The Experts below are selected from a list of 122853 Experts worldwide ranked by ideXlab platform
Stuart H Ralston - One of the best experts on this subject based on the ideXlab platform.
-
randomized trial of intensive bisphosphonate Treatment versus Symptomatic management in paget s disease of bone
Journal of Bone and Mineral Research, 2010Co-Authors: Anne L Langston, Marion K Campbell, William D Fraser, Graeme Maclennan, P L Selby, Stuart H RalstonAbstract:Bisphosphonates are widely regarded as the Treatment of choice for Paget's disease of bone (PDB) because of their potent inhibitory effects on bone turnover, but the effects of bisphosphonate therapy on symptoms and complications of PDB have been little studied. Here we report the results of a randomized trial that compared the effects of Symptomatic Treatment with intensive bisphosphonate therapy in a cohort of 1324 patients with PDB who were followed up for a median of 3 years (range 2 to 5 years). The Symptomatic Treatment group was treated only if they had pagetic bone pain, for which they were first given analgesics or anti-inflammatory drugs, followed by bisphosphonates if they did not respond. The intensive group received repeat courses of bisphosphonates irrespective of symptoms with the aim of reducing and maintaining serum alkaline phosphatase (ALP) levels within the normal range. The endpoints were fracture, orthopedic surgery, quality of life, bone pain, and hearing thresholds. Serum ALP levels were significantly lower in the intensive Treatment group than in with the Symptomatic Treatment group within 4 months of commencing Treatment and remained lower throughout the study (p < .001). There was no difference between the groups in quality of life (as assessed by the SF36 questionnaire), in overall bodily pain, or in pagetic bone pain. Hearing thresholds, as assessed by audiometry did not change significantly and did not differ between the Treatment groups. Clinical fractures occurred in 46 of 661 patients (7.0%) in the intensive Treatment group compared with 49 of 663 patients (7.4%) in the Symptomatic Treatment group, and orthopedic surgery was required in 50 of 661 patients (7.3%) in the intensive Treatment group and in 55 of 663 patients (8.3%) in the Symptomatic Treatment group. These differences were not significant. Subgroup analyses of patients with elevated ALP levels at baseline and those who did or did not receive bisphosphonates during the study yielded similar results to those in the study group as a whole. We conclude that striving to maintain normal ALP levels with intensive bisphosphonate therapy confers no clinical advantage over symptom-driven management in patients with established PDB. Neither management strategy had a significant beneficial impact on pain or quality of life (Clinical trial registration number ISRCTN12989577).
-
randomized trial of intensive bisphosphonate Treatment versus Symptomatic management in paget s disease of bone
Journal of Bone and Mineral Research, 2010Co-Authors: Anne L Langston, Marion K Campbell, William D Fraser, Graeme Maclennan, P L Selby, Stuart H RalstonAbstract:Bisphosphonates are widely regarded as the Treatment of choice for Paget's disease of bone (PDB) because of their potent inhibitory effects on bone turnover, but the effects of bisphosphonate therapy on symptoms and complications of PDB have been little studied. Here we report the results of a randomized trial that compared the effects of Symptomatic Treatment with intensive bisphosphonate therapy in a cohort of 1324 patients with PDB who were followed up for a median of 3 years (range 2 to 5 years). The Symptomatic Treatment group was treated only if they had pagetic bone pain, for which they were first given analgesics or anti-inflammatory drugs, followed by bisphosphonates if they did not respond. The intensive group received repeat courses of bisphosphonates irrespective of symptoms with the aim of reducing and maintaining serum alkaline phosphatase (ALP) levels within the normal range. The endpoints were fracture, orthopedic surgery, quality of life, bone pain, and hearing thresholds. Serum ALP levels were significantly lower in the intensive Treatment group than in with the Symptomatic Treatment group within 4 months of commencing Treatment and remained lower throughout the study (p < .001). There was no difference between the groups in quality of life (as assessed by the SF36 questionnaire), in overall bodily pain, or in pagetic bone pain. Hearing thresholds, as assessed by audiometry did not change significantly and did not differ between the Treatment groups. Clinical fractures occurred in 46 of 661 patients (7.0%) in the intensive Treatment group compared with 49 of 663 patients (7.4%) in the Symptomatic Treatment group, and orthopedic surgery was required in 50 of 661 patients (7.3%) in the intensive Treatment group and in 55 of 663 patients (8.3%) in the Symptomatic Treatment group. These differences were not significant. Subgroup analyses of patients with elevated ALP levels at baseline and those who did or did not receive bisphosphonates during the study yielded similar results to those in the study group as a whole. We conclude that striving to maintain normal ALP levels with intensive bisphosphonate therapy confers no clinical advantage over symptom-driven management in patients with established PDB. Neither management strategy had a significant beneficial impact on pain or quality of life (Clinical trial registration number ISRCTN12989577). © 2010 American Society for Bone and Mineral Research
Anne L Langston - One of the best experts on this subject based on the ideXlab platform.
