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Clinical, Review, Journal: Medical management of patients after atypical femur fractures: a systematic review and recommendations from ECTS. (Pubmed Central) - Feb 10, 2021
There is no evidence-based indication in patients with AFF for teriparatide apart from reducing the risk of typical fragility fractures, although observational data suggest that teriparatide might result in faster healing of surgically treated AFFs. Awaiting further evidence, we formulate recommendations for treatment after an AFF based on expert opinion.
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Retrospective data, Journal: Medication-Related Osteonecrosis of the Jaws and CDK4/6 Inhibitors: A Recent Association. (Pubmed Central) - Feb 10, 2021
The degree of risk for osteonecrosis in patients taking these new classes of drugs is uncertain but warrants awareness and close monitoring. The role of premedication dental evaluation as a prevention strategy has been acknowledged for cancer patients about to initiate intravenous bisphosphonates and/or denosumab for treatment of bone metastasis, but additional attention should be paid to whom are assuming CDK4/6 inhibitors because of their oral adverse events.
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Journal: Denosumab for fibrous dysplasia: Promising, but questions remain. (Pubmed Central) - Feb 9, 2021
The role of premedication dental evaluation as a prevention strategy has been acknowledged for cancer patients about to initiate intravenous bisphosphonates and/or denosumab for treatment of bone metastasis, but additional attention should be paid to whom are assuming CDK4/6 inhibitors because of their oral adverse events. No abstract available
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Journal: Serum profile of microRNAs linked to bone metabolism during sequential treatment for postmenopausal osteoporosis. (Pubmed Central) - Feb 9, 2021
Injected antiosteoporotic medication was associated with lower rates of repeated vertebroplasty and kyphoplasty than was OB application. TPTD treatment potentially affects the expression of the pro-osteoclastogenic miR-21a-5p and miRs related to the expression of osteoblastic genes RUNX2 (miR23a-3p), COL1 (miR-29a-3p) and HDAC5 (miR-2861), while sequential treatment with Dmab acts in the opposite direction.
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Enrollment closed, Enrollment change: DEFENCE: Denosumab for High Risk SMM and SLiM CRAB Positive, Early Myeloma Patients (clinicaltrials.gov) - Feb 9, 2021
P2, N=8, Active, not recruiting,
TPTD treatment potentially affects the expression of the pro-osteoclastogenic miR-21a-5p and miRs related to the expression of osteoblastic genes RUNX2 (miR23a-3p), COL1 (miR-29a-3p) and HDAC5 (miR-2861), while sequential treatment with Dmab acts in the opposite direction. Recruiting --> Active, not recruiting | N=164 --> 8
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Enrollment open: Markers of Osteoporosis in Cystic Fibrosis (clinicaltrials.gov) - Feb 9, 2021
P4, N=100, Recruiting,
Recruiting --> Active, not recruiting | N=164 --> 8 Not yet recruiting --> Recruiting
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Review, Journal: RANKL as a target for the treatment of osteoporosis. (Pubmed Central) - Feb 7, 2021
This review summarized pharmacokinetic and pharmacodynamic properties of denosumab, clinical studies including phase 2 dose-ranging and its extension study, phase 3 fracture prevention study (FREEDOM) with extension up to 10 years, studies on male osteoporosis (ADAMO study), and on glucocorticoid-induced osteoporosis, along with relevant clinical studies in Japan. In addition, mechanism of denosumab action that can explain its long-term sustained effects, combination and sequential treatment as well as the problems in discontinuation of denosumab, and finally safety of denosumab therapy is discussed.
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Review, Journal: RANKL as a therapeutic target of rheumatoid arthritis. (Pubmed Central) - Feb 7, 2021
RANKL is highly expressed in the synovial tissues in patients with RA and is involved in osteoclast development and thus bone destruction in RA. Denosumab, a specific antibody to human RANKL, efficiently suppressed the progression of bone destruction in patients with RA in a randomized controlled study and is considered a putative therapeutic option for RA.
