Benskörhet kostar miljarder (netdoktor.passagen.se 4.6.2007)

SSRIer (lykkepiller) øker risiko for benbrudd (medpagetoday.com 22.1.2007)

Stærkt stigende hyppighed af hoftebrud i Danmark fra 1977 til 1999 (Ugeskr Læger 2008;170(8):621 -623)

Reports of Adverse Events From Bone Drugs Prompt Caution In 2003, case reports of a rare but serious condition occurring in patients taking bisphosphonates to prevent breakdown of bone began surfacing. (JAMA. 2006;295:2833-2836)

Merck forbereder seg på en strøm av Fosamax-søksmål (consumeraffairs.com 6.2.2007)

Måling av østrogen identifiserer ikke økt risiko for beinbrudd (Tidsskr Nor Lægeforen 2007; 127: 2494 (4.10.2007))

Inflammation ger benskörhet (svd.se 21.2.2007)

Ökad risk för frakturer hos kvinnor som använt diabetesläkemedlen Avandia, Avandamet och Avaglim (lakemedelsverket.se 7.3.2007)

Information on Bisphosphonates (fda.gov 7.1.2008)

Kjønnshormoner varsler ikke beinskjørhet (forskning.no 21.6.2007)

- Benskjørhet og trening

Derfor bør du trene mer i 20-årene
kk.no 17.2.2012
Ny forskning viser at fysisk aktivitet tidlig i 20-årene kan redusere risiko for beinskjørhet og beinbrudd senere i livet. (...)

(Anm: Mye tid foran TV og PC svekker skjelettet til unge gutter. Gutter som sitter mer enn seks timer foran skjermen i helgene har lav beintetthet Det viser en ny helseundersøkelse. (nrk.no 19.6.2015).)

(Anm: Increased physical activity is associated with enhanced development of peak bone mass in men: A five year longitudinal study. Journal of Bone and Mineral Research 2012 (Accepted, unedited articles published online for future issues).)

- Å løpe ett minutt per dag kan beskytte kvinners benhelse.

(Anm: Running for 1 minute per day may protect women's bone health. (…) Such brief bursts of activity are equivalent to a run at a medium pace for premenopausal women, and a slow-paced jog for postmenopausal women. The findings were published in the International Journal of Epidemiology. Osteoporosis is a bone disease that causes bone to become weak and brittle. Bone tissue is constantly broken down and replaced, but osteoporosis occurs when new bone production does not keep pace with the removal of old bone. (medicalnewstoday.com 19.7.2017).)

(Anm: Fysisk trening (aktivitet / løping / jogging). (mintankesmie.no).)

(Anm: Brainy bones: new research reveals how our skeleton is a lot like our brain. (...) "Taking recent imaging data, we calculated that the human skeleton contains about 42 million osteocytes. That's about six times the Earth's population. In comparison, the human brain contains 86 billion neurons, packed in a volume (1.2L) comparable with that of the skeleton (1.75L)," Dr Buenzli said. (medicalnewstoday.com 20.4.2015).)

(Anm: Are Your Bones at Risk for Osteoporosis? (medicinenet.com 27.7.2016).)

- Forsker: Rødkløver stopper knogleskørhed hos kvinder. Urten rødkløver har samme effekt som østrogen på nedbrydningen af knogler, men uden bivirkninger, siger forsker. Det kan være slut med østrogenbehandlinger til kvinder, hvor overgangsalderen har givet dem knogleskørhed.

(Anm: Forsker: Rødkløver stopper knogleskørhed hos kvinder. Urten rødkløver har samme effekt som østrogen på nedbrydningen af knogler, men uden bivirkninger, siger forsker. Det kan være slut med østrogenbehandlinger til kvinder, hvor overgangsalderen har givet dem knogleskørhed. I stedet kan et skud koncentreret og fermenteret rødkløver (Trifolium pratense) sætte en stopper for nedbrydningen af knoglerne. Det viser i hvert fald flere nye studier, der for nylig blev offentliggjort i de videnskabelige tidsskrifter American Journal of Clinical Nutrition og Plos One. »Behandlingen er banebrydende, idet vi nu kan behandle knogleskørhed uden at bruge farlige østrogener, der medfører en betydeligt øget risiko for cancer, og som også er behæftet med andre bivirkninger,« fortæller manden bag de nye studier, lektor Per Bendix Jeppesen fra Institut for Klinisk Medicin ved Aarhus Universitet. (…) Kan købes i dag Da fermenteret rødkløver allerede i dag bliver brugt som alternativ behandling, kan kvinder i og efter overgangsalderen uden problemer købe ekstraktet som et værn mod begyndende knogleskørhed. Hvorvidt mænd har samme gavn af den lille urt er stadig uvist. (videnskab.dk 14.10.2017).)

(Anm: Combined Red Clover isoflavones and probiotics potently reduce menopausal vasomotor symptoms. PLoS One. 2017 Jun 7;12(6):e0176590.)

- Fjerning av senescente celler fra ledd kan reversere progresjon av osteoartritt (betennelse i ledd og tilgrensende knokkel).

(Anm: Removing senescent cells from joints could reverse progression of osteoarthritis. In a preclinical study in mice and human cells, researchers report that selectively removing old or 'senescent' cells from joints could stop and even reverse the progression of osteoarthritis. The findings, published April 24 in Nature Medicine, support growing evidence that senescent cells contribute to age-related diseases and demonstrate that using drug therapies to remove them from the joint not only reduces the development of post-traumatic osteoarthritis but creates an environment for new cartilage to grow and repair joints. (news-medical.net 2.5.2017).)

(Anm: Mitochondria (mitokondrie) (mitokondriesykdommer) (mitokondrielle sykdommer). (mintankesmie.no).)

- Mayo Clinic-studie avslører link mellom senescente celler og benskjørhet (osteoporose) hos mus.

(Anm: Mayo Clinic study reveals link between senescent cells and bone loss in mice. Mayo Clinic researchers have reported a causal link between senescent cells - the cells associated with aging and age-related disease - and bone loss in mice. Targeting these cells led to an increase in bone mass and strength. The findings appear online in Nature Medicine. (news-medical.net 21.8.2017).)

(Anm: Forskere mener te hjelper mot sprø knokler (vg.no 25.2.2015).)

(Anm: Women with T2D Face Higher Fracture Risk. —Chances for osteoporotic breaks climb after a decade with type 2 diabetes. ATLANTA -- Women who had type 2 diabetes for longer than 10 years were at increased risk for having major osteoporotic fractures as well as hip fractures, a Canadian study found. (medpagetoday.com 19.9.2016).)

- Bruk av antidepressiva er knyttet til økt risiko for hodeskader og traumatisk hjerneskade blant personer med Alzheimers sykdom, ifølge en ny studie fra Universitetet i Øst-Finland. Antidepressiva har tidligere vært knyttet til økt risiko for fall og hoftefrakturer, men risikoen for hodeskader har ikke blitt gransket tidligere.

(Anm: Antidepressant Use Increases Head Injury Risk in People With Alzheimer's Disease. KUOPIO, Finland -- August 9, 2017 -- Antidepressant use is associated with an increased risk of head injuries and traumatic brain injuries among persons with Alzheimer's disease, according to a new study from the University of Eastern Finland. Antidepressant use has previously been linked with an increased risk of falls and hip fractures, but the risk of head injuries has not been studied before. The results were published in Alzheimer's Research & Therapy. (…) "However, our findings give cause for concern because persons with Alzheimer's disease frequently use antidepressants, which have been considered a safer alternative to, for example, benzodiazepines," said Heidi Taipale, PhD, University of Eastern Finland, Kuopio, Finland. (dgnews.docguide.com 9.8.2017).)

(Anm: Risk of head and traumatic brain injuries associated with antidepressant use among community-dwelling persons with Alzheimer's disease: a nationwide matched cohort study. Alzheimers Res Ther. 2017 Aug 1;9(1):59.)

(Anm: Antidepressiva (nytteverdi) (mintankesmie.no).)

(Anm: Antipsykotika (psykofarmaka etc.) (mintankesmie.no).)

(Anm: Sovemidler (sovemedisiner) og beroligende midler (mintankesmie.no).)

(Anm: Diskriminering, feilmedisineringer hos mennesker med utviklingshemming og utfordrende atferd (psykofarmaka; antidepressiva, antipsykotika, sovemedisiner) etc. (mintankesmie.no).)

(Anm: På tide å revurdere? (Time to rethink?) Legemiddelbehandlinger hos mennesker med utviklingshemming og utfordrende atferd (Drug treatments in people with intellectual disability and challenging behaviour disabilities) Editorials (Lederartikkel) BMJ 2014;349:g4323 (Published 04 July 2014).)

- Opioider og antidepressiva relatert til økt risiko for benbrudd hos RA-pasienter.

(Anm: Opioid and antidepressant use related to increased risk of osteoporotic fractures for RA patients. Opioids and selective serotonin reuptake inhibitors, a widely used group of antidepressants, are both associated with higher risk of osteoporotic fractures for patients with rheumatoid arthritis, according to new research findings presented this week at the 2017 ACR/ARHP Annual Meeting in San Diego. (…) The increased fracture risk linked to use of opioids or SSRIs may be due to an increased risk of falls associated with these medications, the researchers concluded. (news-medical.net 6.11.2017).)

(Anm: Sovemidler knyttes til dødelighet eller kreft: en matchet kohortstudie. (Hypnotics' association with mortality or cancer: a matched cohort study.)  (...) Målsetting Anslagsvis 6 % -10 % av amerikanske voksne tok et sovemiddel (hypnotika) mot dårlig søvn i 2010. Denne studien underbygger tidligere rapporter som knytter hypnotika (sovemidler) til økt dødelighet. BMJ Open 2012;2:e000850 (27 February).)

- Antidepressiva ökar risken för benbrott hos äldre.

(Anm: Antidepressiva ökar risken för benbrott hos äldre. (…) Den förhöjda risken för höftfraktur gällde alla de vanliga antidepressiva läkemedlen, SSRI-preparat, mirtazapin och SNRI-preparat (selektiva serotonin- och noradrenalinåterupptagshämmare. Sambandet gällde även då det kontrollerats för andra faktorer som ålder, annan medicinering som ökar fallrisken, benskörhet, socioekonomisk status, kroniska sjukdomar och psykiatriska diagnoser.) (lakemedelsvarlden.se 12.1.2017).)

(Anm: Ny forskning: Lykkepiller gør mere skade end gavn. Folk med depression får intet ud af at tage antidepressivet SSRI, bedre kendt som lykkepiller, viser nyt dansk studie. (jyllands-posten.dk 13.2.2017).)

- Fysioterapeut mener langt flere med benskjørhet bør prøve denne treningen. Men professor er skeptisk.

Målfrid (67) fikk påvist benskjørhet. To år senere overrasket hun alle.
aftenposten.no 8.6.2017
LØFTER TUNGT: Markløft er en av øvelsene Målfrid Riseth har gjort de to siste årene. Fysioterapeut Kay Arne Skagseth følger med.

Fysioterapeut mener langt flere med benskjørhet bør prøve denne treningen. Men professor er skeptisk.

Målfrid Riseth (67) løfter vektstangen opp fra bakken mens hun balanserer på en fot. Under dagens treningstime står blant annet ettbens strake markløft på programmet.

– Resultatene treningen har gitt, har vært over all forventning, sier Riseth. (…)

– Ikke god nok dokumentasjon
Jorunn Helbostad er professor ved Institutt for nevromedisin og bevegelsesvitenskap ved NTNU. Hun forteller at det er god dokumentasjon på at styrketrening både kan bremse bentap og styrke bentettheten hos benskjøre. Det kan også gi bedre livskvalitet og mindre smerter.

– Jeg vil anbefale styrketrening for dem med benskjørhet, men det er foreløpig ikke nok dokumentasjon til å anbefale alle tung styrketrening, sier Helbostad.

Hun er redd for tunge vekter vil gjøre mer vondt enn godt. (…)

Gode resultater
Knappe to år etter at hun begynte med styrketrening, tok Målfrid Riseth en ny beinmassetetthetstest. Da hadde T-scoren i ryggen gått fra −3,6 til −2,7. Hadde hun hatt −2,5 på målingen, ville hun bare hatt osteopeni, som regnes som forstadiet til benskjørhet.

– Det var over all forventning. Jeg hadde ikke trodd at jeg, ved hjelp av medisiner og trening, nesten skulle bli kvitt benskjørheten, sier Riseth. (…)

– Skjelettet er dynamisk vev som tilpasser seg kravene som stilles, slik det også står i Aktivitetshåndboken. Hvis man øker kravene i form av tyngre vekter, så må resultatene følge etter, sier Skagseth.nesten skulle bli kvitt benskjørheten, sier Riseth. (…)

Han presiserer at det må gjøres individuelle vurderinger før man setter i gang med slik trening.

– Noen pasienter kan ha så alvorlig grad av benskjørhet at brudd kan forekomme bare ved for eksempel hoste eller nys. En slik pasient ville jeg ikke trent tyngre styrke med, men heller fokusert på fallforebygging og lettere trening, som i dag er praksis, sier Skagseth. (…)

(Anm: Fysisk trening (aktivitet / løping / jogging). (mintankesmie.no).)

(Anm: Melk hjelper ikke mot beinskjørhet hos eldre. Eldre med et kosthold rikt på kalsium, er ikke bedre beskyttet mot å brekke bein eller armer. Norge ligger i verdenstoppen på bruddskader. Om lag 9000 voksne nordmenn brekker hoften hvert år. (nrk.no 3.10.2015).)

(Anm: Studie finner høyere risiko for brudd blant eldre, langtids bisfosfonatbrukere. Study finds higher risk of fractures among older, long-term bisphosphonate users. Their study was published in the Journal of the American Geriatrics Society. (…) "Our study and several others have found higher risk of fractures among very long-term bisphosphonate users, compared with short-term users. However, the ideal length of bisphosphonate use has not yet been studied in randomized clinical trials, which are considered the gold standard of research studies. Therefore, long-term bisphosphonate users should see their healthcare providers regularly to decide how long to continue bisphosphonate therapy in their individual cases," stated Rebecca L. Drieling, MPH, an author of the study. (news-medical.net 2.6.2017).)

(Anm: Kaja Helland-Kigen klinisk ernæringsfysiolog, Opplysningskontoret for Meieriprodukter (Melk.no.) De som er mest benskjøre drikker minst melk Niels Christian Geelmuyden fremsetter i boken Sannheten i glasset påstanden «Vi drikker mer melk enn i de fleste andre land, likevel er det ingen som har større andel av benskjørhet enn nordmenn». Vi mener denne påstanden trenger oppklaring. (aftenposten 23.10.2015).)

(Anm: Forskere: Der er ingen beviser for, at mælk er usundt. De seneste år har der været mange skræmmehistorier om mælk. Men sandheden er, at det ikke er muligt at drage nogle meningsfulde konklusioner om mælkens sundhed ud fra den tilgængelige litteratur, konkluderer forskere. Det vides stadig ikke med sikkerhed, om mælk øger risikoen for at udvikle kræft, hjerte-kar-sygdomme eller tidlig død. Forskerne mener, at der er behov for yderligere omfattende og standardiserede undersøgelser. (jyllands-posten.dk 5.11.2015).)

(Anm: Antidepressiva og antipsykotika øker risikoen for hoftebrudd, benskjørhet etc. (- Blant mennesker i alderen 60 år og eldre i Norge hadde de som brukte et antipsykotika hadde dobbelt så stor risiko for å lide av et hoftebrudd enn de som ikke brukte dem.) (mintankesmie.no).)

(Anm: Tanntap (tannløshet) linkes til økt risiko for demens. (Tooth loss linked to an increased risk of dementia.) Våre funn understreker den kliniske betydningen av tannpleie og behandling, spesielt når det gjelder vedlikehold av tenner fra en tidlig alder for å kunne redusere fremtidig risiko for demens. (…) Personer med 10-19, 1-9 og ingen tenner hadde hhv. 62 %, 81 % og 63 % høyere risiko for demens enn personer med > 20 tenner. (medicalnewstoday.com 10.3.2017).)

(Anm: Antidepressiva er ifølge ny studie knyttet til mislykkede tannimplantater. (Antidepressants linked to tooth implant failure, new study finds.) (- Forskning viser at bruk av antidepressiva firedobler risikoen for implantat svikt. For hvert år dobler antidepressiva risikoen for svikt.) (medicalnewstoday.com 10.3.2016).)

(Anm: Antidepressiva ökar risken för benbrott hos äldre. (…) Den förhöjda risken för höftfraktur gällde alla de vanliga antidepressiva läkemedlen, SSRI-preparat, mirtazapin och SNRI-preparat (selektiva serotonin- och noradrenalinåterupptagshämmare. Sambandet gällde även då det kontrollerats för andra faktorer som ålder, annan medicinering som ökar fallrisken, benskörhet, socioekonomisk status, kroniska sjukdomar och psykiatriska diagnoser.) (lakemedelsvarlden.se 12.1.2017).)

- Antidepressiva og antipsykotika øker risikoen for hoftebrudd, benskjørhet etc. (- Blant mennesker i alderen 60 år og eldre i Norge hadde de som brukte et antipsykotika hadde dobbelt så stor risiko for å lide av et hoftebrudd enn de som ikke brukte dem.)

Antipsychotic Drugs and Risk of Hip Fracture in People Aged 60 and Older in Norway. (Antipsykotika og risiko for hoftebrudd hos mennesker i alderen 60 år og eldre i Norge.)
J Am Geriatr Soc. 2016 Jun;64(6):1203-9.)
(…) MÅLSETTING: Å undersøke sammenhengen mellom eksponering for ulike undergrupper av antipsykotika og risiko for hoftebrudd hos eldre voksne. (…) (OBJECTIVES: To examine associations between exposure to various subgroups of antipsychotic drugs and risk of hip fracture in older adults.)

KONKLUSJON: Blant mennesker i alderen 60 år og eldre i Norge hadde de som brukte et antipsykotika hadde dobbelt så stor risiko for å lide av et hoftebrudd enn de som ikke brukte dem. Selv om forvekslinger ved indikasjon, komorbiditet (samtidige sykdommer), eller andre legemidler som brukes ikke kan utelukkes, er denne forbindelsen relevant for klinisk praksis fordi hoftebrudd og bruk av antipsykotika er utbredt hos sårbare eldre individer. Kliniske studier som undersøker mekanismer eller årsakssammenhenger av den observerte forbindelsen mellom bruk av antipsykotika og økt risiko for hoftebrudd er nødvendig. (…) (CONCLUSION: In people aged 60 and older in Norway, those who took an antipsychotic drug had twice the risk of sustaining a hip fracture during exposure than during nonexposure. Although confounding by indication, comorbidity, or other drugs used cannot be excluded, this association is relevant for clinical practice because hip fracture and antipsychotic drug use are prevalent in vulnerable older individuals. Clinical studies examining mechanisms or causality of the observed association between antipsychotic drug use and excess risk of hip fracture are needed.)