-
randomized trial of intensive bisphosphonate Treatment versus Symptomatic management in paget s disease of bone
Journal of Bone and Mineral Research, 2010Co-Authors: Anne L Langston, Marion K Campbell, William D Fraser, Graeme Maclennan, P L Selby, Stuart H RalstonAbstract:Bisphosphonates are widely regarded as the Treatment of choice for Paget's disease of bone (PDB) because of their potent inhibitory effects on bone turnover, but the effects of bisphosphonate therapy on symptoms and complications of PDB have been little studied. Here we report the results of a randomized trial that compared the effects of Symptomatic Treatment with intensive bisphosphonate therapy in a cohort of 1324 patients with PDB who were followed up for a median of 3 years (range 2 to 5 years). The Symptomatic Treatment group was treated only if they had pagetic bone pain, for which they were first given analgesics or anti-inflammatory drugs, followed by bisphosphonates if they did not respond. The intensive group received repeat courses of bisphosphonates irrespective of symptoms with the aim of reducing and maintaining serum alkaline phosphatase (ALP) levels within the normal range. The endpoints were fracture, orthopedic surgery, quality of life, bone pain, and hearing thresholds. Serum ALP levels were significantly lower in the intensive Treatment group than in with the Symptomatic Treatment group within 4 months of commencing Treatment and remained lower throughout the study (p < .001). There was no difference between the groups in quality of life (as assessed by the SF36 questionnaire), in overall bodily pain, or in pagetic bone pain. Hearing thresholds, as assessed by audiometry did not change significantly and did not differ between the Treatment groups. Clinical fractures occurred in 46 of 661 patients (7.0%) in the intensive Treatment group compared with 49 of 663 patients (7.4%) in the Symptomatic Treatment group, and orthopedic surgery was required in 50 of 661 patients (7.3%) in the intensive Treatment group and in 55 of 663 patients (8.3%) in the Symptomatic Treatment group. These differences were not significant. Subgroup analyses of patients with elevated ALP levels at baseline and those who did or did not receive bisphosphonates during the study yielded similar results to those in the study group as a whole. We conclude that striving to maintain normal ALP levels with intensive bisphosphonate therapy confers no clinical advantage over symptom-driven management in patients with established PDB. Neither management strategy had a significant beneficial impact on pain or quality of life (Clinical trial registration number ISRCTN12989577).
-
randomized trial of intensive bisphosphonate Treatment versus Symptomatic management in paget s disease of bone
Journal of Bone and Mineral Research, 2010Co-Authors: Anne L Langston, Marion K Campbell, William D Fraser, Graeme Maclennan, P L Selby, Stuart H RalstonAbstract:Bisphosphonates are widely regarded as the Treatment of choice for Paget's disease of bone (PDB) because of their potent inhibitory effects on bone turnover, but the effects of bisphosphonate therapy on symptoms and complications of PDB have been little studied. Here we report the results of a randomized trial that compared the effects of Symptomatic Treatment with intensive bisphosphonate therapy in a cohort of 1324 patients with PDB who were followed up for a median of 3 years (range 2 to 5 years). The Symptomatic Treatment group was treated only if they had pagetic bone pain, for which they were first given analgesics or anti-inflammatory drugs, followed by bisphosphonates if they did not respond. The intensive group received repeat courses of bisphosphonates irrespective of symptoms with the aim of reducing and maintaining serum alkaline phosphatase (ALP) levels within the normal range. The endpoints were fracture, orthopedic surgery, quality of life, bone pain, and hearing thresholds. Serum ALP levels were significantly lower in the intensive Treatment group than in with the Symptomatic Treatment group within 4 months of commencing Treatment and remained lower throughout the study (p < .001). There was no difference between the groups in quality of life (as assessed by the SF36 questionnaire), in overall bodily pain, or in pagetic bone pain. Hearing thresholds, as assessed by audiometry did not change significantly and did not differ between the Treatment groups. Clinical fractures occurred in 46 of 661 patients (7.0%) in the intensive Treatment group compared with 49 of 663 patients (7.4%) in the Symptomatic Treatment group, and orthopedic surgery was required in 50 of 661 patients (7.3%) in the intensive Treatment group and in 55 of 663 patients (8.3%) in the Symptomatic Treatment group. These differences were not significant. Subgroup analyses of patients with elevated ALP levels at baseline and those who did or did not receive bisphosphonates during the study yielded similar results to those in the study group as a whole. We conclude that striving to maintain normal ALP levels with intensive bisphosphonate therapy confers no clinical advantage over symptom-driven management in patients with established PDB. Neither management strategy had a significant beneficial impact on pain or quality of life (Clinical trial registration number ISRCTN12989577). © 2010 American Society for Bone and Mineral Research
S Söderhäll - One of the best experts on this subject based on the ideXlab platform.