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Review, Journal: Discovery of the RANKL/RANK/OPG system. (Pubmed Central) - Feb 7, 2021
This discovery had a major impact on identification of mechanisms regulating osteoclast differentiation and function, establishment of a research field bridging bone and the immune system (osteoimmunology), and development of a fully human anti-RANKL neutralizing antibody (denosumab)...The review covers recent results showing the importance of RANKL on osteoblasts in regulation of osteogenesis and the role of RANKL-RANK dual signaling in coupling of bone resorption and formation, including demonstration of RANKL reverse signaling that we had previously hypothesized. Possible applications of anti-RANKL antibody in treatment of cancer are also discussed.
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Clinical, Review, Journal: Bone Targeting Agents in Patients with Metastatic Prostate Cancer: State of the Art. (Pubmed Central) - Feb 5, 2021
However, emerging evidence has suggested that the combination of BTAs and abiraterone acetate, enzalutamide and the radiopharmaceutical radium-223 could result in improved clinical outcomes and prolonged survival in bone metastatic CRPC. In this review, we will provide an overview on bone tropism of prostate cancer and on the role of BTAs in metastatic hormone-sensitive and castration-resistant prostate cancer.
- |||||||||| Prolia (denosumab) / Amgen, GSK, Daiichi Sankyo, Opdivo (nivolumab) / Ono Pharma, BMS
[VIRTUAL] A Rare Case of Pulmonary Large Cell Neuroendocrine Carcinoma () - Feb 4, 2021 - Abstract #AFMRER2021AFMR_ER_77;
It was followed by RT and maintenance immunotherapy with nivolumab plus denosumab...Retrospective studies have shown that SCLC treatment regimen of Etoposide-Platin had better survival outcomes (median: 44 vs 11 months) as compared to NSCLC regimens such as Platin in combination with Paclitaxel, Gemcitabine or Vinorelbine...Although data is limited, initial studies have shown positive responses with checkpoint inhibitor anti PD1 antibodies such as nivolumab, pembrolizumab and ipilimumab. CT chest showing 8.6cm perihilar mass compressing the left main pulmonary artery CT chest showing tumor associated with narrowing of the left main bronchus and underlying atelectasis
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[VIRTUAL] Can Long-Standing GnRH Therapy Cause a Pituitary Prolactinoma? (On-Demand) - Feb 2, 2021 - Abstract #ENDO2021ENDO_1474;
He had refused surgical intervention and hence was treated with flutamide, then leuprolide...Patient refused surgery and hence was started on bromocriptine...DEXA scan confirmed osteoporosis with a T score of --2.5, which was treated with denosumab...He then developed a clinically significant pituitary adenoma years after the therapy. We suggest that constant stimulation of the pituitary by GnRH analogues can lead to enlargement of the anterior pituitary in a similar fashion, resulting in the development of the prolactinoma.
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[VIRTUAL] Fix That PHEX Loss (On-Demand) - Feb 2, 2021 - Abstract #ENDO2021ENDO_951;
Due to the recurrent fractures she was switched to denosumab therapy while workup was underway for secondary causes...Most recently her phosphorous levels have been controlled with therapy, and there is current discussion underway to try burosumab, an antibody to FGF23...For oral presentations, the abstracts are embargoed until the session begins. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO 2021.
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[VIRTUAL] Early Osteoporosis in RYR1-Related Central Core Disease (On-Demand) - Feb 2, 2021 - Abstract #ENDO2021ENDO_948;
Unless otherwise noted, all poster abstracts presented at ENDO 2021 are embargoed until 11 AM Eastern on Saturday, March 20. For oral presentations, the abstracts are embargoed until the session begins.