(Anm: Tusenvis dør etter hoftebrudd. Hvert år opplever rundt 10.000 nordmenn hoftebrudd. Nesten en fjerdedel dør innen ett år. (nrk.no 1.2.2015).)

(Anm: Increased risk of hip fracture among older people using antidepressant drugs: data from the Norwegian Prescription Database and the Norwegian Hip Fracture Registry. Age Ageing. 2013 Jul;42(4):514-20.)

(Anm: Antidepressant use nearly doubles the risk of hip fracture among community-dwelling persons with Alzheimer's disease, according to a new study from the University of Eastern Finland. The increased risk was highest at the beginning of antidepressant use and remained elevated even 4 years later. The findings were published in the International Journal of Geriatric Psychiatry. (pharmpro.com 11.1.2017).)

(Anm: Bruk av selektive serotoninreopptakshemmere var signifikant høyere hos pasienter med hoftebrudd (1,9, 1.3 til 2.9), som var mirtazapin (2.3, 1.3 til 4.1) (…) Antidepressants and benzodiazepines are linked to hip fracture in elderly people, finds study. (…) Older people with hip fracture are more likely to be taking antidepressants or benzodiazepines than the general elderly population, an observational study has found. (…) Use of selective serotonin reuptake inhibitors was significantly higher in patients with hip fracture (1.9, 1.3 to 2.9), as was mirtazapine (2.3, 1.3 to 4.1). BMJ 2017;356:j1237 (Published 09 March 2017).)

- Bruk av psykotrope legemidler linket til risiko for beinskjørhet og brudd. (- Det primære funnet er at FRAX bruddrisiko er signifikant undervurdert blant mennesker med psykiske lidelser og blant dem som tar et bredt spekter av psykotrope medisiner," konkluderte forskerne. "Våre resultater er mest anvendelige for eldre personer, spesielt kvinner, som anses å være i fare for osteoporose," la de til. "Helsepersonell bør være oppmerksom på disse effektene når de vurderer osteoporose hos personer med psykisk lidelse.)

(Anm: Bruk av psykotrope legemidler linket til risiko for beinskjørhet og brudd. Psychotropic Medication Use, Fracture Risk Linked. (...) FRAX signifikant underestimert blant personer med psykiske lidelser og blant dem som tok et bredt spekter av psykotrope medisiner. FRAX significantly underestimated fracture risk among people with mental disorders and among those taking a wide range of psychotropic medications.(...) FRAX significantly underestimated the 10-year risk of major osteoporotic fracture by 29% and of hip fracture by 51% for those with depression. FRAX also underestimated the 10-year risk of major osteoporotic fracture for SSRI users by 36%, mood stabilizers by 63%, antipsychotics by 60%, and benzodiazepines by 13%, and underestimated the 10-year risk of hip fracture for SSRI users by 57%, mood stabilizers by 98%, antipsychotics by 171%, and benzodiazepines by 31%. Conversely, FRAX was found to accurately estimate fracture risk in patients without mental disorders and in those not taking psychotropic medications. (...) "The primary finding is that FRAX significantly underestimated fracture risk among people with mental disorders and among those taking a wide range of psychotropic medications," the researchers concluded. "Our results are most applicable to older individuals, especially women, who are considered to be at risk of osteoporosis," they added. "Health care professionals should be aware of these effects when assessing osteoporosis in people with mental illness." JAMA Psychiatry; ePub 2017 Apr 19; Bolton, et al May 4, 2017.)

- FRAX signifikant underestimert blant personer med psykiske lidelser og blant dem som tok et bredt spekter av psykotrope medisiner.

(Anm: Forbindelsen mellom psykiske lidelser og tilhørende medisinering med risiko for store osteoporotiske frakturer (beinskjørhet og brudd). Association of Mental Disorders and Related Medication Use With Risk for Major Osteoporotic Fractures. Question How do mental disorders and psychotropic medications affect fracture risk estimates with FRAX, a tool developed for clinical use in the general population? (…) Conclusions and Relevance Mental disorders and medication use were associated with an increased risk for fracture, but in simultaneous analyses, only medication use was independently associated with fracture. Depression and psychotropic medication use are potential risk indicators that are independent of FRAX estimates. JAMA Psychiatry. 2017 (Published online April 19, 2017).)

(Anm: Tanntap (tannløshet) linkes til økt risiko for demens. (Tooth loss linked to an increased risk of dementia.) Våre funn understreker den kliniske betydningen av tannpleie og behandling, spesielt når det gjelder vedlikehold av tenner fra en tidlig alder for å kunne redusere fremtidig risiko for demens. (…) Personer med 10-19, 1-9 og ingen tenner hadde hhv. 62 %, 81 % og 63 % høyere risiko for demens enn personer med > 20 tenner. (medicalnewstoday.com 10.3.2017).)

(Anm: Combining opioids with anti-anxiety medicines linked to greater risk of overdose. Taking opioids (strong prescription painkillers) together with benzodiazepines (widely used to treat anxiety and sleep problems) is associated with greater risk of opioid overdose, finds a study in The BMJ. (medicalnewstoday.com 16.3.2017).)

(Anm: Antidepressant use and risk of hip fractures among community-dwelling persons with and without Alzheimer's disease. (…) Results During antidepressant use, the age-adjusted rate of hip fractures per 100 person-years was 3.01 (95% CI 2.75–3.34) among persons with and 2.28 (1.94–2.61) among persons without AD. (…) Conclusion Antidepressant use is associated with an increased risk of hip fracture among older persons.  International Journal of Geriatric Psychiatry 2017 (First published: 5 January 2017).)

(Anm: Calcium intake and risk of fracture: systematic review. BMJ. 2015 Sep 29;351:h4580.)

(Anm: The more you run, the denser your bones will be. (…) The scientists assert that training for endurance races is effective in producing physical changes in the physical properties of the calcaneus; hence, this can be used to prevent the progressive decline in bone mineral quality that occurs with age. (medicalnewstoday.com 20.4.2016).)

- Studie kaster nyt lys over knogleskørhed.

Studie kaster nyt lys over knogleskørhed
medwatch.dk 16.2.2012
Nyt, svensk studie viser, at motion i starten af tyverne har en effekt på knogleskørhed.

Som barn fik man fra tid til anden at vide, at "det skal bare løbes væk", når man slog sig. Det råd viser sig i svenske studier at være ganske godt, hvis man vil minimere risikoen for at udvikle osteoporose - knogleskørhed.

Tidligere studier har vist, at motion før og under puberteten har styrket knoglemassen og effektivt minimeret chancerne for brud senere hen i livet.
Et studie foretaget ved Göteborgs Universitet viser ifølge Medica.de nu, at motion i alderen 19 til 24 år også har stor betydning for knoglemassen. (...)

833 svenske mænd deltog i studiet, som viste, at de, der øgede deres fysiske aktivitet i alderen 19 til 24, også øgede deres knoglemasse i hofter, lænderyghvirvler, arme og underben - mens de, der sænkede deres fysiske aktivitet i denne periode, havde betydeligt mere skrøbelige knogler.

En rapport foretaget for Lægemiddelstyrelsen viser, at antallet af personer i behandling med lægemidler mod osteoporose er steget støt fra 2000-2010. (...)

(Anm: Increased physical activity is associated with enhanced development of peak bone mass in men: A five year longitudinal study. Journal of Bone and Mineral Research 2012 (Accepted, unedited articles published online for future issues).)

Motion kan hele brækkede knogler
videnskab.dk 4.8.2011
Nyt studie antyder, at motion kan få brækkede knogler til at hele hurtigere. Den nye viden kan ende med ny behandling til folk med knogleskørhed.

Det er især ældre kvinder, der rammes af sygdommen osteoporose, mere populært kendt som knogleskørhed, som i dag er uhelbredelig.

Når dine løbesko rammer den morgenvåde asfalt, er det ikke blot din kondition, der bliver forbedret.

Hver gang cellerne i knoglerne belastes af din vægt, frigiver de et stof, som har vist sig at have helt unikke egenskaber. Stoffet ATP vedligeholder skelettets celler og ser endda ud til at kunne fremskynde helingen i brækkede knogler, viser ny dansk forskning.

»Vi har længe vidst, at motion forebygger knogleskørhed. Men nu ved vi hvorfor,« siger Peter Schwarz, der leder Forskningscenter for Aldring og Osteoporose ved Glostrup Hospital og er klinisk professor på Det Sundhedsvidenskabelige Fakultet ved Københavns Universitet. (...)

ATP er cellernes talerør
ATP er egentlig et energimolekyle, men det bruges også til at signalere, eller kommunikere, fra en celle til en anden.

Når en knoglecelle belastes, for eksempel ved motion, sender den kalciumbølger ud og frigiver ATP til de omkringliggende celler både på knoglens overflade og dens indre; en måde at sige: ”Hey, jeg har fået et gok i nøden!” til de andre. Det får igen de andre cellers ATP-niveau til at stige, og det er netop den proces, der stimulerer dannelsen af nyt knoglevæv. (...)

Sådan virker bindingsproteiner
Et bindingsprotein, også kaldet en receptor, er et molekyle som oftest sidder på overfladen af cellen eller inde i cellen.

Når et signalmolekyle såsom ATP binder sig til bindingsproteiner, bliver én eller flere af en lang række processer sat i gang inde i cellen. For eksempel begynder cellen at dele sig, og der sker dannelse af forskellige proteiner, optagelse eller udskillelse af forskellige stoffer fra cellen eller vandring af signalet til de omkringliggende celler. Det kan i sidste ende føre til en fysiologisk reaktion i en hob af celler eller et helt væv eller organ. (...)

Lovande resultat av träning vid mild form av osteoporos
dagensmedicin.se 27.9.2010
Ett hemträningsprogram bromsade försämring i balansen hos finländska kvinnor och möjligen skydda mot höftfrakturer, enligt en ny studie. (...)

(Anm: Long-term Outcomes of Exercise. Follow-up of a Randomized Trial in Older Women With Osteopenia. Arch Intern Med. 2010;170(17):1548-1556 (September 27).)

Aktive barn får sterkere bein
nrk.no 13.5.2010
Aktivitet i barndommen kan forebygge beinbrudd som voksen. (...)

Man har lenge visst at fysisk aktivitet styrker skjelettet hos denne gruppen.

Men nå viser det seg altså at aktivitet tidlig i livet har større innvirkning på beintettheten enn tidligere antatt, skriver FPN.dk. (...)

Motion ger hårt skelett länge
aftonbladet.se 14.4.2010
Barn och ungdomar som idrottar är bättre skyddade mot benskörhet än sina mer stillasittande kamrater, och effekten kan hålla i sig längre än forskare tidigare har trott.

Detta framkommer av en avhandling som bland annat är baserad på studier av hälbenen på drygt 2 300 18-åriga män. (...)

Exercising with osteoporosis: Stay active the safe way (Trening med benskjørhet: Forbli aktiv på sikker måte)
mayoclinic.com 3.10.2008
If you have osteoporosis, you might mistakenly think exercise will lead to fracture. In fact, though, using your muscles helps protect your bones.

Osteoporosis is a major cause of disability in older women. So if you have osteoporosis, how can you reduce your risk of the spinal problems and broken bones that can result in loss of mobility and independence?

The answer: Exercise.

If you've always been physically active, good for you. Even though your bones may lose some density as you age, they're less likely to become brittle enough to break if you slip and fall. (...)

Slide show: Exercises for osteoporosis
mayoclinic.com 1.7.2008
Source: Sinaki M. Postmenopausal spinal osteoporosis: Physical therapy and rehabilitation principles. Mayo Clinic Proc. 1982; 57:699-703. (...)

- Antidepressiva er ifølge ny studie knyttet til mislykkede tannimplantater. (- Forskning viser at bruk av antidepressiva firedobler risikoen for implantat svikt. For hvert år dobler antidepressiva risikoen for svikt.) (- Antidepressiva ökar risken för benbrott hos äldre.)

Antidepressants linked to tooth implant failure, new study finds (Antidepressiva er ifølge ny studie knyttet til mislykkede tannimplantater.)
medicalnewstoday.com 10.3.2016
Bivirkninger av antidepressiva, det nest mest forskrevne legemiddelet i USA, svekker beinvekst, en avgjørende faktor for vellykkede implantater. (Side effects of antidepressants, the second most prescribed drug in America, weaken bone growth, a crucial factor for implant success.)

Antidepressiva, vanlig brukt til å behandle angst, smerter og andre lidelser, kan spille en rolle ved dental implantat svikt, ifølge en pilotstudie utført av forskere ved University at Buffalo. (Antidepressants, commonly used to treat anxiety, pain and other disorders, may play a role in dental implant failure, according to a new pilot study by University at Buffalo researchers.)

Forskningen viser at antidepressiva firedobler risikoen for implantat svikt. For hvert år med bruk av antidepressiva dobles risikoen for svikt. (The research found that the use of antidepressants increased the odds of implant failure by four times. Each year of antidepressant use doubled the odds of failure.)

Mens disse legemidlene ofte brukes til å regulere humør og følelser, reduserer en bivirkning reguleringen av beinmetabolisme, noe som er avgjørende for helingsprosessen . (While these drugs are often used to manage mood and emotions, a side effect decreases the regulation of bone metabolism, which is crucial to the healing process.)

For å få et implantat til å gro skikkelig må nytt bein dannes rundt det for å sikre at det kommer skikkelig på plass, sier Sulochana Gurung, forskningsleder og doktorkandidat innen tannkirurgi (DDS). (…) (For an implant to heal properly, new bone must form around it to secure it in place, says Sulochana Gurung, lead investigator and a doctor of dental surgery (DDS) candidate.)

"Fire av de mange kjente bivirkninger som er rapportert i litteraturen er en stor bekymring for oss som tannleger mht. til munn og beinhelse." ("Four of the many known side effects that are reported in the literature are a big concern to us as dentists in regard to oral and bone health.")

Andre bivirkninger av legemidlene inkluderer osteoporose, en tilstand der bein blir svake og sprø; akatisi, en lidelse karakterisert ved behovet for å være i konstant bevegelse, inkludert hode og kjeve; bruksisme, eller tanngisninger; og tørrhet i munnen, som alle påvirker implantatets helende prosess, sier Bairam;. (Additional side effects of the drug include osteoporosis, a condition in which bones become weak and brittle; akathisia, a disorder characterized by the need to be in constant motion, including the head and jaw; bruxism, or teeth grinding; and dryness of the mouth, all of which affect the implant healing process, says Bairam.)

The research, "A Pilot Study: Association between Antidepressant Use and Implant Failure," was funded by the Student Research Program through the SDM Dean's Vision Fund. (…)

She completed the study under the mentorship of Bairam, Sebastiano Andreana, DDS, MS, associate professor and director of implant dentistry, and Mine Tezal, PhD, DDS, clinical assistant professor in the Department of Oral Biology. (…)

Og antallet som rammes er økende. Bruken av antidepressive har økt 400 prosent i periodene 1988-1994 og 2005-2008, ifølge CDC. (And the rate is increasing. Antidepressant use has surged 400 percent between the periods 1988-94 and 2005-08, according to the CDC.)

Forskerne planlegger å videreføre studien ved å teste sine resultater i større skala. Inntil videre råder de dem som bruker antidepressiva til å konsultere sin lege om legemidlenes bivirkninger og bruke alternative metoder for å håndtere depresjon, angst eller smerter.  (…) (The researchers plan to build on the study by retesting their results on a larger scale. For now, they advise those using antidepressants to consult with their physician about the drug's side effects and alternative methods of managing depression, anxiety or pain.)

(Anm: Beinmetabolisme. Vi forsker på effekten av ulike substanser på beintetthet og på beinmetabolisme, blant annet ser vi på hvordan adipocytokiner (leptin, resistin og adiponectin) og ulike medikamenter som benyttes i klinikken påvirker skjelettet. (ntnu.no).)

(Anm: Bone remodeling (or bone metabolism) is a lifelong process where mature bone tissue is removed from the skeleton (a process called bone resorption) and new bone tissue is formed (a process called ossification or new bone formation). These processes also control the reshaping or replacement of bone following injuries like fractures but also micro-damage, which occurs during normal activity. Remodeling responds also to functional demands of the mechanical loading. (en.wikipedia.org).)

(Anm: Bruksisme, betegnelse på overdreven gnisning, skjæring eller pressing av tennene. Bitekraften som kjevene presses sammen med, kan være opptil 900 N. Personer som gnisser tenner, gjør dette oftest ubevisst i søvne. Kilde: Store norske leksikon.)

(Anm: Tandsjukdom efter implantat. Nästan var sjätte person som fått tandimplantat drabbas av en allvarlig inflammation i angränsande vävnader, peri-implantit. Det visar en studie vid Sahlgrenska akademin i Göteborg. Studien omfattar 4 716 personer som fick tandimplantat 2003-2004. Nio år efteråt hade 14,5 procent drabbats av peri-implantit, som liknar tandlossning men har ett snabbare och aggressivare förlopp, skriver Dagens Nyheter. De som drabbas behöver ytterligare behandling, vilket kan bli ekonomiskt kännbart. Över 30 000 patienter i Sverige fick förra året nya tänder som skruvas fast i käkbenet. (dagensmedisin.no 28.10.2015).)

(Anm: Antidepressiva er ifølge ny studie knyttet til mislykkede tannimplantater. (Antidepressants linked to tooth implant failure, new study finds.) (- Forskning viser at bruk av antidepressiva firedobler risikoen for implantat svikt. For hvert år dobler antidepressiva risikoen for svikt.) (medicalnewstoday.com 10.3.2016).)

(Anm: Antidepressiva ökar risken för benbrott hos äldre. (…) Den förhöjda risken för höftfraktur gällde alla de vanliga antidepressiva läkemedlen, SSRI-preparat, mirtazapin och SNRI-preparat (selektiva serotonin- och noradrenalinåterupptagshämmare. Sambandet gällde även då det kontrollerats för andra faktorer som ålder, annan medicinering som ökar fallrisken, benskörhet, socioekonomisk status, kroniska sjukdomar och psykiatriska diagnoser.) (lakemedelsvarlden.se 12.1.2017).)