-
ORIGINAL ARTICLE Beneficial effect of long term intravenous bisphosphonate Treatment of osteogenesis imperfecta
2016Co-Authors: E Åström, S SöderhällAbstract:Aim: To find an effective Symptomatic Treatment for osteogenesis imperfecta (OI). Methods: In a prospective observational study disodium pamidronate (APD) was given as monthly intravenous infusions to 28 children and adolescents (aged 0.6–18 years) with severe OI or a milder form of the disease, but with spinal compression fractures. Results: During Treatment for 2–9 years, dual energy x ray absorptiometry measurements of the total body and of the lumbar spine showed a gradual increase in bone density. All bone metabolism vari-ables in serum (alkaline phosphatase, osteocalcin, procollagen 1 C-terminal peptide, collagen 1 tele-opeptide) and urine (deoxypyridinoline) indicated that there was a decrease in bone turnover. All patients experienced beneficial effects and the younger patients reported a major improvement in well-being, pain, and mobility without significant side effects. Vertebral remodelling was also seen. Conclusions: APD seems to be an efficient Symptomatic Treatment for children and adolescents with OI. Osteogenesis imperfecta (OI) is a congenital disease ofcollagen with variable phenotype. In milder forms thefracture rate is only slightly increased and the stature is normal or slightly decreased. In severe forms, bone softness and multiple fractures lead to progressive bone deformitie
-
beneficial effect of long term intravenous bisphosphonate Treatment of osteogenesis imperfecta
Archives of Disease in Childhood, 2002Co-Authors: E Åström, S SöderhällAbstract:Aim: To find an effective Symptomatic Treatment for osteogenesis imperfecta (OI). Methods: In a prospective observational study disodium pamidronate (APD) was given as monthly intravenous infusions to 28 children and adolescents (aged 0.6–18 years) with severe OI or a milder form of the disease, but with spinal compression fractures. Results: During Treatment for 2–9 years, dual energy x ray absorptiometry measurements of the total body and of the lumbar spine showed a gradual increase in bone density. All bone metabolism variables in serum (alkaline phosphatase, osteocalcin, procollagen 1 C-terminal peptide, collagen 1 teleopeptide) and urine (deoxypyridinoline) indicated that there was a decrease in bone turnover. All patients experienced beneficial effects and the younger patients reported a major improvement in wellbeing, pain, and mobility without significant side effects. Vertebral remodelling was also seen. Conclusions: APD seems to be an efficient Symptomatic Treatment for children and adolescents with OI.
P L Selby - One of the best experts on this subject based on the ideXlab platform.