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[VIRTUAL] A Case of Chronic Bone Pain in Mc-CuneAlbright Syndrome. (On-Demand) - Feb 2, 2021 - Abstract #ENDO2021ENDO_940;
She was taking Tramadol as needed...She was treated with zoledronic acid 4 mg IV on a monthly basis for 1 year without any improvement in bone density or pain symptoms She reached menarche at age 12, and is currently menopausal...Thus, denosumab is a promising and well-tolerated agent that may be effective in FD, especially when response to bisphosphonates is inadequate. the embargo on specific abstracts that are selected for promotion prior to or during ENDO 2021.
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[VIRTUAL] Denosumab Induced Severe Hypocalcemia in a Patient With Metastatic Prostate Cancer (On-Demand) - Feb 2, 2021 - Abstract #ENDO2021ENDO_905;
Several patients had underlying risk factors such as vitamin D deficiency, osteoblastic lesion, and AKI leading to an additional cause of hypocalcemia. We emphasize careful monitoring of serum Ca levels particularly in the first few weeks of treatment even without significant risk factors for hypocalcemia.
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[VIRTUAL] Rebound Hypercalcemia After Denosumab Therapy in a Child With Cherubism (On-Demand) - Feb 2, 2021 - Abstract #ENDO2021ENDO_879;
The hypercalcemia appears to respond best to bisphosphonates, with a more sustained response to zoledrenate compared to pamidronate. Unless otherwise noted, all poster abstracts presented at ENDO 2021 are embargoed until 11 AM Eastern on Saturday, March 20.
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[VIRTUAL] Ectopic Intact PTH Secretion Causing Humoral Hypercalcemia of Malignancy (On-Demand) - Feb 2, 2021 - Abstract #ENDO2021ENDO_878;
Treatment of the malignancy may lead to an improvement in hypercalcemia and iPTH levels. Employment of iPTH mRNA testing or intra-abdominal venous sampling to prove ectopic iPTH secretion would be ideal, as iPTH staining could be falsely negative.
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[VIRTUAL] Single Dose of Denosumab Effective for Management of Bisphosphonate-Refractory Hypercalcemia of Malignancy Related to Non-Small Cell Lung Cancer (On-Demand) - Feb 2, 2021 - Abstract #ENDO2021ENDO_871;
Denosumab was approved for BR-HCM with a complex treatment schedule based on a single-arm study of 33 patients, of whom 39% had treatment-related adverse events.1 We present a case of successful management of BR-HCM with a single dose of 120mg denosumab with CSC <11.5 mg/dL at day 4 after treatment and persistent control of calcium at day 70 without further treatment. Further investigation is warranted to determine the most effective treatment schedule of denosumab for BR-HCM to reduce adverse events including hypocalcemia and overtreatment.
- |||||||||| Prolia (denosumab) / Amgen, GSK, Daiichi Sankyo
[VIRTUAL] Silicone Induced Severe Hypercalcemia (On-Demand) - Feb 2, 2021 - Abstract #ENDO2021ENDO_870;
Calcium improved in 4 days to 10.5 mg/dL with intravenous hydration, calcitonin 260 units, IV furosemide 20 mg, and pamidronate of 60 mg...Prednisone 20 mg daily was started for granulomatous disease and Calcium improved to 10.3 mg/dL...Based on the few reported cases, silicone induced severe hypercalcemia is managed with IV hydration, denosumab, or zoledronic acid...For oral presentations, the abstracts are embargoed until the session begins. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO 2021.
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[VIRTUAL] A Challenging Case of Vitamin D Toxicity Responding to Cinacalcet (On-Demand) - Feb 2, 2021 - Abstract #ENDO2021ENDO_846;
He was treated with aggressive IV hydration, calcitonin and received 2 doses of pamidronate with an initial improvement in his Calcium level down to 10 mg/dL followed by recurrence of hypercalcemia...Conclusion PTH-independent hypercalcemia is usually treated with hydration, anti-resorptive agents including bisphosphonates, denosumab and calcitonin, in addition to steroids in cases of increased 1 αλπηα-hydroxylase activity...For oral presentations, the abstracts are embargoed until the session begins. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO 2021.
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