“Our goal should always be to prevent the first fracture by identifying those at risk. The Own the Bone program from the American Orthopaedic Association has called on orthopedic surgeons to “capture the fracture” (ie, recognize fragility fractures and recommend treatment for osteoporosis) to optimize bone health prior to elective orthopedic surgery,” explained Dr. Serota. 

"The current paper adds to our growing body of evidence that consideration of underlying bone health is just as important to arthroplasty surgeons as to orthopedic trauma and spine surgeons," said Dr. Serota. 

Read the full article at healio.com. 

Dr. Stein and Shannon Clare, research assistant and first author of the study, cited “Our results are notable because we found that the duration of suppression of bone formation extended beyond 12 weeks, a far longer duration than seen previously with intra-articular injections [of glucocorticoids].”

According to the authors, women are not typically screened for osteopenia or osteoporosis before ESI. However, Dr. Stein and Clare noted, “Our results suggest that physicians should consider screening women for osteoporosis who receive ESI, particularly those who are treated with multiple doses. Steroid exposure should be minimized as much as possible by having patients space injections as far as they can tolerate."

The authors stated that further studies are needed of the relationship between these short-term changes in bone turnover and bone loss and the risk for fracture among the burgeoning population treated with ESIs.

Read the full article at Medscape.com.

Infectious Disease Advisor spoke to experts who discussed the effects of ART on bone health in PLWH, including Jessica Rachel Starr, MD, endocrinologist at HSS. Dr. Starr explained, “ART, when given intermittently vs continuously, has a better effect on BMD decline, meaning bone density is less negatively affected when patients take breaks from the antiretroviral agents.” She added, “This is a complex topic and highlights how HIV has become a chronic disease, meaning patients with HIV are living long enough to develop chronic age-related conditions such as osteoporosis, although they are perhaps developing these conditions at an earlier time in life and with a higher degree of severity than their HIV-negative peers.”

Dr. Starr expressed the need for further research, stating, “Additional research is needed to tease out the relative contribution of the HIV itself to low BMD vs the medications used to control the virus. There is also a need to determine whether ART affects bone metabolism or vitamin D metabolism or both.”

Dr. Starr also addressed key considerations for clinicians, citing, “Osteoporosis and osteopenia are more common in women, older patients, and those with lower body weight. All patients with HIV should have BMD screening before initiating treatment with ART.”

Read the full article at Infectiousdiseaseadvisor.com.