(Anm: Heart disease risk higher with latent tooth infection. If you missed your last dental checkup, a new study might encourage you to book that appointment right away; researchers have identified a higher risk of heart disease for individuals who have hidden tooth infections. (…) Last year, for example, a study published in Infection and Immunity suggested that the bacterium involved in gum disease may also raise the risk of heart disease. Now, researchers from the University of Helsinki in Finland have uncovered a link between dental root tip infection, known as apical periodontitis, and greater risk for acute coronary syndrome (ACS) - an umbrella term for conditions that involve blocked blood flow to the coronary arteries. (medicalnewstoday.com 3.8.2016).)

(Anm: Munhälsan bättre än på 80-talet – men tandlossning ökar igjen. De två största tandsjukdomarna karies och parodontit (tandlossning) minskade fram till 2008. Därefter ökade antalet individer med parodontit och den positiva utvecklingen för karies stannade av. – Även om munhälsan har förbättras under denna 30-årsperiod ser vi en försämring mellan 2008 och 2013 då det gäller främst tandlossning, säger Kristina Edman vid Uppsala universitet har undersökt munhälsans utveckling över en trettioårsperiod. (forskning.se 3.5.2016).)

(Anm: Stimulant Medications Linked to Bone Mass Reductions in Children, Adolescents. BOSTON -- April 6, 2016 -- Use of stimulant medications in the treatment of attention deficit hyperactivity disorder (ADHD) in childhood and adolescence is associated with significant reductions in bone mass, according to a study presented here at the 98th Annual Meeting of the Endocrine Society (ENDO). (…) “We suggest that stimulant medications, which release and block reuptake of dopamine and norepinephrine, may affect bone mass,” said the researchers. (dgnews.docguide.com 6.4.2016).)

(Anm: Antidepressant Exposure and Risk of Fracture Among Medicaid-Covered Youth. Conclusions: Antidepressant use may be associated with a small but significant increase in fracture risk, particularly within the first 30 days of treatment. Findings underscore a need for additional prospective and mechanistic research. Prescribers should consider other risks for fracture in antidepressant-treated youth, particularly disability and the concomitant use of other medications that increase fracture risk. J Clin Psychiatry 2016.)

(Anm: Increased risk of hip fracture among older people using antidepressant drugs: data from the Norwegian Prescription Database and the Norwegian Hip Fracture Registry. Age Ageing. 2013 Jul;42(4):514-20.)

(Anm: Antidepressant use nearly doubles the risk of hip fracture among community-dwelling persons with Alzheimer's disease, according to a new study from the University of Eastern Finland. The increased risk was highest at the beginning of antidepressant use and remained elevated even 4 years later. The findings were published in the International Journal of Geriatric Psychiatry. (pharmpro.com 11.1.2017).)

(Anm: Antidepressant use and risk of hip fractures among community-dwelling persons with and without Alzheimer's disease. (…) Results During antidepressant use, the age-adjusted rate of hip fractures per 100 person-years was 3.01 (95% CI 2.75–3.34) among persons with and 2.28 (1.94–2.61) among persons without AD. (…) Conclusion Antidepressant use is associated with an increased risk of hip fracture among older persons.  International Journal of Geriatric Psychiatry 2017 (First published: 5 January 2017).)

- Ny anti-kreft DNA-vaksine kan bekjempe aldring, kronisk betennelse og osteoporose

Novel anti-cancer DNA vaccine may fight aging, chronic inflammation and osteoporosis (Ny anti-kreft DNA-vaksine kan bekjempe aldring, kronisk betennelse og osteoporose)
medicalnewstoday.com 1.3.2015
An international team of scientists including CureLab Oncology, Inc. (Boston), University of Camerino (Italy), and Boston University have serendipitously discovered a DNA vaccine, which systemically alleviates chronic inflammation in the body. Since osteoporosis is an inflammatory disease, preventive and therapeutic effects of the new vaccine were demonstrated on mouse models with osteoporosis. A paper reporting these results is published in the latest issue of the journal Gerotarget (the geriatric section of Oncotarget). An online preprint of the paper is available on the journal's website. (…)

- Smog kan skade dine ben, også.

(Anm: Smog May Harm Your Bones, Too. The findings showed that people who lived in areas with higher levels of PM2.5 and black carbon -- a type of air pollution from vehicle exhaust -- had lower levels of an important calcium and bone-related hormone, and greater decreases in bone mineral density than did those exposed to lower levels of the two pollutants. The study was published Nov. 9 in The Lancet Planetary Health. (webmd.com 22.9.2017).)

- Forsyth-forskning forklarer hvorfor populære syrenøytraliserende midler kan øke sjansen for benbrudd

Forsyth research explains why popular antacids may increase chance of bone fractures (Forsyth-forskning forklarer hvorfor populære syrenøytraliserende midler kan øke sjansen for benbrudd)
medicalnewstoday.com 3.4.2015
Newly published research from the Forsyth Institute details a discovery explaining why the 100 million Americans estimated to be taking prescription and over-the-counter antacid and heartburn medications may be at an increased risk of bone fractures.

The new report from Forsyth, published in the March issue of the prestigious medical research journal PLOS Genetics, explains that stomach acid in the gastrointestinal tract plays an important role in helping the intestines absorb and transfer calcium to the skeletal system. While the introduction of proton pump inhibitor-based antacids reduces the level of acidity in the stomach to bring relief to patients, the reduction also interrupts and even stops the gut from absorbing much needed calcium.

The connection between proton pump inhibitors and bone fractures has been well established, with the Food and Drug Administration in 2010 requiring a warning label placed on all product packaging. Other research has indicated these medications may block the absorption of important nutrients, but until this study it was not known how or why this was happening in the body. (…)

(Anm: Protonpumpehemmere (proton pump inhibitors (PPIs) (syrepumpehemmere) (magesyrehemmere) (syrenøytraliserende midler (antacida)). (mintankesmie.no).)

(Anm: Lederartikkel. Øker protonpumpehemmere risikoen for demens? (Editorial. Do Proton Pump Inhibitors Increase the Risk of Dementia? JAMA Neurol. 2016 (Published online February 15, 2016).)

(Anm: Legemidler mot halsbrann gir tidlig aldring av blodkar. (Heartburn drug prematurely ages blood vessels. (…) A new study, published in Circulation Research, finds a potential mechanism to explain these negative health implications.) (medicalnewstoday.com 11.5.2016).)

- Antipsykotika og antidepressiva øker risikoen for benskjørhet (bl.a. hoftebrudd)

Antipsychotic Treatment and the Risk of Hip Fracture in Subjects With Schizophrenia: A 10-Year Population-Based Case-Control Study
J Clin Psychiatry 2015;76(9):1216–1223
Background: To investigate the association between antipsychotic treatment and risk of hip fracture in subjects with schizophrenia.

Conclusions: These results extend previous findings and demonstrate an increased risk of hip fracture associated with antipsychotic use in schizophrenia subjects. Further investigation is needed to dissect the underlying mechanisms related to the effect of antipsychotic use on hip fracture in subjects at risk. (…)

(Anm: SSRI use and risk of fractures among perimenopausal women without mental disorders. (...) Conclusions SSRIs appear to increase fracture risk among middle-aged women without psychiatric disorders, an effect sustained over time, suggesting that shorter duration of treatment may decrease fracture risk. Future efforts should examine whether this association pertains at lower doses. Inj Prev 2015 (25 June 2015).)

(Anm: Recurrent Depression, Use of Antidepressants Associated With Lower Bone Density in Men. According to the study, recurrent major depression may increase the risk of osteoporosis in men. Furthermore, the use of antidepressants should be taken into account as a potential risk factor of osteoporosis especially in men with a low body weight. (dgnews.docguide.com 12.6.2015).)

(Anm: ADHD-medicin giver risiko for nedsat knogletæthed. Børn og unge, der behandles med ADHD-medicin, har større risiko for nedsat knogletæthed, viser amerikansk undersøgelse af over 5.000 patienter. (dagenspharma.dk 7.3.2016).)

- Antidepressiva ökar risken för benbrott hos äldre (- Den förhöjda risken för höftfraktur gällde alla de vanliga antidepressiva läkemedlen, SSRI-preparat, mirtazapin och SNRI-preparat (selektiva serotonin- och noradrenalinåterupptagshämmare). Sambandet gällde även då det kontrollerats för andra faktorer som ålder, annan medicinering som ökar fallrisken, benskörhet, socioekonomisk status, kroniska sjukdomar och psykiatriska diagnoser.)

Antidepressiva ökar risken för benbrott hos äldre
lakemedelsvarlden.se 12.1.2017
Risken för höftfraktur nästan fördubblades för äldre som tagit antidepressiva, visar en ny studie från Finland.

Studien, som publiceras i International Journal of Geriatric Psychiatry, bygger på register över ett stort antal personer, drygt 50 000 personer med Alzheimer, som fått diagnosen under perioden 2005 – 2011, och drygt 100 000 personer utan diagnos. Medelåldern hos de studerade kohorterna var 80 år. En uppföljning gjordes fyra år senare.

Studiens resultat visar att risken för höftfraktur nästan var den dubbla för de som fått antidepressiv behandling. Den största riskökningen var i början av medicineringen, men var förhöjd även fyra år senare.

Antidepressiva läkemedel används inte bara mot depression utan även mot psykiska symtom vid demens, som till exempel oro, sömnsvårigheter och ångest. Det används även mot kronisk smärta. (...)

- Antidepressiva og angstdempende legemidler knyttet til økt risiko for hoftebrudd

Antidepressants and Anti-Anxiety Drugs Linked to Increased Risk of Hip Fracture (Antidepressiva og angstdempende legemidler knyttet til økt risiko for hoftebrudd)
newsroom.wiley.com 7.3.2017
«Vi ble overrasket over å finne at så mange pasienter hadde sentraltvirkende legemidler i blodet uten leger å være klar over dette ved bruk. Flere av de påviste stoffene øker risikoen for å falle, noe som understreker den kliniske relevansen av disse funnene». ("We were surprised to find that so many patients had centrally-acting drugs in their blood without doctors being aware of this use. Several of the detected drugs increase the risk of falling, which underscores the clinical relevance of these findings")

I en fersk studie hadde eldre personer som falt og hadde brukket en hofte brukt antidepressiva og anti-angst-legemidler oftere enn den generelle eldre befolkningen. (In a recent study, older individuals who had fallen and broken a hip used antidepressant and anti-anxiety medications more frequently than the general older population.)

The analysis measured drug levels in individuals’ blood samples, which provided investigators with a more precise measure than asking participants if they took the medications or examining their medical records. Indeed, the drugs were often present in these samples despite no information in patients’ medical records.

“We were surprised to find that so many patients had centrally-acting drugs in their blood without doctors being aware of this use. Several of the detected drugs increase the risk of falling, which underscores the clinical relevance of these findings,” said Ragnhild Birkeland Waade, lead author of the British Journal of Clinical Pharmacology study. (…)

(Anm: Psychotropics and weak opioid analgesics in plasma samples of older hip fracture patients - detection frequencies and consistency with drug records. Br J Clin Pharmacol. 2017 Mar 7.)

- Tannhelse ved bruk av bisfosfonater mot brystkreft

Tannhelse ved bruk av bisfosfonater mot brystkreft
Tidsskr Nor Legeforen 2014; 134:1451 (19.8.2014)
Kjeveosteonekrose er en sjelden, men alvorlig komplikasjon til bisfosfonatbehandling og andre beinresorpsjonshemmere som denosumab. Forebyggende tannbehandling er det viktigste tiltaket for å unngå tilstanden, og retningslinjer for håndtering av tannproblemer ved adjuvant bisfosfonatbehandling mot brystkreft er nå tilgjengelig. (…)

(Anm: Increased risk for atypical fractures associated with bisphosphonate use. Fam Pract. 2015 Apr 5. pii: cmu088. [Epub ahead of print].)

- Bisfosfonater skyddade inte mot bröstcancer

Bisfosfonater skyddade inte mot bröstcancer
dagensmedicin.se 13.8.2014
Observationsstudier har antytt att benskörhetsläkemedel av typen bisfosfonater kan minska insjuknandet i bröstcancer. Men det sambandet får inget stöd i en ny analys av randomiserade studier. (...)

Forskarna tror att de tidigare positiva resultaten kan ha berott på att det varit kvinnor med i grunden lägre risk för bröstcancer som också tagit bisfosfonater i större utsträckning. (...)

New Study on Osteoporosis Drugs, Breast Cancer
pharmatimes.com 12.8.2014
The most-widely used osteoporosis drugs may not protect women from breast cancer after all. Also, a new look at the science of sleep medication shows there may be little evidence the drugs provide much benefits. (…)

- Kjeveosteonekrose ved bisfosfonatbehandling

Kjeveosteonekrose ved bisfosfonatbehandling
Tidsskr Nor Lægeforen 2007; 127: 1945-7
(...) Resultater og fortolkning. Forekomsten av bisfosfonatassosiert kjeveosteonekrose ved kreftbehandling er usikker, men angis å være opptil 10 %. Ved behandling mot osteoporose er den lavere. I Norge behandles hvert år 100 - 200 kreftpasienter og over 50 000 osteoporosepasienter med bisfosfonat. (...)

(Anm: Femurfraktur og kjeveleddsdestruksjon etter bruk av bisfosfonater Tidsskr Nor Legeforen - Publisert først på nett 16. januar 2015.)

(Anm: Increased risk for atypical fractures associated with bisphosphonate use. Fam Pract. 2015 Apr 5. pii: cmu088. [Epub ahead of print].)

(Anm: Risk of atrial fibrillation with bisphosphonate treatment. (…) The risk of new onset atrial fibrillation is increased by the use of both oral and intravenous bisphosphonates, although the risk may be greater with intravenous preparations,3 probably because of increased release of inflammatory cytokines. BMJ 2015;351:h5870 (Published 04 November 2015).)

(Anm: Drugs that treat osteoporosis also can cause small risk of thigh bone fractures. Osteoporosis drugs have significantly reduced the risk of bone fractures for millions of people, but also have been linked to unusual fractures of the femur (thigh bone). (medicalnewstoday.com 1.3.2016).)

(Anm: Bisphosphonates beyond five years. BMJ 2016;352:i264 (Published 16 March 2016).)

- Atypiske brudd med langvarig bisfosfonatbehandling er assosiert med endret kortikal sammensetning og redusert bruddmotstand.

(Anm: Atypical fracture with long-term bisphosphonate therapy is associated with altered cortical composition and reduced fracture resistance. (…) Significance. Since the first reports of atypical femoral fractures (AFFs), a clinical phenomenon in which patients experience catastrophic brittle fractures of the femoral shaft with minimal trauma, the risk associated with bisphosphonates, the most widely prescribed pharmaceuticals for osteoporosis, has become increasingly well-established. However, the underlying cause of AFFs and their causal relationship to bisphosphonates is unknown. Here we examine bone tissue from women with AFFs and show that long-term bisphosphonate treatment degrades the fracture-resistance toughening mechanisms that are inherent to healthy bone. Our work resolves the apparent paradox of AFFs as a side effect of the most common osteoporosis treatment by clarifying the differing effects of bisphosphonates on bone tissue structure and mechanical properties across multiple length scales. PNAS (Proceedings of the National Academy of Sciences 2017 (Early Edition).)

(Anm: How Do Bisphosphonates Cause Atypical Femoral Fractures? With long-term use, bones become harder but also more shatter-prone. Long-term bisphosphonate therapy can change bones at the microscopic level to make them more susceptible to the rare catastrophic transverse breaks known as atypical femoral fractures (AFFs), scientists said. (medpagetoday.com 2.8.2017).)

- Studie finner høyere risiko for brudd blant eldre, langtids bisfosfonatbrukere.

(Anm: Studie finner høyere risiko for brudd blant eldre, langtids bisfosfonatbrukere. Study finds higher risk of fractures among older, long-term bisphosphonate users. Their study was published in the Journal of the American Geriatrics Society. (…) "Our study and several others have found higher risk of fractures among very long-term bisphosphonate users, compared with short-term users. However, the ideal length of bisphosphonate use has not yet been studied in randomized clinical trials, which are considered the gold standard of research studies. Therefore, long-term bisphosphonate users should see their healthcare providers regularly to decide how long to continue bisphosphonate therapy in their individual cases," stated Rebecca L. Drieling, MPH, an author of the study. (news-medical.net 2.6.2017).)

- Sterkere skjelett med olivenolje

Sterkere skjelett med olivenolje
kk.no 31.1.2014
Forskere mener det har en positiv effekt på benbygningen.

OLIVENOLJE FOR HELSAS SKYLD: Olivenolje er fettkilden du bør foretrekke - i hvert fall framfor mettet fett.

At olivenolje er sunt, er noe de fleste har fått med seg. Nå tyder en ny, spansk studie på at olivenoljen har enda flere positive helseeffekter enn vi har trodd.

Forskere ved Universitetet i Madrid har etter en to år lang studie funnet en sammenheng mellom bentetthet og konsum av olivenolje. (...)

– Mineralfattig drikkevann kan føre til beinbrudd

– Mineralfattig drikkevann kan føre til beinbrudd
nrk.no 16.2.2014
Forskere mener mer magnesium i drikkevannet kan føre til færre hoftebrudd.

Drikkevannet i Norge bør tilføres magnesium. Det vil antakelig hindre mange hundre hoftebrudd årlig, sier forsker Cecilie Dahl, stipendiat ved Folkehelseinstituttet.

For første gang har forskere sett på sammenhengen mellom mineralinnholdet i drikkevannet vårt og hoftebrudd, skriver Bergens Tidende.

9.000 norske kvinner og menn brekker lårhalsen hvert år. Hvert brudd koster samfunnet 200.000 kroner bare det første året.

Norsk drikkevann er fra naturens side fattig på mineraler. Forskningen viser at magnesium i drikkevannet kan være nøkkelen til færre hoftebrudd. Det må i så fall tilføres vannet.

Cecilie Dahl har ledet prosjektet i forskningsgruppen NOREPOS, som består av forskere fra universitetene i Bergen, Tromsø, Trondheim og Oslo, samt Folkehelseinstituttet. (...)

- Bruskens vakre reisverk

Bruskens vakre reisverk
nrk.no 2.9.2012
Utan dette nettverket er alle ledd i kroppen ubrukelege. Konfokalt lasermikroskopibilete som viser nettverk av kollagenfibrar i brusk. Sidene i biletet er 0,11mm lange.

