction and implantation: a retrospective study

  • Da Woon Kwack;Sung Min Park
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.49 no.3
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    • pp.135-141
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    • 2023
  • Objectives: This study aimed to develop and validate machine learning (ML) models using H2O-AutoML, an automated ML program, for predicting medication-related osteonecrosis of the jaw (MRONJ) in patients with osteoporosis undergoing tooth extraction or implantation. Patients and Methods: We conducted a retrospective chart review of 340 patients who visited Dankook University Dental Hospital between January 2019 and June 2022 who met the following inclusion criteria: female, age ≥55 years, osteoporosis treated with antiresorptive therapy, and recent dental extraction or implantation. We considered medication administration and duration, demographics, and systemic factors (age and medical history). Local factors, such as surgical method, number of operated teeth, and operation area, were also included. Six algorithms were used to generate the MRONJ prediction model. Results: Gradient boosting demonstrated the best diagnostic accuracy, with an area under the receiver operating characteristic curve (AUC) of 0.8283. Validation with the test dataset yielded a stable AUC of 0.7526. Variable importance analysis identified duration of medication as the most important variable, followed by age, number of teeth operated, and operation site. Conclusion: ML models can help predict MRONJ occurrence in patients with osteoporosis undergoing tooth extraction or implantation based on questionnaire data acquired at the first visit.

Hormone Therapy Review for Perimenopausal Symptoms: Focused on Perimenopausal Women without Other Risk Factors (폐경기 증상을 완화시키기 위한 개별화 호르몬 요법에 대한 고찰: 다른 위험요소가 없는 폐경기 여성을 중심으로)

  • Lee, Young Mee;Yun, Hwi-yeol
    • Korean Journal of Clinical Pharmacy
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    • v.27 no.4
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    • pp.199-206
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    • 2017
  • As the population ages, the life of women after menopause becomes much longer than the past, and the quality of life of old age becomes increasingly principal issue. There is a period that women experience the physical symptoms of menopause, although there are differences in degree, and the management of this period is a suitable time for women to improve their quality of life. According to the menopausal hormone therapy (MHT) and Timing Hypothesis, which has been proven in the Kronos Early Estrogen Prevention Study (KEEPS) and the Early vs Late Intervention Trial with Estradiol (ELITE) study, a relatively young woman before and after menopause can benefit from long-term beneficial effects such as prevention of osteoporosis and cardiovascular disease by early initiation of hormone therapy to alleviate menopausal symptoms. MHT should be considered for all women in healthy (without other important diseases) menopausal years, expecting to improve their quality of life through symptom relief in menopausal women and, in the long term, to prevent cardiovascular disease and osteoporosis. When applying hormone therapy to individuals, it is necessary to establish various treatment strategies according to the menopausal symptoms of individual patients (individualization of treatment) and judge the suitability of clinical application.

The Effect of Genetically Modified Lactobacillus plantarum Carrying Bone Morphogenetic Protein 2 Gene on an Ovariectomized Rat

  • Jin, Eun-Sun;Kim, Ji Yeon;Yang, Jung-Mo;Kim, Jun-Sub;Min, JoongKee;Jeon, Sang Ryong;Choi, Kyoung Hyo;Moon, Gi-Seong;Jeong, Je Hoon
    • Journal of Korean Neurosurgical Society
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    • v.65 no.2
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    • pp.204-214
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    • 2022
  • Objective : Osteoporosis result from age-related decline in the number of osteoblast progenitors in the bone marrow. Probiotics have beneficial effects on the host, when administered in appropriate amounts. This study investigated the effects of probiotics expressing specific genes, especially the effects of genetically modified bone morphogenetic protein (BMP)-2-expressing Lactobacillus plantarum CJNU 3003 (LP) on ovariectomized rats. Methods : Twenty-eight female Wistar rats (250-300 g, 12 weeks old) were divided into four groups : the sham (control), the ovariectomy (OVX)-induced osteoporosis group (OVX), the OVX and LP (OVX/LP), OVX and genetically modified BMP-2-expressing LP (OVX/LP with BMP) groups. The three groups underwent bilateral OVX and two of these groups were administered two different types of LP via oral gavage daily. At 16 weeks post-OVX, blood was collected from the heart and the bilateral tibiae were extracted and were scanned by ex-vivo micro-computed tomography and stained with hematoxylin-and-eosin (H&E) and Masson's trichrome stain for pathological assessment. The serum levels of osteocalcin (OC), rat C-telopeptide of type I collagen (CTX-I), BMP-2, and receptor activator of nuclear factor-ĸB ligand (RANKL) were measured. Results : The 3D-micro-computed tomography images showed that the trabecular structure in the OVX/LP with BMP group was maintained compared with OVX and OVX/LP groups. No significant differences were detected in trabecular thickness (Tb.Th) between control and OVX/LP with BMP groups (p>0.05). Furthermore, a tendency toward increased BMD, trabecular bone volume, Tb.Th, and trabecular number and decreased trabecular separation was found in rats in the OVX/LP with BMP groups when compared with the OVX and OVX/LP groups (p>0.05). The H&E and Masson's trichrome stained sections showed a thicker trabecular bone in the OVX/LP with BMP group compared with the OVX and OVX/LP groups. There was no difference in serum levels of OC, CTX and RANKL control and OVX/LP with BMP groups (p>0.05). In contrast, significant differences were found in OC and CTX-1 levels between the OVX and OVX/LP with BMP groups (p<0.05). Conclusion : Our results showed that the expression of genetically modified BMP-2 showed inhibition effect for bone loss in a rat model of osteoporosis.