-
randomized trial of intensive bisphosphonate Treatment versus Symptomatic management in paget s disease of bone
Journal of Bone and Mineral Research, 2010Co-Authors: Anne L Langston, Marion K Campbell, William D Fraser, Graeme Maclennan, P L Selby, Stuart H RalstonAbstract:Bisphosphonates are widely regarded as the Treatment of choice for Paget's disease of bone (PDB) because of their potent inhibitory effects on bone turnover, but the effects of bisphosphonate therapy on symptoms and complications of PDB have been little studied. Here we report the results of a randomized trial that compared the effects of Symptomatic Treatment with intensive bisphosphonate therapy in a cohort of 1324 patients with PDB who were followed up for a median of 3 years (range 2 to 5 years). The Symptomatic Treatment group was treated only if they had pagetic bone pain, for which they were first given analgesics or anti-inflammatory drugs, followed by bisphosphonates if they did not respond. The intensive group received repeat courses of bisphosphonates irrespective of symptoms with the aim of reducing and maintaining serum alkaline phosphatase (ALP) levels within the normal range. The endpoints were fracture, orthopedic surgery, quality of life, bone pain, and hearing thresholds. Serum ALP levels were significantly lower in the intensive Treatment group than in with the Symptomatic Treatment group within 4 months of commencing Treatment and remained lower throughout the study (p < .001). There was no difference between the groups in quality of life (as assessed by the SF36 questionnaire), in overall bodily pain, or in pagetic bone pain. Hearing thresholds, as assessed by audiometry did not change significantly and did not differ between the Treatment groups. Clinical fractures occurred in 46 of 661 patients (7.0%) in the intensive Treatment group compared with 49 of 663 patients (7.4%) in the Symptomatic Treatment group, and orthopedic surgery was required in 50 of 661 patients (7.3%) in the intensive Treatment group and in 55 of 663 patients (8.3%) in the Symptomatic Treatment group. These differences were not significant. Subgroup analyses of patients with elevated ALP levels at baseline and those who did or did not receive bisphosphonates during the study yielded similar results to those in the study group as a whole. We conclude that striving to maintain normal ALP levels with intensive bisphosphonate therapy confers no clinical advantage over symptom-driven management in patients with established PDB. Neither management strategy had a significant beneficial impact on pain or quality of life (Clinical trial registration number ISRCTN12989577).
-
randomized trial of intensive bisphosphonate Treatment versus Symptomatic management in paget s disease of bone
Journal of Bone and Mineral Research, 2010Co-Authors: Anne L Langston, Marion K Campbell, William D Fraser, Graeme Maclennan, P L Selby, Stuart H RalstonAbstract:Bisphosphonates are widely regarded as the Treatment of choice for Paget's disease of bone (PDB) because of their potent inhibitory effects on bone turnover, but the effects of bisphosphonate therapy on symptoms and complications of PDB have been little studied. Here we report the results of a randomized trial that compared the effects of Symptomatic Treatment with intensive bisphosphonate therapy in a cohort of 1324 patients with PDB who were followed up for a median of 3 years (range 2 to 5 years). The Symptomatic Treatment group was treated only if they had pagetic bone pain, for which they were first given analgesics or anti-inflammatory drugs, followed by bisphosphonates if they did not respond. The intensive group received repeat courses of bisphosphonates irrespective of symptoms with the aim of reducing and maintaining serum alkaline phosphatase (ALP) levels within the normal range. The endpoints were fracture, orthopedic surgery, quality of life, bone pain, and hearing thresholds. Serum ALP levels were significantly lower in the intensive Treatment group than in with the Symptomatic Treatment group within 4 months of commencing Treatment and remained lower throughout the study (p < .001). There was no difference between the groups in quality of life (as assessed by the SF36 questionnaire), in overall bodily pain, or in pagetic bone pain. Hearing thresholds, as assessed by audiometry did not change significantly and did not differ between the Treatment groups. Clinical fractures occurred in 46 of 661 patients (7.0%) in the intensive Treatment group compared with 49 of 663 patients (7.4%) in the Symptomatic Treatment group, and orthopedic surgery was required in 50 of 661 patients (7.3%) in the intensive Treatment group and in 55 of 663 patients (8.3%) in the Symptomatic Treatment group. These differences were not significant. Subgroup analyses of patients with elevated ALP levels at baseline and those who did or did not receive bisphosphonates during the study yielded similar results to those in the study group as a whole. We conclude that striving to maintain normal ALP levels with intensive bisphosphonate therapy confers no clinical advantage over symptom-driven management in patients with established PDB. Neither management strategy had a significant beneficial impact on pain or quality of life (Clinical trial registration number ISRCTN12989577). © 2010 American Society for Bone and Mineral Research
Graeme Maclennan - One of the best experts on this subject based on the ideXlab platform.