Brusk under mikroskopet
Ved å studere brusken under mikroskop håpar forskarane å gjere leddoperasjonar overflødige i framtida.

– Det er det som er så utruleg, når du er ute og spring har du to beinflater som støyter mot kvarandre, og viss du slår deg litt på skinnleggen kjenner du jo at det gjer vondt når du slår på eit bein, fortel Magnus Lilledahl mens han bøyer seg og slår ei hand mot leggen under dongeribuksa.

– Men oppå beinflata ligg brusken som fordeler krafta på heile flata, noko som gjer at det er både sterkt og friksjonsfritt.

Vi er på eit kontor på NTNU med vindauge som vender ut mot eit glaskledd atrium som strekker seg over fleire etasjar. I ein stol sit Magnus Lilledahl, ein høg ung fysikar som har spesialisert seg på biletdiagnostisering av brusk.

I dag er det ein aukande tendens til sjukdommar som angrip brusken, fordi folk blir eldre og tyngre og fordi vi sit meir stille. Lilledahls bilete hjelper legar i behandling av pasientar med sjukommar som angrip brusken (sjå faktaboks om artrose).

I tillegg til å gi større innsikt, er bileta av brusk også overraskande vakre å sjå på. (...)

Artrose
Atrose eller slitasjegikt er den vanlegaste revmatiske leddsjukdommen. Leddbrusken blir ramma.
Nyare viten om artrosesjukdommar tyder på at den norske nemninga «slitasjegikt» er misvisande som skildring av sjukdomsprosessen. Det handlar ikkje einsidig om ein sjukdom utløyst av slitasje i ledda, men snarare om sluttstadiet av ulike og til dels ukjente sjukdomsprosessar i leddbrusken.
Dei viktigaste symptoma er stivheit og smerte i ledd, samt innskrenking i rørsle.
Risikofaktorar for utvikling av artrose er alder, kjønn, arv, auka leddbelasting og overvekt.

Kjelde: Store Norske Leksikon. (...)

- Genterapi hjalp mus mot slitasjegikt

Genterapi kan bremse udvikling af slidgigt
dagenspharma.dk 19.3.2013
Nyopdaget protein beskytter brusk og smører led og kan derved beskytte mod slidgigt (…)

Gene Therapy Helped Mice Withstand Osteoarthritis: Study (Genterapi hjalp mus mot slitasjegikt: studie)
health.usnews.com 14.3.2013
Injecting a gene responsible for lubrication in joints may one day help humans, researcher says

THURSDAY, March 14 (HealthDay News) -- In a very early sign of medical progress on the osteoarthritis front, scientists report they've used injections of modified genes to reduce the risk that mice will develop the painful, debilitating condition.

There's no way to know if the gene therapy treatment will help humans, and scientists are far from understanding the treatment's side effects and potential cost. But the findings are more than just good news for mice with creaky joints.

"This work identifies an approach that can make a difference," explained study co-author Dr. Brendan Lee, director of the Rolanette and Berdon Lawrence Bone Disease Program of Texas. "There's a great need for treating and preventing osteoarthritis."

The disease, the most common form of arthritis, appears as your joints deteriorate with aging. It often strikes the hands, knees, neck and hips, causing pain, stiffness and difficulty moving. (...)

(Anm: Proteoglycan 4 Expression Protects Against the Development of Osteoarthritis. Sci Transl Med 2012;5(176):176 (13 March 2013).)

- Bildene som avslører sykdom

Bildene som avslører sykdom
kk.no 3.10.2012
AVSLØRER BENSKJØRHET: Røntgenbildene hos tannlegen viser også kjevens tilstand - slik at man kan se om benmassen er så tett den bør være.

Røntgenbildene av tennene dine viser om du er utsatt.

Benskjørhet er en sykdom som rammer svært mange nordmenn. Det regnes med at rundt 250.000 kvinner og 50.000 menn lider av dette.

Benskjørhet, eller osteoporose, er enkelt forklart en tilstand der benmassen blir mer porøs og skjør, og dermed kan beina i kroppen brekke lettere.

Kvinner er spesielt utsatte når de kommer i overgangsalderen, for da skjer en rekke hormonelle endringer i kroppen, og dette reduserer kalsiumopptaket i skjelettet.

Tidligere fikk man ikke visshet i om man led av benskjørhet før man fikk et brudd, og legen kunne se på tettheten i benmassen. Men nå har forskere ved Manchester University utviklet en programvare som kan lese av røntgenbildene vi tar hos tannlegen og finne ut om risikoen for benskjørhet er der, skriver Daily Mail.

Røntgenbildene tannlegen tar for å sjekke tennenes tilstand viser nemlig også kjevens tilstand. Programvaren kan utfra bildene lese kjevens benmasse, og se om den er så tett den bør være.

Røntgenbildene tannlegen tar for å sjekke tennenes tilstand viser nemlig også kjevens tilstand. Programvaren kan utfra bildene lese kjevens benmasse, og se om den er så tett den bør være. (...)

- Medel mot benskörhet ökade risken för stressfraktur etc.

CHEST: Bisphosphonates May Increase Risk of Atrial Fibrillation (BRYST: Bisfosfonater kan øke risikoen for atrieflimmer)
medpagetoday.com 23.4.2014
For patients who have osteoporosis, the use of bisphosphonates appears to increase the risk of serious atrial fibrillation, according to a meta-analysis. (...)

(Anm: Hva er atrieflimmer og atrieflutter? (pasienthandboka.no).)

(Anm: Atrieflimmer og atrieflutter (nhi.no).)

(Anm: atrieflimmer; ujamn takt og styrke av puls og hjarteslag fordi hjarteslaga vert stimulerte av impulsar frå raske, uregelbundne flimrande trekkingar i forkammermuskulaturen; orda flimmer, flimmerpuls, hjarteflimmer viser oftast til denne tilstanden som kan gi lite plager, men stundom tung pust, hjartebank og ein tendens til emboliar frå venstre atrium (auricula) gjerne til hjernen; årsakene er mangslungne, f eks revmatisk hjartesjukdom, hjartesvikt av ulike typar, koronarsjukdom, tyreotoksikose, alkohol, perikarditt, anomaliar i impulsleiinga, ofte er tilstanden idiopatisk – lone fibrillation, i sjeldne tilfelle arveleg pga mutasjon i eit gen på kromosom 10; jf ventrikkelflimmer EN atrial fibrillation Kilde: Norsk medisinsk ordbok.)

(Anm: Bisphosphonate-Related Osteonecrosis of the Jaw, Revisited (jwatch.org 21.8.2014).)

(Anm: RBK-talent har fått sjelden betennelse i hjertet. 19-åringen har fått påvist betennelse på hjerteposen, eller perikarditt som det heter. Ifølge RBK.no er stortalentet ikke innlagt ved St. Olavs Hospital, men han er under behandling og får oppfølging ved hjerteklinikken på sykehuset. (adressa.no 27.2.2017).)

(Anm: Hjerteposebetennelse – perikarditt. (…) Hvordan stilles diagnosen? Legen får mistanke om diagnosen ut fra sykehistorien. Det mest typiske funnet er en gnidningslyd som høres med stetoskopet. Den skyldes at de to hinnene i perikardiet er blitt betente og gnisser mot hverandre. Hvis det samler seg mer væske i hjertesekken, som det noen ganger gjør, kan gnidningslyden forsvinne. (nhi.no 27.2.2017).)

Bone Drug Link to Uncommon Breaks Confirmed (Link mellom legemiddel mot benskjørhet og uvanlige benbrudd bekreftet)
medpagetoday.com 21.5.2012
Bisphosphonate therapy appears to be associated with an increased risk of atypical fractures of the femur, and may be driven by the duration of treatment, according to new research.

Of 477 patients hospitalized at one center, 39 had atypical fractures and 438 had common fractures. Among those with atypical fractures, 82.1% had been taking bisphosphonates compared with just 6.4% of those with common fractures, Raphael P.H. Meier, MD, from University Hospitals of Geneva, and colleagues reported online in the Archives of Internal Medicine. (...)

(Anm: Increasing Occurrence of Atypical Femoral Fractures Associated With Bisphosphonate Use. Arch Intern Med. 2012;():1-7 (Published online May 2012).)

Bisphosphonates for Osteoporosis — Where Do We Go from Here? (Bisfosfonater mot osteoporose - Hvor går vi herfra?)
NEJM 2012 (May 9)
Osteoporosis, a disease characterized by reduced bone mass and increased skeletal fragility, affects 10 million Americans; another 34 million are at risk for it. Bisphosphonates are widely prescribed for osteoporosis; more than 150 million prescriptions were dispensed to outpatients between 2005 and 2009. All the bisphosphonates that have been approved for the treatment of osteoporosis have shown robust efficacy in preventing fractures in registration trials lasting 3 to 4 years. Recently, however, data on safety have raised concern regarding the optimal duration of use for achieving and maintaining protection against fractures.

Normal bone growth and remodeling entail a tightly coupled process of bone resorption and new bone formation. Osteoporosis-related bone loss occurs when bone resorption exceeds bone formation; bisphosphonates decrease bone resorption, thereby slowing bone loss. The pharmacology of bisphosphonates is complex. During therapy, bisphosphonates are incorporated into newly formed bone and can persist there for years, through multiple cycles of bone resorption and deposition. Thus, patients continue to be exposed to the pharmacologic effects of bisphosphonate activity long after they stop taking the medication.

The long-term safety and efficacy of bisphosphonate therapy for osteoporosis are important concerns for the Food and Drug Administration (FDA). In response to postmarketing reports of rare but serious adverse events associated with bisphosphonates, such as atypical femur fractures, osteonecrosis of the jaw, and esophageal cancer, the FDA performed a systematic review of long-term bisphosphonate efficacy. The findings, summarized here, were presented at a joint meeting of the FDA Advisory Committee for Reproductive Health Drugs and the Drug Safety and Risk Management Committee.1 The committees jointly recommended that bisphosphonate labeling be updated, although there was consensus that the data did not support a regulatory restriction on the duration of drug use. (...)

(Anm: Should We Be Concerned About Jaw Osteonecrosis with Oral Bisphosphonates? BRONJ probably occurs rarely with oral bisphosphonate therapy, but the true incidence isn’t clear yet. (jwatch.org 8.4.2008).)

New Cautions About Long-Term Use of Bone Drugs (Nye advarsler for langtidsbruk av legemidler mot benskjørhet)
nytimes.com 10.5.2012
In an unusual move that may prompt millions of women to rethink their use of popular bone-building drugs, the Food and Drug Administration published an analysis that suggested caution about long-term use of the drugs, but fell short of issuing specific recommendations.

An X-ray shows a fracture in the femur of a woman who used Fosamax for seven years.

The F.D.A. review, published in The New England Journal of Medicine online on Wednesday, was prompted by a growing debate over how long women should continue using the drugs, known as bisphosphonates, which are sold as generic versions of brands like Fosamax and Boniva, as well as Novartis’s Reclast.

The concern is that after years of use, the drugs may in rare cases actually lead to weaker bones in certain women, contributing to “rare but serious adverse events,” including unusual femur fractures, esophageal cancer and osteonecrosis of the jaw, a painful and disfiguring crumbling of the jaw bone. (...)

Discontinuing bisphosphonates 'reduces' fracture risk (Avslutning av behandling med bisfosfonater "reduserer" bruddrisiko)
hospitalpharmacyeurope.com 14.2.2012
Discontinuing bisphosphonate use following an atypical femur fracture can significantly lower the risk for a subsequent atypical fracture, according to research presented at the 2012 Annual Meeting of the American Academy of Orthopaedic Surgeons.

Researchers reviewed femur fracture data from January 1, 2007 until December 31, 2009 in patients older than 45 enrolled in a large California health maintenance organisation.

There were 126 patients with an atypical femur fracture who reportedly took bisphosphonates prior to their bone break.

The incidence of a subsequent atypical femur fracture occurring in the other thigh was 53.9% in patients who continued bisphosphonates for three or more years after their first fracture, compared to 19.3% in patients who discontinued bisphosphonate use.

Overall, subsequent atypical femur fractures were decreased by 65.6% when bisphosphonates were stopped within one year following the first fracture.

"The risk of a contralateral atypical femur fracture increases over time if the bisphosphonates are continued," said lead author Richard Dell, Researcher in the Department of Orthopaedics at Kaiser Permanente.

"Based on these observations, we recommend discontinuing bisphosphonate use as soon as possible after the initial atypical femur fracture has occurred."

Dr Dell then recommends the ongoing evaluation of these patients, through X-ray or magnetic resonance imaging (MRI), as they still are at risk for a subsequent, atypical femur fracture on the other femur.

If the patient is at high risk for other fractures, the study recommends use of an alternative osteoporosis medication.

American Academy of Orthopaedic Surgeons (...)

Medel mot benskörhet ökade risken för stressfraktur
dagensmedicin.se 5.5.2011
Nya bevis för att bisfosfonater mot benskörhet ökar risken för vissa typer av frakturer presenteras i en svensk studie.

Det har funnits farhågor om att bisfosfonater, läkemedel som hindrar nedbrytning av ben och förhindrar frakturer vid benskörhet, samtidigt ökar risken för så kallade utmattningsfrakturer.

Tidigare forskning har delvis visat motstridiga resultat, men nu stärks sambandet i en nationell studie av Per Aspenberg, professor i ortopedi vid Linköpings universitet, och medarbetare. (...)

Bisfosfonater og atypiske lårbensbrudd
legemiddelverket.no 20.4.2011
Atypiske lårbensbrudd er en alvorlig bivirkning som i sjeldne tilfeller oppstår ved behandling med bisfosfonater. I en ny utredning konkluderes det med at nytten av bisfosfonater er større enn risikoen for bivirkninger for pasientgruppen som helhet.

Bisfosfonater brukes i behandling av benskjørhet og kreft.

Atypiske lårbensbrudd (tretthetsbrudd) er i sjeldne tilfeller rapportert ved behandling med bisfosfonater, oftest etter lang tids bruk. Bruddene kan oppstå uten traume. Enkelte pasienter har hatt smerter i lår eller lyske noen uker før bruddet ble påvist. Det europeiske legemiddelkontorets vitenskapelige komité (CHMP) har vurdert rapportene om atypiske lårbensbrudd ved behandling med bisfosfonater og konkludert med at nytte-risiko-forholdet for bisfosfonater fortsatt er positivt. (...)

Bisfosfonater och risk för lårbensfraktur
lakemedelsvarlden.se 15.4.2011
En ovanlig typ av lårbensfrakturer har i sällsynta fall rapporterats hos patienter som långtidsbehandlats med bisfosfonater mot benskörhet (osteoporos). Smärta eller obehag i låret, ljumsken eller höften kan vara ett tidigt tecken på en möjlig lårbensfraktur.

Patienter som behandlas med bisfosfonater rekommenderas att kontakta sin läkare för rådgivning och undersökning om de beskrivna symtomen uppstår. (...)

Bisphosphonate Use and the Risk of Subtrochanteric or Femoral Shaft Fractures in Older Women
JAMA. 2011;305(8):783-789 (February 23)
Context Osteoporosis is associated with significant morbidity and mortality. Oral bisphosphonates have become a mainstay of treatment, but concerns have emerged that long-term use of these drugs may suppress bone remodeling, leading to unusual fractures. (...)

Conclusion Among older women, treatment with a bisphosphonate for more than 5 years was associated with an increased risk of subtrochanteric or femoral shaft fractures; however, the absolute risk of these fractures is low. (...)

FDA Confirms Small Fracture Risk With Bisphosphonates (FDA bekrefter liten risiko for benbrudd med bisphosphonater)
medpagetoday.com 13.10.2010
WASHINGTON -- The FDA has confirmed that bisphosphonate drugs for osteoporosis carry a small but meaningful risk of femoral fractures and has ordered that product labels be updated accordingly.

The move represents a reversal in the agency's view of femoral fracture risk associated with the popular drugs. In March, the FDA said its initial review suggested no significant increase in risk, but promised to continue collecting data.

Last month, an American Society for Bone Mineral Research task force concluded that the risk is real, if small, and asked the FDA to add cautions to bisphosphonate drug labels. (...)

EU regulators start safety review of bisphosphonates (EU-kontrollorgan starter sikkerhetsgjennomgang av bisphosphonater)
pharmatimes.com 28.9.2010
The safety of popular osteoporosis drugs such as Merck’s Fosamax and Roche’s Boniva is under the spotlight in Europe after regulators launched a probe into a possible link between bisphosphonates and stress fractures of the femur.

The European Medicines Agency said Friday that its Committee for Medicinal Products for Human Use has kicked off a review to determine whether an increased risk of atypical stress fractures in osteoporosis patients taking bisphosphonate medicines is a class effect, following in the footsteps of US regulators which announced a similar move earlier this month.

Concerns over the safety of bisphosphonates were heightened by a recent study, published in the Journal of Bone and Mineral Research, which showed that their long-term use could indeed increase the risk of unusual fractures of the femur. (...)

ASBMR Task Force Report on Atypical Femoral Fractures Published in the JBMR (ASBMRs ekspertgrupperapport på atypiske lårbensbrudd publisert i JBMR)
jbmr.org 14.9.2010 (Journal of Bone and Mineral Research (JBMR))
In a review published online in the Journal of Bone and Mineral Research (JBMR), an expert task force convened by the American Society of Bone and Mineral Research reports that bisphosphonates are highly effective in reducing common bone fractures in people with osteoporosis, but long term use of these medications may be related to unusual but serious fractures of the femur. (...)

FDA Statement on ASBMR report: Possible Increased Risk of Certain Types of Thigh Bone Fractures with Long-Term Bisphosphonates Use
fda.gov 14.9.2010
FDA appreciates the report from the American Society of Bone and Mineral Research's (ASBMR's) expert Task Force, released today, providing important perspectives on the potential association between long term treatment with the class of osteoporosis drugs known as bisphosphonates and a rare but serious type of fracture of the thigh bone (femur). The report includes a case definition that describes the atypical features of these unusual femur fractures. FDA believes this case definition will help greatly in identifying cases and reporting on them, and should facilitate future studies comparing the frequency of these unusual fractures both in patients treated with bisphosphonates and those who have not received bisphosphonates. (...)

AAOS: Osteoporosis Drugs May Weaken Bones in Long Term (Legemidler mot benskjørhet svekker på sikt beina)
medpagetoday.com 11.3.2010
NEW ORLEANS -- The gains bisphosphonate use brings in the structural integrity of the femur decay over time in postmenopausal women with osteoporosis, researchers found.

In women who took oral bisphosphonates for four to five years, buckling ratio, a measure of structural integrity, improved significantly in the proximal femur from baseline, according to Anthony Ding, a medical student at Columbia University College of Physicians and Surgeons in New York City.

However, those improvements started to erode and creep back toward pretreatment levels when bisphosphonate use lasted more than five years, he reported at the American Academy of Orthopaedic Surgeons meeting here. (...)

- Legemidler mot benskjørhet kan øke risiko for øyesykdommer senere i livet

Osteoporosis Drugs ‘May Increase Risk Of Eye Disease' Later In Life (Legemidler mot benskjørhet "kan øke risiko for øyesykdommer" senere i livet)
huffingtonpost.com 3.4.2012
Drugs commonly used to help prevent osteoporosis may increase the risk of a serious inflammatory eye disease, Canadian researchers have discovered.

The drug, oral bisphosphonates, which is prescribed to those suffering from osteoporosis, has previously been linked to irregular heartbeat and esophageal and colon cancer.

This time around, to investigate the role of bisphosphonates and the eye disease uveitis (or scleritis), researchers from the Child and Family Research Institute and the University of British Columbia studied data of 934,147 people who had a ophthalmologist between 2000 and 2007.

Of the total, 10,827 were first-time users of bisphosphonates and 923,320 were non-users.

"We found that first-time users of bisphosphonates are at an increased risk of scleritis and uveitis," explains Dr Mahyar Etminan from the study.

"The risk of inflammatory ocular adverse events, including scleritis and uveitis, is not highlighted in most package inserts included with oral bisphosphonates.

"Our study highlights the need for clinicians to inform their patients about the signs and symptoms of scleritis and uveitis, so that prompt treatment may be sought and further complications averted."

Bisphosphonates are drugs that in certain situations can help to protect your bones against some of the effects of cancer, such as pain and weakness. They may also be used to reduce a raised calcium level in the blood.

The findings were published in the Canadian Medical Association Journal. (...)

(Anm: Skleritt (se bilde) er en betennelse i sklera, senehinnen, som er det vi ser som det hvite på øyet . Sykdommen kan finnes på begge øynene samtidig eller på bare det ene. (nhi.no).)

(Anm: Uveitt, også kalt revmatisk øyebetennelse eller regnbuhinnebetennelse, er en en såkalt autoimmun sykdom som oppstår når kroppens immunforsvar angriper sitt eget vev som i dette tilfellet er øyets uvea. (no.wikipedia.org).)

- Avandia (rosiglitazon)

New Data Supports Link Between Diabetes Drugs, Fractures (Nye data støtter link mellom diabeteslegemidler, benbrudd)
drugs.com 29.7.2010
THURSDAY, July 29 -- New research finds that two widely prescribed diabetes drugs may raise the risk of broken bones in postmenopausal women with type 2 diabetes.

There was also a fracture risk seen among men who had been prescribed either Avandia or Actos plus a loop diuretic.

This isn't the first time such an association has been seen, raising doubts as to whether these drugs, which belong to the class of medications known as thiazolidinediones (TZDs), should be the first choice for treating type 2 diabetes. (...)

Diabetes drugs Avandia and Actos double risk of fractures in women (Diabeteslegemidlene Avandia og Actos dobler risiko for brudd hos kvinner)
pharmatimes.com 10.12.2008
Questions are being asked about GlaxoSmithKline’s and Takeda’s Type 2 diabetes drugs after a study found the medicines were linked to higher bone fracture rates in women.

The study, published in the Canadian Medical Association Journal, found long-term use of Avandia (rosiglitazone) and Actos (pioglitazone) doubled the risk of fractures in women with Type 2 diabetes, without a significant increase in fracture risk in men.

The researchers estimate a fracture would occur in every one in 21 high-risk women – particularly those over the age of 70 – taking either of the drugs for one year. For women with a lower risk, the incidence was still one fracture in every 55 women taking the drugs for more than a year. (...)

(Anm: Avandia (rosiglitazone) - informasjon versus kunnskap og visdom - hvem visste hva? (mintankesmie.no).)

Effekt af rosiglitazon på risiko for AMI og død af kardiovaskulær årsag
Rationel Farmakoterapi nr. 6 (juni 2007)
Rosiglitazon (Avandia) anvendes til behandling af type-2 diabetes. (...)

Der er på det foreliggende ikke grundlag for at fraråde behandling med rosiglitazon, men resultaterne af metaanalysen er tankevækkende.

Første behandling af type-2 diabetes er fortsat metformin og sulfonylurinstof. Behandling med glitazoner medfører øget hyppighed af hjerteinsufficiens, og der er kommet meddelelser om øget hyppighed af frakturer hos kvinder (3).
(...)

Långtidsbehandling med glitazoner ökar risken för frakturer hos kvinnor
lakemedelsverket.se 14.5.2007
Nya säkerhetsdata har framkommit för tiazolidindionerna Actos (pioglitazon) och Avandia (rosiglitazon) samt kombinationer med dessa läkemedel angående ökad risk för frakturer hos kvinnor som behandlas med läkemedlen. Tillgängliga data talar för att effekten torde vara en klasseffekt för glitazoner.(...)

GlaxoSmithKline says Avandia use linked to fractures in females
marketwatch.com 21.2.2007
LONDON (MarketWatch) -- U.K. drugmaker GlaxoSmithKline PLC (GSK) has alerted doctors that long-term use of diabetes drug Avandia has been linked to an increased incidence of fractures in female patients, according to a document published on the Web site of the U.S. Food and Drug Administration.

A safety review of the data from a large-scale clinical study of over 4,000 patients with type 2 diabetes has highlighted that more female patients who took Avandia experienced fractures when compared with females taking other drugs, the company said. (...)

Actos (pioglitazone)

Långtidsbehandling med glitazoner ökar risken för frakturer hos kvinnor
lakemedelsverket.se 14.5.2007
Nya säkerhetsdata har framkommit för tiazolidindionerna Actos (pioglitazon) och Avandia (rosiglitazon) samt kombinationer med dessa läkemedel angående ökad risk för frakturer hos kvinnor som behandlas med läkemedlen. Tillgängliga data talar för att effekten torde vara en klasseffekt för glitazoner.(...)

(Anm: Diabetes treatments and risk of amputation, blindness, severe kidney failure, hyperglycaemia, and hypoglycaemia: open cohort study in primary care. BMJ 2016;352:i1450 (Published 30 March 2016).)

(Anm: Pioglitazone use and risk of bladder cancer: population based cohort study. (…) Conclusion The results of this large population based study indicate that pioglitazone is associated with an increased risk of bladder cancer. The absence of an association with rosiglitazone suggests that the increased risk is drug specific and not a class effect. BMJ 2016;352:i1541 (Published 30 March 2016).)

(Anm: Pioglitazone use and risk of bladder cancer in patients with type 2 diabetes: retrospective cohort study using datasets fromfour European countries. (…) Conclusions This study shows no evidence of an association between ever use of pioglitzone and risk of bladder cancer compared with never use, which is consistent with results from other recent studies that also included a long follow-up period. BMJ 2016;354:i3903 (Published 16 August 2016).)

(Anm: Pioglitazone-containing medicines: drug safety communication — updated FDA review, increased risk of bladder cancer. ISSUE: As a result of an updated review, the FDA has concluded that use of the type 2 diabetes medicine pioglitazone (Actos, Actoplus Met, Actoplus Met XR, Duetact, Oseni) may be linked to an increased risk of bladder cancer. The labels of pioglitazone-containing medicines already contain warnings about this risk, and FDA has approved label updates to describe the additional studies reviewed. See the FDA Drug Safety Communication for more details, including a data summary. (pharmpro.com 13.12.2016).)

(Anm: Editorials. Selecting the right drug treatment for adults with type 2 diabetes. BMJ 2016;352:i1663 (Published 30 March 2016).)

Diabetes Drugs Tied to Fractures in Women
JAMA. 2007;297:1645.
A warning from the US Food and Drug Administration (FDA) has linked pioglitazone (Actos), a thiazolidinedione prescribed for the treatment of type 2 diabetes, with an increased rate of arm, hand, and lower leg fractures among women. The action comes less than a month after a similar warning about excess fractures in women taking rosiglitazone (Avandia), another drug in the same class. The increased risk did not appear in men. (...)

Takeda Warns of Broken Bones in Women Taking Actos for Diabetes
bloomberg.com 10.3.2007
By Catherine Larkin
March 10 (Bloomberg) -- Takeda Pharmaceutical Co. warned U.S. doctors that a study found an increased risk of broken bones in women taking Actos for diabetes, less than three weeks after rival GlaxoSmithKline Plc issued a similar precaution.

Takeda, Japan's largest drugmaker, and U.S. regulators urged doctors to consider the risk of fractures when treating women with type 2 diabetes, the Food and Drug Administration said on its Web site today. (...)

(Anm: Actos (pioglitazone) fda.gov/medwatch.)

- Dosering av levotyroksin og risiko for benbrudd hos eldre

Levothyroxine dose and risk of fractures in older adults: nested case-control study (Dosering av levotyroksin og risiko for benbrudd hos eldre: nøstet kasus-kontroll-studie)
BMJ 2011; 342:d2238 (28 April)
(...) Objective To quantify the effect of levothyroxine dose on risk of fractures in older adults. (...)

Results Of 213 511 prevalent levothyroxine users identified, 22 236 (10.4%) experienced a fracture over a mean 3.8 years of follow-up, 18 108 (88%) of whom were women. Compared with remote levothyroxine use, current use was associated with a significantly higher risk of fracture (adjusted odds ratio 1.88, 95% confidence interval 1.71 to 2.05), despite adjustment for numerous risk factors. Among current users, high and medium cumulative doses (>0.093 mg/day and 0.044-0.093 mg/day) were associated with a significantly increased risk of fracture compared with low cumulative doses (<0.044 mg/day): 3.45 (3.27 to 3.65) and 2.62 (2.50 to 2.76), respectively.

Conclusion Among adults aged 70 or more, current levothyroxine treatment was associated with a significantly increased risk of fracture, with a strong dose-response relation. Ongoing monitoring of levothyroxine dose is important to avoid overtreatment in this population. (...)

Bisphosphonates (bisfonater) - Fosamax (alendronate), Didrocal (etidronate) og risedronate (actonel)

Bisfosfonaters bivirkninger på langt sigt er ukendte
dagenspharma.dk 19.1.2012
Stadigt flere patienter med knogleskørhed sættes i behandling med bisfosfonater, ofte i mange år. Men der mangler viden om, hvad det indebærer at blive behandlet med bisfosfonater i en længere periode. Det konkluderer Lægemiddelstyrelsen i en ny rapport: ’Langtidsbehandling af osteoporosepatienter med bisfosfonater’. Her har de lavet en gennemgang af behandlingsmønstre og evidens for formodede bivirkninger ved længerevarende behandling med bisfosfonater.

Patienter, der sættes i gang med bisfosfonater-behandling, fortsætter ofte i langvarige behandlingsforløb, i nogle tilfælde livslange. 65 pct. af de patienter, der sættes i behandling med bisfosfornater, er stadig i behandling efter fem år.

Inden for en femårig behandlingsperiode er bisfosfonater til knogleskørhedspatienter veldokumenteret, men når behandlingsforløbet er længere end fem år, mangler der evidens for bisfosfonaternes sikkerhed og effekt. Derfor er det vigtigt at få mere viden om langtidsvirkninger ved behandling med bisfosfornater, fastslår Lægemiddelstyrelsen. (...)

(Anm: Ny rapport om langtidsbehandling af osteoporosepatienter med bisfosfonater. Rapport: Langtidsbehandling af osteoporosepatienter med bisfosfonater (pdf). (laegemiddelstyrelsen.dk).)

Expert Panel Links Popular Bone Drugs to Rare Fracture
health.msn.com 14.9.2010
FDA should add warning label to meds such as Boniva, Fosamax, panelists say

The panel is urging the U.S. Food and Drug Administration -- which has been awaiting the report -- to add a special warning to that effect on the drugs' labeling.

"Bisphosphonates may be related to atypical femur fractures," said Dr. Elizabeth Shane, a professor of medicine at Columbia University's College of Physicians and Surgeons in New York City. She is the lead author of the report, which was compiled by a special task force at the American Society for Bone and Mineral Research.

"These fractures are very unusual," Shane added. "But we are still concerned that patients could still have these fractures. There may well be a link between these fractures and bisphosphonates."

The FDA has been given a copy of the panel report for review, she said. The findings are published Sept. 14 in the Journal of Bone and Mineral Research. (...)

First Fosamax case declared a mistrial by US judge
pharmatimes.com 12.9.2009
Shares in Merck & Co have risen on the decision by a US judge to declare a mistrial in the first liability case to reach the courts linking the firm’s osteoporosis drug Fosamax to osteonecrosis of the jaw.

A mistrial was declared by US District Court Judge John Keenan regarding the case of Shirley Boles, a 71-year-old Florida woman who blamed her dental and jaw problems on Fosomax (alendronate) and has been seeking damages in excess of $1 million. The decision was taken after “several days of deliberations by an eight-person jury” who could not reach a unanimous verdict.

Reports of the trial suggest that it was a lively affair and one juror had accused others of intimidation. It was alleged that chairs had been thrown and physical threats made. (...)

US Judge rejects Merck bid to dismiss Fosamax lawsuits
pharmatimes.com 10.9.2009
Merck & Co has lost its chance to shelve 24 lawsuits brought by patients that claim the drug Fosamax (alendronate) caused “jaw death” when taken for less than three years.

US District Judge John Keenan refused to dismiss the lawsuits saying there was sufficient evidence for a jury to link the osteoporosis drug to osteonecrosis of the jaw. (...)

Battle over popular bone drug Fosamax bursts into court
Drug Safety
BMJ 2009;339:b3155 (6 August)
A New York judge has revealed internal Merck discussions about a possible link between its widely prescribed drug and dead jaw syndrome, finds Ray Moynihan
A spring evening back in May 1996 was something of a high point for the folks at the global drug company Merck. Three American television networks ran news stories celebrating Merck’s latest blockbuster to fight brittle bones—Fosamax, whose generic name is alendronic acid (or alendronate sodium).

Reporters told tens of millions of viewers that the recently approved drug could cut the risk of a hip fracture in half, and one report described this as "almost miraculous."1 The televangelism proved both efficacious and prophetic: in the years since, the drug became one of Merck’s top selling products, with sales in excess of $3bn (£1.8bn; €2.1bn) annually for several years during the past decade. (...)

US judge rules Merck won’t face "punitive damages" in first Fosamax case
BMJ 2009;339:b3225 (6 August)
A district court judge in the United States has ruled that the drug maker Merck will not face the risk of "punitive damages" in the first case to be tried involving its widely prescribed osteoporosis drug, Fosamax (alendronate or alendronic acid).

The trial was scheduled to open on Tuesday in New York before Judge John Keenan, and the first case involves Shirley Boles, a woman from Florida who first took the drug in 1997.

Ms Boles is part of a class action of about 800 cases, where plaintiffs are claiming that alendronic acid caused them osteonecrosis of the jaw, and that the maker failed to adequately warn of this risk. (...)

Study Links Osteoporosis Drugs to Jaw Trouble (Studie linker legemidler mot benskjørhet til kjeveproblemer)
washingtonpost.com 1.1.2009
THURSDAY, Jan. 1 (HealthDay News) -- The proportion of people taking widely prescribed oral osteoporosis drugs who develop a nasty jaw condition may be much higher than previously thought, a new study suggests.

Previous reports had indicated that the risk of developing osteonecrosis of the jaw (ONJ) from bisphosphonates in pill form were "negligible," although there was a noted risk in people taking the higher-dose intravenous form of the drug.

But Dr. Parish Sedghizadeh, an assistant professor of clinical dentistry at the University of Southern California School of Dentistry in Los Angeles, said his clinic is seeing one to four new cases a week, compared to one a year in the past. This led him to investigate the phenomenon and publish the findings in the Jan. 1 issue of the Journal of the American Dental Association.

"This is more frequent than everybody would like to think it is," said Sedghizadeh, lead author of the study.

ONJ is characterized by pain, soft-tissue swelling, infection, loose teeth and exposed bone. (...)

(Anm: Oral bisphosphonate use and the prevalence of osteonecrosis of the jaw: An institutional inquiry. J Am Dent Assoc 2009; 140: 61-66.)

(Anm: osteonecrosis; osteonekrose; tap av livsevna i beinvev, beinmorskning, beinnekrose; årsaker kan vera sviktande blodforsyning (beinvevsinfarkt), beinbrot, luksasjon, osteomyelitt, metastasar, cytostatikabehandling, kronisk alkoholmisbruk, prednisonbehandling m v; sjå sekvester, aseptisk beinnekrose, dykkarsjuke, kaputnekrose EN osteonecrosis ET [gr osteon bein + nekros død + -osis tilstand] Kilde: Norsk medisinsk ordbok.)

(Anm: Prednisolone. Not to be confused with Prednisone. Prednisolone is a synthetic glucocorticoid, a derivative of cortisol, used to treat a variety of inflammatory and autoimmune conditions and some cancers. (en.wikipedia.org).)

(Anm: Oral glucocorticoid use and osteonecrosis in children and adults with chronic inflammatory diseases: a population-based cohort study. Abstract OBJECTIVES: We studied oral glucocorticoids and osteonecrosis, a rare but serious bone disease, in individuals with various chronic inflammatory diseases. We hypothesised that we would find stronger associations in adults versus children and in people with autoimmune diseases. CONCLUSIONS: Glucocorticoid use was clearly associated with osteonecrosis in a dose-related fashion in adults, especially young adults, but this risk was not detectable in children. The absolute risk of glucocorticoid-associated osteonecrosis in the general paediatric population and in adults taking low glucocorticoid doses is at most extremely small. BMJ Open. 2017 Jul 21;7(7):e016788.)

(Anm: Data Lacking on Prednisone Use in RA. Glucocorticoid treatment may be the best and worst possible option. (…) "The medical community has been inept at producing a solid evidence base for the proper application of glucocorticoid therapy," stated Frank Buttgereit, MD, of Charité University Hospital in Berlin, and colleagues. (medpagetoday.com 5.1.2017).)

(Anm: Orale steroider (glukokortikoider) linket til 10 ganger økt risiko for diabetes. (Oral steriods linked with ten-fold increased risk of diabetes. (pulsetoday.co.uk 5.5.2016).)