-
randomized trial of intensive bisphosphonate Treatment versus Symptomatic management in paget s disease of bone
Journal of Bone and Mineral Research, 2010Co-Authors: Anne L Langston, Marion K Campbell, William D Fraser, Graeme Maclennan, P L Selby, Stuart H RalstonAbstract:Bisphosphonates are widely regarded as the Treatment of choice for Paget's disease of bone (PDB) because of their potent inhibitory effects on bone turnover, but the effects of bisphosphonate therapy on symptoms and complications of PDB have been little studied. Here we report the results of a randomized trial that compared the effects of Symptomatic Treatment with intensive bisphosphonate therapy in a cohort of 1324 patients with PDB who were followed up for a median of 3 years (range 2 to 5 years). The Symptomatic Treatment group was treated only if they had pagetic bone pain, for which they were first given analgesics or anti-inflammatory drugs, followed by bisphosphonates if they did not respond. The intensive group received repeat courses of bisphosphonates irrespective of symptoms with the aim of reducing and maintaining serum alkaline phosphatase (ALP) levels within the normal range. The endpoints were fracture, orthopedic surgery, quality of life, bone pain, and hearing thresholds. Serum ALP levels were significantly lower in the intensive Treatment group than in with the Symptomatic Treatment group within 4 months of commencing Treatment and remained lower throughout the study (p < .001). There was no difference between the groups in quality of life (as assessed by the SF36 questionnaire), in overall bodily pain, or in pagetic bone pain. Hearing thresholds, as assessed by audiometry did not change significantly and did not differ between the Treatment groups. Clinical fractures occurred in 46 of 661 patients (7.0%) in the intensive Treatment group compared with 49 of 663 patients (7.4%) in the Symptomatic Treatment group, and orthopedic surgery was required in 50 of 661 patients (7.3%) in the intensive Treatment group and in 55 of 663 patients (8.3%) in the Symptomatic Treatment group. These differences were not significant. Subgroup analyses of patients with elevated ALP levels at baseline and those who did or did not receive bisphosphonates during the study yielded similar results to those in the study group as a whole. We conclude that striving to maintain normal ALP levels with intensive bisphosphonate therapy confers no clinical advantage over symptom-driven management in patients with established PDB. Neither management strategy had a significant beneficial impact on pain or quality of life (Clinical trial registration number ISRCTN12989577).
-
randomized trial of intensive bisphosphonate Treatment versus Symptomatic management in paget s disease of bone
Journal of Bone and Mineral Research, 2010Co-Authors: Anne L Langston, Marion K Campbell, William D Fraser, Graeme Maclennan, P L Selby, Stuart H RalstonAbstract:Bisphosphonates are widely regarded as the Treatment of choice for Paget's disease of bone (PDB) because of their potent inhibitory effects on bone turnover, but the effects of bisphosphonate therapy on symptoms and complications of PDB have been little studied. Here we report the results of a randomized trial that compared the effects of Symptomatic Treatment with intensive bisphosphonate therapy in a cohort of 1324 patients with PDB who were followed up for a median of 3 years (range 2 to 5 years). The Symptomatic Treatment group was treated only if they had pagetic bone pain, for which they were first given analgesics or anti-inflammatory drugs, followed by bisphosphonates if they did not respond. The intensive group received repeat courses of bisphosphonates irrespective of symptoms with the aim of reducing and maintaining serum alkaline phosphatase (ALP) levels within the normal range. The endpoints were fracture, orthopedic surgery, quality of life, bone pain, and hearing thresholds. Serum ALP levels were significantly lower in the intensive Treatment group than in with the Symptomatic Treatment group within 4 months of commencing Treatment and remained lower throughout the study (p < .001). There was no difference between the groups in quality of life (as assessed by the SF36 questionnaire), in overall bodily pain, or in pagetic bone pain. Hearing thresholds, as assessed by audiometry did not change significantly and did not differ between the Treatment groups. Clinical fractures occurred in 46 of 661 patients (7.0%) in the intensive Treatment group compared with 49 of 663 patients (7.4%) in the Symptomatic Treatment group, and orthopedic surgery was required in 50 of 661 patients (7.3%) in the intensive Treatment group and in 55 of 663 patients (8.3%) in the Symptomatic Treatment group. These differences were not significant. Subgroup analyses of patients with elevated ALP levels at baseline and those who did or did not receive bisphosphonates during the study yielded similar results to those in the study group as a whole. We conclude that striving to maintain normal ALP levels with intensive bisphosphonate therapy confers no clinical advantage over symptom-driven management in patients with established PDB. Neither management strategy had a significant beneficial impact on pain or quality of life (Clinical trial registration number ISRCTN12989577). © 2010 American Society for Bone and Mineral Research