(Anm: Vanlige legemidler, uvanlig risiko? Høyere frekvens av alvorlige problemer etter kortvarig steroidbruk. (Common drugs, uncommon risks? Higher rate of serious problems after short-term steroid use.) (…) Personer som tok legemidlene var mer sannsynlig å brekke et ben, få en potensielt farlig blodpropp eller få en livstruende sykdom som sepsis i månedene etter deres behandling. (…) Selv om bare en liten prosentandel av begge gruppene kom på sykehus for disse alvorlige helsetruslene, viste det høyere antallet blant mennesker som tok steroider bare noen få dager, at det er grunn til forsiktig og til og med bekymringer, sier forskerne. (news-medical.net 14.4.2017).)

(Anm: Glukokortiokoider. Glukokortikoider har et vidt spekter av forbruksområder; og er uunnværlige i behandlingen av mange alvorlige sykdommer. På folkemunne kalles denne typen medisiner ofte "kortison". Det er egentlig ikke helt riktig. Kortison er riktignok et glukokortikoid, men det finnes også mange andre. Glukokortikoider finnes i: Betametason (Celeston Chronodose®). Deksametason (Decadron®). Metylprednisolon (Depo-Medrol®, Medrol®, Solu-Medrol®). Prednisolon. Prednison. Triamcinolon (Kenacort-T®, Lederspan®). Hydrokortison (Solu-Cortef®). Kortison (Cortison®, Cortone®). Disse preparatene er enten tabletter eller injeksjonsvæske som settes med sprøyte. Glukokortikoider finnes også i en rekke salver, kremer, øyedråper, øredråper, nesesprayer, inhalasjonsprayer og stikkpiller. (lommelegen.no 17.9.2004).)

(Anm: Solu-Medrol 40 mg kan gi alvorlige allergiske reaksjoner hos pasienter med melkeproteinallergi. Legemidler med metylprednisolon til injeksjon som inneholder laktose kan forårsake alvorlige allergiske reaksjoner hos pasienter som er allergiske for melkeproteiner. (legemiddelverket.no 28.8.2017).)

(Anm: Fra Wikipedia, den frie encyklopedi. Inhalasjon av glukokortikoider brukes i behandling av
astma. Glukokortikoider er en klasse steroidhormoner som produseres i binyrebarken, karakterisert ved at de kan binde kortisolreseptorer og dermed gi kortisollignende effekter. Begrepet kortikosteroid omfatter både mineralkortikoider og glukokortikoider, men brukes ofte synonymt med glukokortikoid. Det er utviklet en rekke syntetiske glukokortikoider til bruk som legemiddel ved en rekke tilstander. Populært kalles glukokortikoider ofte Studies shed light on risks of commonly used drugs (Studier kaster lys over risikoer ved vanlige brukte legemidler)
reuters.com 28.4.2008
CHICAGO (Reuters) - Two studies provide new evidence of risks associated with drugs commonly used to treat diabetes and osteoporosis, researchers said on Monday.

In one study, U.S. researchers found women who took Merck & Co Inc's osteoporosis drug Fosamax, or alendronate sodium, were nearly twice as likely to have a type of abnormal heartbeat known as atrial fibrillation.

In another, Swiss researchers found the diabetes drugs Avandia, or rosiglitazone, from GlaxoSmithKline Plc and Actos, or pioglitazone, from Takeda Pharmaceutical Co Ltd can more than double the risk of bone fractures.

The studies, published in the Archives of Internal Medicine, underscore the need for patients to weigh the risks and benefits of drugs carefully, said Dr. Jane Cauley of the University of Pittsburgh, who wrote a commentary. (...)

(Anm: Use of Thiazolidinediones and Fracture Risk. Arch Intern Med. 2008;168(8):820-825.

Use of Alendronate and Risk of Incident Atrial Fibrillation in Women. Arch Intern Med. 2008;168(8):826-831.)

Nytt prosjekt: Er alendronat kostnadseffektivt?
kunnskapssenteret.no 28.02.2008
Er bruk av alendronat kostnadseffektivt som tillegg til kalsium/D-vitamin og livsstilsråd hos pasienter med benskjørhet og som ennå ikke har fått brudd? Dette skal Kunnskapssenteret svare på. (...)

Oppdraget er bestilt av professor Ivar Sønbø Kristiansen ved Institutt for helseledelse og helseøkonomi, Universitetet i Oslo.

Les prosjektplanen for alendronat…

Se også omtale av om klinisk nytte av alendronat for benskjøre kvinner etter overgangsalderen fra en fersk Cochrane Library-oversikt … (...)

Severe Pain with Osteoporosis Drugs
fda.gov (March 2008)
FDA is alerting healthcare professionals that severe bone, joint, or muscle pain can occur in patients taking bisphosphonate drugs such as Fosamax (alendronate sodium), Actonel (risedronate sodium), Reclast (zoledronic acid) and Boniva (ibandronate sodium). These drugs are used to treat osteoporosis and certain other diseases.

This severe, sometimes incapacitating musculoskeletal pain has occurred within days, months, or even years after starting bisphosphonates. In the most serious cases, the pain was so severe that patients could not continue their normal activities. Some patients have complete relief of symptoms after they stop taking the drug, while others have reported slow or incomplete resolution. (...)

Suit Alleges More Health Problems
From Merck's Fosamax Drug

online.wsj.com 28.1.2008
A Connecticut woman has sued Merck & Co., claiming that its osteoporosis drug Fosamax caused multiple stress fractures and suppressed bone regeneration in her legs. JoAnn Moranski of Fairfield alleges in a complaint filed in New Jersey state court that she took the drug from 1996-2006.

More than 400 people already have sued Merck alleging that Fosamax causes a bone-wasting condition known as osteonecrosis of the jaw.

Fosamax, which loses its patent protection in the U.S. next month, generated sales of nearly $3 billion in 2007. (...)

(Anm: osteonecrosis; osteonekrose; tap av livsevna i beinvev, beinmorskning, beinnekrose; årsaker kan vera sviktande blodforsyning (beinvevsinfarkt), beinbrot, luksasjon, osteomyelitt, metastasar, cytostatikabehandling, kronisk alkoholmisbruk, prednisonbehandling m v; sjå sekvester, aseptisk beinnekrose, dykkarsjuke, kaputnekrose EN osteonecrosis ET [gr osteon bein + nekros død + -osis tilstand] Kilde: Norsk medisinsk ordbok.)

US drugs regulator issues severe pain alert on bisphosphonates
BMJ 2008;336:117 (19 January)
Bisphosphonate drugs, which are used to reduce bone fractures in patients with osteoporosis, may cause severe and even "incapacitating" musculoskeletal pain, says the US Food and Drug Administration in an alert issued on 7 January.

The pain can occur within days or years after starting treatment, says the agency. Severe musculoskeletal pain is mentioned in the prescribing information for all bisphosphonates, but the agency issued the alert because of "a sizable number of additional reports of severe bone, joint, and/or muscle pain in patients taking a variety of bisphosphonates" since a 2005 report on the problem. (...)

Information on Bisphosphonates
(marketed as Actonel, Actonel+Ca, Aredia, Boniva, Didronel, Fosamax, Fosamax+D, Reclast, Skelid, and Zometa)

fda.gov 7.1.2008
FDA ALERT [1/7/2008] - FDA is highlighting the possibility of severe and sometimes incapacitating bone, joint, and/or muscle (musculoskeletal) pain in patients taking bisphosphonates. Although severe musculoskeletal pain is included in the prescribing information for all bisphosphonates, the association between bisphosphonates and severe musculoskeletal pain may be overlooked by healthcare professionals, delaying diagnosis, prolonging pain and/or impairment, and necessitating the use of analgesics. (...)

Health Advocates Concerned as FDA Approves New Dosage Strength of Fosamax
lawyersandsettlements.com 4.6.2007
Washington, DC: The FDA has approved a new dosage strength of Fosamax Plus D, despite an avalanche of lawsuits related to Fosamax and concerns among health advocates. Hundreds of lawsuits have been filed related to Fosamax, Merck & Co.'s best-selling drug and one of the most prescribed drugs to increase bone density in patients with osteoporosis. (...)

Merck faces Canadian suit over Fosamax
boston.com 29.5.2007
CHICAGO -- Merck & Co., the drug maker defending about 27,000 lawsuits filed by users of the painkiller Vioxx, was accused in a Canadian lawsuit of failing to warn consumers its bone drug Fosamax may damage jaw bones, a law firm said. (...)

Merck Braces for Flood of Fosamax Lawsuits (Merck forbereder seg på en strøm av Fosamax-søksmål)
consumeraffairs.com 6.2.2007
Legemiddel mot osteoporose (benskjørhet) kan ødelegge pasienters kjeveben (...) (Osteoporosis Medication Can Destroy Patients' Jawbones)

(Anm: Tannleger og tannhelse (munnhulen er kroppens speil). (mintankesmie.no/).)

(Anm: Astmaspray kan gi munnsopp. (…) Noen er mer plaget av dette enn andre, men du merker det ved at det svir, blir ømt, du blir rød, får sår i munnen og et hvitt belegg på tungen, opplyser Grethe Amdal, seniorrådgiver i Norges Astma- og Allergiforbund (NAAF) til NRK.no. (…) Har du en kraftig immunsvikt som hiv/aids, vil dette spre seg nedover i spiserøret, hvilket er meget ubehagelig, fortsetter han. (…) Munnen avslører sykdom. (…) Han oppfordrer til å oppsøke tannlegen hvis du har sår i munnhulen som ikke går bort. Det kan være ufarlige hudsykdommer, men også noe mer alvorlig, som kreft.) (nrk.no 13.5.2011).)

(Anm: Top Problems in Your Mouth (webmd.com 2016).)

(Anm: Does Inflammation Harm Your Health? (webmd.com 30.3.2015).)

Ostenekrose i kjeven ved bruk av bisfosfonater
legemiddelverket.no 18.7.2006
Det er observert osteonekrose, særlig i kjeveben, ved bruk av bisfosfonater. Vi ber leger og tannleger være oppmerksomme være observante hos utsatte pasientgrupper. (...)

(Anm: osteonekrose; tap av livsevna i beinvev, beinmorskning, beinnekrose; årsaker kan vera sviktande blodforsyning (beinvevsinfarkt), beinbrot, luksasjon, osteomyelitt, metastasar, cytostatikabehandling, kronisk alkoholmisbruk, prednisonbehandling m v; sjå sekvester, aseptisk beinnekrose, dykkarsjuke, kaputnekrose EN osteonecrosis ET [gr osteon bein + nekros død + -osis tilstand].

bisfosfonat; kalsiumsambindingar som bind seg så fast til hydroksyapatitten i beinvev at osteoklastar ikkje greier å fordøya beinvevet; til bruk som middel mot osteoporose og ved hyperkalsemi, kan også hjelpa ved myelomatose eller andre slags beinmetastasar og mot smertene ved refleksdystrofi; også kalla difosfonat; jf pamidronat, alendronat, klodronsyre, risedronat og etidronat; handelsnamn for klodronsyrepreparat er Ostac, Bonefos. EN bisphosphonate. Kilde: Norsk medisinsk ordbok.)

Bisphosphonates linked to osteonecrosis of the jaw
BMJ 2006;333:1213 (9 December)
For more than a decade bisphosphonates have been widely used to control bony metastases and to prevent and treat osteoporosis, among other things. So far, they have had a good safety profile, with the possible exception of some isolated case reports of osteonecrosis of the jaw. (...)

Bisphosphonate-Associated Contact Stomatitis
NEJM 2006;355:e25 (November 30, 2006)

Bisphosphonate-Associated Osteonecrosis of the Jaw
NEJM Volume 355:2348 (November 30, 2006)
http://content.nejm.org/cgi/content/full/355/22/2348/F1

Osteonecrosis of the jaw and bisphosphonates
BMJ 2006;333:1123 (25 November)
100 years ago the manufacture of matches using yellow phosphorus was subject to an International Convention in Berne (1906), which resulted in substitution of yellow phosphorus for phosphorus sesquisulphide and the control of a disease "phossy jaw. (...)

It is of interest that the same problem has resurfaced with the use of bisphosphonates.3 (...)

Severe Bone and Muscle Pain with Bisphosphonates
fda.gov 3.8.2006
A recent FDA article describes severe pain associated with two bisphosphonate drugs: Fosamax (alendronate sodium) and Actonel (risedronate sodium).

The article, which was published in the Archives of Internal Medicine, describes over a hundred reports received by the FDA of severe bone, joint and muscle pain in patients being treated with Fosamax for osteoporosis. Many patients were unable to walk, climb stairs, or perform usual activities, and some of them became bedridden. Many of them had numerous diagnostic tests with mostly normal findings. (...)

Ostenekrose i kjeven ved bruk av bisfosfonater
legemiddelverket.no 18.7.2006
Det er observert osteonekrose, særlig i kjeveben, ved bruk av bisfosfonater. Vi ber leger og tannleger være oppmerksomme være observante hos utsatte pasientgrupper. (...)

Another Merck Drug Is Under Legal Attack
latimes.com 5.7.2006
Trial lawyers may file hundreds of suits over an osteoporosis remedy linked to jaw decay.

As Merck & Co. defends itself against a deluge of litigation involving its pain reliever Vioxx, the pharmaceutical giant also is fielding the first of what could be another wave of lawsuits involving Fosamax, its second-biggest seller.

The emerging litigation targeting the osteoporosis drug, still in its early stages, illustrates how quickly lawyers can organize themselves and assemble prospective plaintiffs after reports of adverse drug effects — even when those problems appear to be relatively rare. (...)

Reports of Adverse Events From Bone Drugs Prompt Caution
JAMA. 2006;295:2833-2836
In 2003, case reports of a rare but serious condition occurring in patients taking bisphosphonates to prevent breakdown of bone began surfacing. Since then, reports of more than 2000 cases of this adverse event, osteonecrosis of the jaw, have spurred letters of caution from the manufacturer to physicians and dentists, revisions to the labels of some of the products, and recommendations from the US Food and Drug Administration (FDA). (...)

Fosamax lawsuit brings risks to light
sltrib.com 20.6.2006Fosamax: Bone-building med linked to jaw decay in dental patients, a fact Merck is accused of veiling (...)

Drug for Bones Is Newly Linked to Jaw Disease
nytimes.com 2.6.2006
In the last 10 years, millions of patients have taken a class of drugs that can prevent agonizing broken and deteriorating bones. The drugs once seemed perfectly safe and have transformed life for patients with cancer or osteoporosis.

But recently there have been reports of a serious side effect: death of areas of bone in the jaw.

Everyone agrees that the condition, osteonecrosis of the jaw, is an uncommon complication, but that its true incidence is not known. It is estimated that among the 500,000 American cancer patients who take the drugs because their disease is affecting their bones, 1 to 10 percent may develop the problem.

As for the millions of osteoporosis patients, who take lower doses, the condition seems less common. But no one knows how much less. Some oral surgeons have as many as a couple of dozen cases, but their clinics have become centers to which patients elsewhere are referred. Among people with osteoporosis, only 15 cases of the new ailment have been reported in the medical literature.

So for now, doctors and dentists are perplexed. Firm data are scarce to nonexistent, studies that may provide answers are only about to begin, and medical organizations and drug companies are scrambling to provide guidance, often based only on hunches. Some dentists are refusing to treat patients taking the drugs, fearful that the dental work will induce a case of osteonecrosis, and lawyers are lining up to sue the drugs' makers, saying they failed to give patients adequate warning. (...)

Fosamax Could Become Merck's Next Woe
wsj.com (The Wall Street Journal) 12.4.2006
Plaintiffs' attorneys are setting their sights on another Merck drug, Fosamax, that they say is linked to a rare jaw disease.

As Merck & Co. was hit with big punitive damages in a Vioxx case yesterday, plaintiffs' attorneys are setting their sights on one of the company's other blockbusters: osteoporosis drug Fosamax.

The drug maker is facing 10,000 lawsuits related to its painkiller Vioxx, which it pulled from the market in 2004 after a study showed that using the drug for 18 months or longer increased the risk of heart attacks and strokes. Now, adding to Merck's woes are reports that link long-term use of Fosamax to a rare disease in which a patient's jawbone rots and dies, called osteonecrosis of the jaw, or ONJ. (...)

With Fosamax, attorneys are closely following the Vioxx playbook while claiming that they have more powerful cases because the link between Fosamax and the disease is easier to establish.

"With Vioxx, Merck can get away with saying, 'Hey, a lot of people have heart attacks for a number of reasons that have nothing to do with our product," says Tim O'Brien, a lawyer with Levin Papantonio. "But this is a very unique condition that isn't caused by cigarette-smoking or eating cheeseburgers."

Merck says most of the reported cases of osteonecrosis in patients taking bisphosphonates -- the class of drugs Fosamax belongs to -- have been cancer patients injected with more-powerful intravenous forms, and that a direct link to Fosamax isn't so easily drawn.

"The cause of osteonecrosis of the jaw (ONJ) is not well understood and is likely to include a number of conditions," the company says in a statement. (...)

Bone drugs' reverse danger
latimes.com 3.4.2006
Rare instances of jaw decay are being linked to medicines used to prevent bone loss.

Sue Piervin never suspected the pills she took to strengthen her bones could severely damage her jaw. Twelve years ago, a routine X-ray revealed her bones were thinning, so her doctor prescribed a drug to help stop the erosion of bone density. Then, in 1999, Piervin developed a painful bone spur in her jaw that had decayed to such an extent that it had to be surgically removed.

At the time, doctors were puzzled. But when she had a recurrence last year, they had a pretty good idea what was causing the trouble: Fosamax, the medication she was taking to prevent bone loss.

"I had three oral surgeries to remove all the dead bone," says the 56-year-old Los Angeles resident. "It was not a fun summer."

Since 2001, more than 2,400 patients taking Fosamax and other bone-building medications like it have reported bone death in their jaws, mostly after a minor trauma such as getting a tooth extracted. Most were taking especially potent, intravenously delivered versions of these drugs, which are known as bisphosphonates. (...)

- Patienter kan få erstatning, hvis en langvarig behandling med prednisolon har medført knogleskørhed, fordi lægen har glemt at supplere med kalk og D-vitamin

Ny sag om fejlbehandling af 50.000
ekstrabladet.dk 12.11.2010
Patienter kan få erstatning, hvis en langvarig behandling med prednisolon har medført knogleskørhed, fordi lægen har glemt at supplere med kalk og D-vitamin

Danmark er på vej mod en historisk stor sag om forkert behandling af en stor patientgruppe, skriver Dagens Medicin. Det handler om binyrebarkhormonet prednisolon, som nedbryder knoglerne, hvis ikke patienterne får tilskud af kalk og D-vitamin.

Sundhedsstyrelsen har siden 1999 anbefalet, at alle i længerevarende behandling med prednisolon skal knogleskannes og sikres kalk og D-vitamin som supplement. Det er også almen viden for danske læger. Alligevel har lægerne ikke sikret, at en stor patientgruppe har fået kalk og D-vitamin.

50.000 patienter i farezonen
De første 15 patienter har fået tilkendt erstatning på i gennemsnit 440.000 kroner og mange flere kan være på vej. Op mod 50.000 danskere er i en højrisikogruppe, idet de har fået prednisolon i meget lang tid. (...)

(Anm: prednisolon; er et legemiddel, et syntetisk glukokortikoid som brukes i behandlingen av en rekke inflammatoriske tilstander. (no.wikipedia.org).)

(Anm: Alendronate may cut hip fracture risk in older patients taking prednisolone. Older patients who take the anti-inflammatory steroid prednisolone would benefit from treatment with the osteoporosis drug alendronate because it reduces the risk of hip fracture, a retrospective cohort study published in JAMA has found.1 BMJ 2017;358:j3348 (Published 11 July 2017).)

(Anm: Orale steroider (glukokortikoider) linket til 10 ganger økt risiko for diabetes. (Oral steriods linked with ten-fold increased risk of diabetes. (pulsetoday.co.uk 5.5.2016).)

(Anm: Vanlige legemidler, uvanlig risiko? Høyere frekvens av alvorlige problemer etter kortvarig steroidbruk. (Common drugs, uncommon risks? Higher rate of serious problems after short-term steroid use.) (…) Personer som tok legemidlene var mer sannsynlig å brekke et ben, få en potensielt farlig blodpropp eller få en livstruende sykdom som sepsis i månedene etter deres behandling. (…) Selv om bare en liten prosentandel av begge gruppene kom på sykehus for disse alvorlige helsetruslene, viste det høyere antallet blant mennesker som tok steroider bare noen få dager, at det er grunn til forsiktig og til og med bekymringer, sier forskerne. (news-medical.net 14.4.2017).)

(Anm: Glukokortiokoider. Glukokortikoider har et vidt spekter av forbruksområder; og er uunnværlige i behandlingen av mange alvorlige sykdommer. På folkemunne kalles denne typen medisiner ofte "kortison". Det er egentlig ikke helt riktig. Kortison er riktignok et glukokortikoid, men det finnes også mange andre. Glukokortikoider finnes i: Betametason (Celeston Chronodose®). Deksametason (Decadron®). Metylprednisolon (Depo-Medrol®, Medrol®, Solu-Medrol®). Prednisolon. Prednison. Triamcinolon (Kenacort-T®, Lederspan®). Hydrokortison (Solu-Cortef®). Kortison (Cortison®, Cortone®). Disse preparatene er enten tabletter eller injeksjonsvæske som settes med sprøyte. Glukokortikoider finnes også i en rekke salver, kremer, øyedråper, øredråper, nesesprayer, inhalasjonsprayer og stikkpiller. (lommelegen.no 17.9.2004).)

(Anm: Solu-Medrol 40 mg kan gi alvorlige allergiske reaksjoner hos pasienter med melkeproteinallergi. Legemidler med metylprednisolon til injeksjon som inneholder laktose kan forårsake alvorlige allergiske reaksjoner hos pasienter som er allergiske for melkeproteiner. (legemiddelverket.no 28.8.2017).)

(Anm: Fra Wikipedia, den frie encyklopedi. Inhalasjon av glukokortikoider brukes i behandling av
astma. Glukokortikoider er en klasse steroidhormoner som produseres i binyrebarken, karakterisert ved at de kan binde kortisolreseptorer og dermed gi kortisollignende effekter. Begrepet kortikosteroid omfatter både mineralkortikoider og glukokortikoider, men brukes ofte synonymt med glukokortikoid. Det er utviklet en rekke syntetiske glukokortikoider til bruk som legemiddel ved en rekke tilstander. Populært kalles glukokortikoider ofte Den europeiska läkemedelsmyndigheten EMA har granskat risken för lunginflammation hos KOL-patienter som använder inhalerade kortikosteroider och kan konstatera att risken gäller samtliga läkemedel i denna klass. Det finns inga bevis för några skillnader i risk mellan de olika preparaten. (lakemedelsverket.se 16.5.2016).)

- Kortison

Understanding High-Dose Steroid Link to Osteoporosis
healthfinder.gov 2.8.2006
Study finds cortisone inhibited ability of cells to dismantle old bone in normal mice

-- U.S. scientists have learned more about why high doses of the steroid cortisone -- used to treat asthma, rheumatoid arthritis and other inflammatory and autoimmune diseases -- weaken bones and cause osteoporosis.

A team at Washington University School of Medicine in St. Louis conducted studies with mice and identified osteoclasts (cells that dismantle old bone) as the essential link between cortisone and osteoporosis. (...)

- Protonpumpehemmere (Nexium, Prevacid or Prilosec etc.)

Proton Pump Inhibitors (PPIs)
fda.gov 9.8.2010
The FDA is revising the prescription and over-the-counter (OTC) labels for proton pump inhibitors to include new safety information about a possible increased risk of fractures of the hip, wrist, and spine with the use of these medications.

The new safety information is based on FDA's review of several epidemiological studies. Some studies found that those at greatest risk for these fractures received high doses of proton pump inhibitors or used them for one year or more. The majority of the studies evaluated individuals 50 years of age or older and the increased risk of fracture primarily was observed in this age group. As a precaution, the "Drug Facts" label on the OTC proton pump inhibitors (indicated for 14 days of continuous use) also is being revised to include information about this risk. (...)

(Anm: Protonpumpehemmere og magekreft. Langtidsbivirkninger av medisiner kan overses i randomiserte, kontrollerte legemiddelutprøvninger fordi oppfølgingstiden er for kort. Vi har lenge visst at protonpumpehemmere gir magekreft hos gnagere, og det er ingen åpenbar biologisk grunn til at dette skulle være annerledes hos menneske. Tidsskr Nor Legeforen 2016; 136:13 (12.1.2016).)

FDA revises labels on stomach drugs over bone break risks (FDA reviderer preparatomaler for legemidler som nedsetter syresekresjon grunnet risiko for benbrudd)
pharmatimes.com 26.5.2010
(...) The US Food and Drug Administration has changed the labels on PPIs, to include the possible increased risk of fractures of the hip, wrist and spine with high doses or long-term use of the drugs. They are used to treat gastroesophageal reflux disease, stomach and small intestine ulcers, and inflammation of the esophagus, as well as over-the-counter treatments for frequent heartburn.

The FDA noted that drugs which will be affected by the label change include Protonix (pantoprazole), Nexium (esomeprazole) and AstraZeneca’s older treatment Prilosec (omeprazole), as well as Takeda’s Dexilant (dexlansoprazole) and Prevacid (lansoprazole), plus Johnson & Johnson’s Aciphex (rabeprazole). (...)

(Anm: Eosinofil øsofagitt. Bakgrunn. Eosinofil øsofagitt er en kronisk inflammasjonstilstand i spiserøret. De siste årene er man blitt mer oppmerksom på denne sykdommen som en vanlig årsak til dysfunksjon av oesophagus hos både barn og voksne. (…)  Fortolkning. Eosinofil øsofagitt diagnostiseres hos stadig flere, men det er usikkert om dette skyldes økt forekomst eller økt oppmerksomhet fra det medisinske miljøet. Kunnskap om sykdommen er viktig, da enkel endoskopisk eller medisinsk behandling gir et godt resultat hos flertallet av pasientene og kan forhindre komplikasjoner som strikturdanning og fastsittende mat i spiserøret. Tidsskr Nor Legeforen 2011; 131:2470 – 4 (13.12.2011).)

(Anm: Barrett's Esophagus: Symptoms, Causes, and Treatments (webmd.com 2016).)

(Anm: Barrett’s Esophagus and Cancer Risk. Barrett’s esophagus (BE) is a condition where the tissues present in the esophagus undergo transformation and become similar to those found in the intestinal lining. It is present mostly in people who have gastroesophageal reflux disease (GERD), especially if it has been present for a very long period. This in turn is related to an increased risk for developing esophageal cancer. (news-medical.net 12.10.2017).)

(Anm: CUMC researchers discover ‘cell of origin’ for esophageal cancer. (…) The discovery of this "cell of origin" promises to accelerate the development of more precise screening tools and therapies for Barrett's esophagus and esophageal adenocarcinoma, the fastest growing form of cancer in the U.S. The findings, made in mice and in human tissue, were published in today's online edition of Nature. (news-medical.net 11.10.2017).)

Behandling med PPI kan öka frakturrisk varnar FDA
lakemedelsvarlden.se 26.5.2010
Den amerikanska läkemedelsmyndigheten FDA har gått ut med en varning där man vill uppmärksamma på sambandet mellan långvarig användning av protonpumpshämmare och en ökad frakturrisk.

På tisdagen publicerade FDA ett meddelande på sin hemsida om att den kan finnas en risk för frakturer för patienter som behandlas en längre tid med protonpumpshämmare, PPI. (...)

Overuse of heartburn drugs is risky: study (Overforbruk av legemidler mot halsbrann er risikabelt ifølge studie)
reuters.com 10.5.2010
(Reuters) - Although they are sometimes used to make spicy meals go down easier, common heartburn drugs can cause serious side effects and should be used with caution, a series of studies released on Monday suggests.

Well-known brands of the drugs -- called proton pump inhibitors or PPIs -- include AstraZeneca's Nexium and Prilosec. Formerly AstraZeneca's biggest seller, Prilosec is available generically as omeprazole and is also sold over the counter by Procter & Gamble Co.

While the drugs are a great help to the right patients, they can raise the risk of fractures in post-menopausal women and cause bacterial infections in many patients, according to a special report in the Archives of Internal Medicine. (...)

(Anm: Benefits of Proton Pump Inhibitors May Not Justify the Risks for Many Users. Arch Intern Med. 2010;170(9):747-748 (May 10).)

Long term use of proton pump inhibitors raises risk of osteoporosis (Langtidsbruk av protonpumpehemmere øker risiko for benskjørhet)
BMJ 2008;337:a1272 (13 August 2008)
Patients who use proton pump inhibitors for seven or more years to treat reflux, peptic ulcers, and other conditions are at more risk of fractures related to osteoporosis, a large Canadian study has found (CMAJ 2008;179:319-26, doi: 10.1503/cmaj.071330). (...)

Proton Pump Inhibitors Over Years Increase Osteoporotic Fracture Risks
medpagetoday.com 12.8.2008
WINNIPEG, Manitoba, Aug. 12 -- Chronic use of proton pump inhibitors over years for gastroesophageal acid reflux is associated with osteoporotic fractures but short-term use seems to be safe, researchers here found. (...)

Stomach drugs 'may weaken bones'
bbc.co.uk 27.12.2006
Hip fractures are more common among the elderly
Long-term use of some of the most common drugs prescribed to tackle stomach acid problems may be weakening people's bones. (...)

Study Links Heartburn Drugs, Broken Hip
forbes.com 26.12.2006
Taking such popular heartburn drugs as Nexium, Prevacid or Prilosec for a year or more can raise the risk of a broken hip markedly in people over 50, a large study in Britain found.

The study raises questions about the safety of some of the most widely used and heavily promoted prescription drugs on the market, taken by millions of people.

The researchers speculated that when the drugs reduce acid in the stomach, they also make it more difficult for the body to absorb bone-building calcium. That can lead to weaker bones and fractures.

Hip fractures in the elderly often lead to life-threatening complications. As a result, doctors should make sure patients have good reason to stay on heartburn drugs long term, said study co-author Dr. Yu-Xiao Yang of the University of Pennsylvania School of Medicine.

"The general perception is they are relatively harmless," Yang said. "They often are used without a clear or justified indication for the treatment." (...)

P-piller kan forårsake benskjørhet

Birth control pills may weaken bones (P-piller kan forårsake benskjørhet)
msnbc.msn.com 24.8.2007
Subjects already had adequate calcium intake, healthy lifestyles, study says

NEW YORK - Oral contraceptive use and loss of normal menstrual function may negatively impact bone health, according to a study of female military cadets.

By contrast, “greater amounts of exercise and increased milk intake were found to be important to skeletal health,” co-investigator Dr. Jeri Nieves told Reuters Health. (...)

Conventional and atypical antipsychotics appear to increase the risk of hospitalization for femur fracture in a population of institutionalized elderly patients

Antipsychotic-Induced Hyperprolactinemia Inhibits the Hypothalamo-Pituitary-Gonadal Axis and Reduces Bone Mineral Density in Male Patients With Schizophrenia.
J Clin Psychiatry. 2008 Feb 13;:e1-e7 [Epub ahead of print]
(...) CONCLUSION: Male patients with schizophrenia had lower BMD than normal individuals irrespective of the amount of exercise or the level of VitD. The results support the hypothesis that inhibition of the hypothalamo-pituitary-gonadal axis by hyperprolactinemia contributes to the mechanism of the bone loss and suggest that the longer the duration of hyperprolactinemia, the greater the reduction in BMD. (...)

Conventional or atypical antipsychotics and the risk of femur fracture among elderly patients results of a case control study
J Clin Psychiatry. 2007 Jun;68(6):929-34
OBJECTIVE: Conventional antipsychotics have been linked to an increased risk of femur fracture. Despite a lower propensity of atypical agents to cause gait and movement disorders, a correlation between these medications and the risk of femur fracture remains to be established. (...)

CONCLUSION: Conventional and atypical antipsychotics appear to increase the risk of hospitalization for femur fracture in a population of institutionalized elderly patients. These medications should be used with caution, especially among patients with a high risk of falls. (...)

(Anm: Funksjonsevnen før og etter en alvorlig fallskade. (The Course of Disability Before and After a Serious Fall Injury.) (...) Konklusjoner og relevans. Fungeringsevnen før og etter en alvorlig fallskade er ganske variabel, men svært sammenvevd, noe som tyder på at sannsynligheten for restitusjon er sterkt avhengig av fungeringsevnen før fallet. JAMA Intern Med. 2013;173(19):1780-1786 (October 28, 2013).)

(Anm: Funksjonsevnen før og etter en alvorlig fallskade. (The Course of Disability Before and After a Serious Fall Injury.) (...) Konklusjoner og relevans. Fungeringsevnen før og etter en alvorlig fallskade er ganske variabel, men svært sammenvevd, noe som tyder på at sannsynligheten for restitusjon er sterkt avhengig av fungeringsevnen før fallet. JAMA Intern Med. 2013;173(19):1780-1786 (October 28, 2013).)

(Anm: Risk of falls and fractures in older adults using antipsychotic agents: a propensity-matched retrospective cohort study. Drugs Aging. 2010 Oct 1;27(10):815-29.)

(Anm: Fall er ledende årsak til skader som resulterer i dødsfall blant eldre mennesker i USA, ifølge studie. (Falls are leading cause of injury deaths among older people, US study finds. Falls are the leading cause of fatal and non-fatal injuries among adults aged 65 years and older in the United States, a Centers for Disease Control and Prevention study has found.1 The study, published in Morbidity and Mortality Weekly Report, noted that in 2014 around 27 000 US adults in this age group died because of falling and 2.8 million were treated in emergency departments for fall related injuries. Of these, 800 000 were subsequently admitted to hospital, the report said.) BMJ 2016;354:i5190 (Published 23 September 2016)).)

(Anm: Reducing Antipsychotic Medications in Elderly Patients is Associated With Fewer Falls. -- Reducing the dosages of antipsychotic medications prescribed to geriatric patients may help lower the rate of falls in this patient population, according to a prospective study presented here on February 23 at the 45th Annual Meeting of the Society of Critical Care Medicine (SCCM). (…) The investigators found that the rate of falls decreased from 9.4% pre-intervention to 7.6% post-intervention (P =.04). (dgnews.docguide.com 24.2.2016).)

(Anm: Fall blant eldre: Ny studie viser at infeksjoner har mye av skylden. (…) «Blame the bug, not the rug» Men forskerne foreslår nå at leger, familiemedlemmer og øvrige omsorgspersoner bør vurdere nok en årsak: infeksjoner. Infeksjoner i blod, urin- og luftveier er de vanligste syndebukkene når det gjelder infeksjonsrelaterte fall. Dette, ifølge en studie presentert fredag ​​i forrige uke på en årlig konferanse for smittsomme sykdommer, kjent som IDWeek, i San Diego, California. (aftenposten.no 13.10.2015).)

(Anm: Depression, antidepressant medications, and risk of Clostridium difficile infection. BMC Medicine 2013;11:121 (7 May).)

(Anm: Infeksjoner, antibiotika knyttet til maniske episoder hos personer med alvorlige psykiske lidelser. (Infections, antibiotic use linked to manic episodes in people with serious mental illness. (…) Their findings, published in Bipolar Disorders, add to evidence that the body's immune system, the so-called gut brain axis, and the particular bacterial microbiome each person has play an integral part in the ebb and flow of psychiatric symptoms and psychiatric disorders, including bipolar disorder and schizophrenia.) (medicalnewstoday.com 21.7.2016).)

(Anm: Forskere ved Mayo Clinic trekker forbindelsen mellom mikrobiomer og kreft fra samme menneskelige brystvev. (…) Vår forskning fant at vevsprøver ved brystkreft tatt i operasjonssalen under sterile forhold inneholder bakteriell DNA, selv når det er ingen tegn til infeksjon, "sa Hieken i en pressemelding fra Mayo Clinic . "Videre har vi identifisert betydelige forskjeller i mikrobiomer I brystvevet fra kvinner med kreft versus kvinner uten kreft. Mayo Clinic researchers draw connection between microbiome and cancer from the same human breast tissue.) (fiercepharma.com 9.8.2016).)

(Anm: Gut pathogens thrive on body's tissue-repair mechanism. Venture-capital interest in the microbiome—the collection of microbes that inhabit humans, animals and plants—is growing like a culture in a petri dish. More than 100 trillion microorganisms make up the microbiome, living in and on the human body, and performing vital functions: They synthesize vitamins, aid digestion and help the immune system develop. (online.wsj.com 19.9.2016).)

(Anm: Studie: tarmfloraen påvirker legemiddelrespons & bivirkninger. (Study: Intestinal Flora Affects Drug Response & Side Effects.) Antibakterielle legemidler fører til endringer i tarmfloraen. Disse endringene har innvirkning på kapasiteten til leveren og nyrene til å avgifte og eliminere terapeutiske legemidler på grunn av store endringer i metabolisering og transportproteiner. (Antibacterial drugs cause changes in the intestinal flora. These changes have an influence on the capacity of the liver and kidneys to detoxify and eliminate therapeutic drugs due to large changes in the metabolizing and transport proteins.) (pharmapro.com 16.8.2016).)

(Anm: Effect of Selective Serotonin Reuptake Inhibitors on the Risk of Fracture. (…) Conclusions  Daily SSRI use in adults 50 years and older remained associated with a 2-fold increased risk of clinical fragility fracture after adjustment for potential covariates. Depression and fragility fractures are common in this age group, and the elevated risk attributed to daily SSRI use may have important public health consequences. Arch Intern Med. 2007;167(2):188-194.)

(Anm: Tusenvis dør etter hoftebrudd. Hvert år opplever rundt 10.000 nordmenn hoftebrudd. Nesten en fjerdedel dør innen ett år. (nrk.no 1.2.2015).)

(Anm: Selective Serotonin Reuptake Inhibitors Decrease Pancreatic Insulin Secretion in Older Adults and Increase the Risk of Insulin Dependence in Type 2 Diabetes Patients. J Clin Psychiatry. 2016 Aug 2.)

(Anm: Antidepressiva og antipsykotika øker risikoen for hoftebrudd, benskjørhet etc. (- Blant mennesker i alderen 60 år og eldre i Norge hadde de som brukte et antipsykotika hadde dobbelt så stor risiko for å lide av et hoftebrudd enn de som ikke brukte dem.) (mintankesmie.no).)

(Anm: Tanntap (tannløshet) linkes til økt risiko for demens. (Tooth loss linked to an increased risk of dementia.) Våre funn understreker den kliniske betydningen av tannpleie og behandling, spesielt når det gjelder vedlikehold av tenner fra en tidlig alder for å kunne redusere fremtidig risiko for demens. (…) Personer med 10-19, 1-9 og ingen tenner hadde hhv. 62 %, 81 % og 63 % høyere risiko for demens enn personer med > 20 tenner. (medicalnewstoday.com 10.3.2017).)

(Anm: Høye nivåer av vitamin A øker ikke risiko for hoftebrudd. Norge har verdens høyeste forekomst av hoftebrudd, og forskere har spekulert i om det blant annet skyldes at vi spiser mye mat som innholder vitamin A. Nå viser en ny studie fra Folkehelseinstituttet at høye nivåer av vitamin A i blodet ikke gir økt risiko for hoftebrudd. (fhi.no 16.12.2015).)

(Anm: Sterke bein hele livet. I Norge er osteoporose eller beinskjørhet et stort problem. (…) Forskning ved Folkehelseinstituttet viser at det skjer omkring 9 000 hoftebrudd per år i Norge, 70 % av disse er blant kvinner. Aldersspesifikk forekomst er nedadgående, men på grunn av det økende antallet eldre i befolkningen har antallet hoftebrudd vært stabilt over tid. (fhi.no 20.10.2015).)

(Anm: Stor nedgang i hoftebrudd i Norge - men forskerne vet ikke hvorfor. Folkesykdommene hjerteinfarkt og hoftebrudd har mange likhetstrekk, men forskerne vet mye mer om én av dem.  Norge ligger på topp i verden når det gjelder hoftebrudd, og vi vet ikke hvorfor. (aftenposten.no 4.6.2016).)

(Anm: Melk hjelper ikke mot beinskjørhet hos eldre. Eldre med et kosthold rikt på kalsium, er ikke bedre beskyttet mot å brekke bein eller armer. Norge ligger i verdenstoppen på bruddskader. Om lag 9000 voksne nordmenn brekker hoften hvert år. (nrk.no 3.10.2015).)

- Mange psykotrope legemidler kan være dårlig for ben

Many Psychotropic Medications May Be Bad for Bones (Mange psykotrope legemidler kan være dårlig for ben)
May 27, 2010 (New Orleans, Louisiana) —The use of certain psychotropic medications enhances an already high underlying risk for osteoporosis, according to several studies presented here at the American Psychiatric Association 2010 Annual Meeting.

Psychotropic agents have been linked to fractures and antidepressants have been associated with low bone mineral density (BMD). Studies presented at this meeting validate these earlier findings and suggest that many patients may already be at high risk for bone disease.

In a large study from Canada, osteoporosis was found to be associated with the use of selective serotonin reuptake inhibitors (SSRIs), mood stabilizers other than lithium, and benzodiazepines. Use of tricyclic antidepressants was protective, he reported.

"We found a 40% increased risk for low BMD with SSRIs and a 37% reduced risk with tricyclic antidepressants," said James Bolton, MD, of the University of Manitoba in Winnipeg, Canada.

Data were derived from Manitoba's healthcare database that captures all physician contacts and diagnoses, all medication prescriptions, all hospitalizations, and census data, which was linked to data from the Manitoba Bone Density Program, a clinical database of information from dual-energy X-ray absorptiometry scans. (...)

(Anm: Recurrent major depressive disorder and use of antidepressants associated with lower bone density. (…) Selective serotonin reuptake inhibitors (SSRIs) used to treat depression have been shown to weaken bone health. However, the majority of studies has focused on postmenopausal women. (medicalnewstoday.com 15.6.2015).)

- SSRI-er (lykkepiller) dobler risiko for benbrudd

Use of selective serotonin reuptake inhibitors and risk of fracture: A systematic review and meta-analysis
J Bone Miner Res. 2012 Jan 18. doi: 10.1002/jbmr.1554. [Epub ahead of print]
(...) INTRODUCTION: Previous studies have reported inconsistent findings regarding the association between the use of selective serotonin reuptake inhibitors (SSRIs) and the risk of fracture. (...)

CONCLUSION: Fracture risk associated with SSRIs use may have a significant clinical impact. Clinicians should carefully consider bone mineral density screening before prescribing SSRIs and proper management for high risk population. © 2012 American Society for Bone and Mineral Research. (...)

Selective Serotonin Reuptake Inhibitors Linked to Bone Loss in Older Men: Presented at ASBMR
docguide.com 22.10.2010
TORONTO -- October 22, 2010 -- Men taking selective serotonin reuptake inhibitors (SSRIs) experience greater bone loss than men who do not take SSRIs, according to data from the Osteoporotic Fractures in Men (MrOS) Study presented here at the American Society of Bone and Mineral Research (ASBMR) 2010 Annual Meeting.

The analysis, presented here at a poster session on October 18, found that use of SSRIs was associated with rising loss of bone mineral density (BMD) at the total hip and subregions, according to lead investigator Elizabeth Haney, MD, Oregon Health Sciences Center, Portland, Oregon. (...)

Statistical analyses revealed that patients who took SSRIs had greater loss of BMD at the total hip and subregions, and there was no statistically significant difference between the 2 groups at the total spine.

They also found that SSRI users had lower grip strength, lower physical activity scores, and a greater history of falls compared to nonusers. (...)

Update in Serotonin and Bone (Oppdatering på serotonin og ben)
The Journal of Clinical Endocrinology & Metabolism 2010;95(9):4124-4132
Context: Serotonin (5-HT) may be an important regulatory agent in bone, and agents that modify 5-HT signaling, such as selective serotonin reuptake inhibitors (SSRIs), are in widespread clinical use. (...)

Conclusions: 5-HT may have regulatory effects on bone. Initial preclinical data suggest that its effects may be deleterious and may be regulated by low-density lipoprotein receptor-related protein 5. These studies need confirmation, as well as elucidation, of the biochemical pathways utilized and the feedback loops involved among bone, gut, and perhaps brain. Paradoxically, targeting of 5-HT synthesis and/or signaling in selective tissues may hold promise as an anabolic intervention for bone. Epidemiological data suggest that clinicians should be vigilant about detection of bone disease in patients who are using SSRIs. (...)

Antidepressants linked with significant risk of stroke and fracture (Antidepressiva linket til betydelig risiko for hjerneslag og benbrudd)
pulsetoday.co.uk 3.8.2010
Forskrivning av antidepressiva er assosiert med en betydelig økt risiko for slag, fall og benbrudd hos eldre pasienter ifølge analyser av data fra primærhelsetjenesten utført av britiske forskere. (Antidepressant prescribing is associated with a significantly increased risk of stroke, falls and fractures in older people, according to analyses of primary care data by UK researchers.)

Two analyses by the same team of researchers from the University of Nottingham of the QResearch database – a network of 602 practices in England – found antidepressants increased the stroke rate by up to half, the rate of falls by more than three quarters and the fracture rate by 87% compared with no antidepressant use.

Figures from the NHS information Centre show antidepressants are the 10th most commonly prescribed class of drugs in primary care, with 39 million prescriptions issued in England in 2009.

Although depression is common in older people, clinical trials for antidepressants often under-represent the elderly population so little is known about the risks of adverse events in older patients and the relative safety of individual drugs in this class. (...)

SSRI Use May Correlate With Lower Bone Mineral Density in Middle-Aged Women: Presented at ASBMR
docguide.com 13.9.2009
DENVER -- September 13, 2009 -- A study presented at the 31st Annual Meeting of the American Society for Bone and Mineral Research (ASBMR) found that use of some antidepressants may have a correlation with reduced bone mineral density (BMD) in women. (...)

"They were based on database studies and were not able to control for important variables such as bone density and other health conditions," said Susan Diem, MD, University of Minnesota, Minneapolis, Minnesota, on September 12. "Basic science data in the last few years have also found that serotonin transcriptors may exist on bone cells. SSRIs, which block serotonin transcription, might then have an effect on bone density." (...)

Breaking into bone biology: serotonin's secrets
Nature Medicine 2009;15, 145-146 (1 February)
Bedside to Bench Selective serotonin reuptake inhibitors (SSRIs) have been the cornerstone of treatment for depression for over a decade. However, two recent studies have shown that patients who are prescribed SSRIs have lower bone mineral density (BMD) than those taking older, tricyclic antidepressants such as amitriptyline. (...)

Serotonin in Gut Linked to Bone Formation (Serotonin i tarm linket til bendannelse)
medpagetoday.com 28.11.2008
NEW YORK, Nov. 26 -- That Thanksgiving turkey may be bad for your bones.

That's one of the implications of a study that -- for the first time -- links the gut to bone formation, according to Gerard Karsenty, M.D., Ph.D., of the Columbia University College of Physicians and Surgeons, and colleagues.

The research, conducted mainly in mice, links serotonin produced in the duodenum to the proliferation of osteoblasts, the cells that create new bone, Dr. Karsenty and colleagues reported in the Nov. 26 issue of Cell.

"This is totally new," Dr. Karsenty said. "We had no clue that the gut had control over bone, and in such a powerful manner." (...)

Until these experiments, Dr. Karsenty said, the function of gut-associated serotonin was not known.

"The findings demonstrate without a doubt that serotonin from the gut is acting as a hormone to regulate bone mass," he said. (...)

Do Antidepressants Make Bones Brittle?
washingtonpost.com 11.7.2008
FRIDAY, July 11 -- (HealthDay News) -- Older adults may get a needed mood boost from a prescribed antidepressant, but they're also at increased risk for bone fractures, a growing number of studies suggest.

In one of the latest reports, Leslie Spangler, a researcher at Group Health, a Seattle-based health plan, found that antidepressant use in postmenopausal women, who averaged 64 years of age, was linked to an increased risk of fractures of the spine and other sites.

"Our study didn't show any strong association between antidepressants and wrist fractures and hip fractures," she said. "It did find an association with spine fracture."

Those women on antidepressants had a 30 percent increased risk of spine fracture, she said, and a 20 percent increased risk of any type of fracture. (...)

Sick in the bones or sick in the head?
brockpress.com 5.2.2008
(...) "SSRIs were associated with a two-fold risk of developing minimal trauma or osteoporotic fractures," said Goltzman. "The absolute risk of developing fractures was 13.2 per cent in the individuals taking SSRIs and 6.6 per cent in the individuals not taking SSRIs." (...)

SSRI ökar risken för osteoporos och frakturer
lakartidningen.se 4.12.2007
(...) Samtliga tre benceller – osteoblaster, osteoklaster och osteocyter – har funktionella receptorer för serotonin. Serotonininducerad signalering bestäms också av ett cellmembranbundet protein som intracellulärt kan ta upp serotonin och därmed minska serotoninsignaleringen. Detta serotonintransporterande protein, som påvisats i både osteoblaster och osteoklaster, kan hämmas med serotoninåterupptagshämmare (SSRI). Möss som saknar återupptagsproteinet, liksom möss som behandlats med SSRI, har lägre benmassa och svagare skelett, sannolikt på grund av minskad benbildning. (...)

Mend the Mind, but Mind the Bones!
Arch Intern Med. 2007;167:1231-1232
Balancing Benefits and Potential Skeletal Risks of Serotonin Reuptake Inhibitors (...)

This issue of the Archives contains 2 reports7-8 from unique, well-characterized national cohorts that raise concerns about a reduction in bone mineral density (BMD) in persons receiving SSRIs. Although one investigation is a cross-sectional study of men7 and the other is a longitudinal analysis of women,8 there are many similarities between these reports. Both cohorts have carefully defined many of the more traditional osteoporosis risk factors, yet both lack detailed definitions of depression, a key limitation to their findings. (...)

(Anm: Use of Antidepressants and Rates of Hip Bone Loss in Older Women: The Study of Osteoporotic Fractures. Arch Intern Med 2007;167 1240-1245.)

Association of Low Bone Mineral Density With Selective Serotonin Reuptake
Inhibitor Use by Older Men Bliziotes; for the Osteoporotic Fractures in Men Study Group. Arch Intern Med 2007;167 1246-1251
.)

Antidepressants Increase Fracture Risk for Older Patients (Antidepressiva øker risikoen for benbrudd hos eldre pasienter)
medpagetoday.com 22.1.2007
(...) The prospective population-based study confirmed the link that had been found in previous database studies t, which had limited ability to control for confounding factors. (...)

Antidepressants enhance old age fracture risk
themoneytimes.com 23.1.2007
(...) The results of the study conducted at the McGill University in Montreal also revealed that as SSRIs have a direct weakening effect on bones, it makes them more susceptible to fracture. Furthermore, formulated to numb the brain and central nervous system, antidepressants lead to low blood pressure and fainting spells, thus raising the risk of falling. (...)

On examination, the researchers found a direct link between the use of SSRI’s and fractures. The patients were found at twice the risk of fractures than their normal counterparts.

Participants were particularly vulnerable to fractures of the forearm, ankle and foot, whereas, fractures of the hip, rib, femur, and back were less prone areas, researchers reported.

The researchers also found that the effect depended on the dose of the drug. Doubling the dose resulted in a 1.5 times increase in the risk of falling. (...)

Daily Antidepressants Linked to Increased Fracture Risk
ivanhoe.com 23.1.2007
(Ivanhoe Newswire) -- Taking an antidepressant every day may increase the risk of fractures in older adults.

New research from Canada reveals antidepressants known as selective serotonin reuptake inhibitors (SSRIs) can double the risk of some fractures in adults age 50 and older.

Researchers looked at the relationship between taking SSRIs, bone mineral density and falls in 5,008 adults 50 years and older. Investigators followed the participants for more than five years. (...)

Effect of Selective Serotonin Reuptake Inhibitors on the Risk of Fracture
Arch Intern Med. 2007;167:188-194
(...) Conclusions Daily SSRI use in adults 50 years and older remained associated with a 2-fold increased risk of clinical fragility fracture after adjustment for potential covariates. Depression and fragility fractures are common in this age group, and the elevated risk attributed to daily SSRI use may have important public health consequences. (...)

Antidepressants Linked to Fracture Risk (Antidepressiva linket til risiko for knokkelbrudd)
healthfinder.gov 22.1.2007
Patients should have bone tests before taking SSRIs, study suggests.

MONDAY, Jan. 22 (HealthDay News) -- Men and women in their 50s and older who take antidepressants known as selective serotonin reuptake inhibitors may be doubling their risk of fractures, a new Canadian study suggests.
SSRIs, such as Prozac and Paxil, are commonly used to treat depression and anxiety. But previous studies had shown these drugs are associated with an increased risk of fractures from falling.

The new research, led by Dr. David Goltzman, a professor of medicine and physiology and director of the McGill Centre for Bone and Periodontal Research at McGill University in Montreal, seems to support the earlier studies.

"There is good scientific evidence that serotonin is involved in bone physiology, and if you alter the system, you can get low bone density," Goltzman said. "Patients should be monitored to prevent the risk of fractures." The finding is published in the Jan. 22 issue of the Archives of Internal Medicine. (...)

New model makes diagnosing osteoporosis easier
innovations-report.de 6.6.2006
International Osteoporosis Foundation
(...) SSRIs May Increase Fracture Risk
An additional study found that drugs used to treat depression and other mental illnesses may heighten the risk of fractures. Dr. Brent Richards from McGill University, working with researchers in the Canadian Multicentre Osteoporosis Study (CaMos) presented the findings. According to the study’s results, daily use of selective serotonin reuptake inhibitors (SSRIs)—which rank among the most widely prescribed drugs in the world with combined annual sales of US $8.3 billion— were associated with an elevated risk of X-ray confirmed fragility fractures among subjects aged 50 years and above. “The take home message is that SSRI use, depression and fractures are common in the elderly,” Richards said. “So, given these high prevelances, the effect of SSRI use on fractures may have important public health implications.” (...)

Lykkepiller kan øke risiko for beinskjørhet
forskning.no 28.11.2005
400 000 nordmenn bruker i dag såkalte lykkepiller. Pillene kan gi varige skader på skjelettet. (...)

- Lykkepillen hemmer nemlig aktiviteten til de beinbyggende cellene. Samtidig øker den produksjonen av signalstoffer som stimulerer til økt nedbryting av beinmassen.

Det sier Björn I. Gustafsson, stipendiat ved NTNU og overlege ved St. Olavs Hospital. Han har påvist denne medisinske sammenhengen ved cellestudier, som en del av sitt doktorgradsarbeid. (...)

Endrer kjemi, bryter ned bein
Ved bruk av lykkepiller (også kalt SSRI-medikamenter) økes mengden serotonin lokalt i hjernen. Serotonin er et viktig signalstoff i hjernen. Mesteparten av kroppens serotonin produseres av bestemte celler i kroppens mage- og tarmsystem.

Økt mengde av serotonin i hjernen har positiv effekt på depresjoner og andre psykiske lidelser. Men lykkepiller påvirker også nivået og funksjon av serotonin i resten av kroppen. (...)

Fin balanse
Ved normal beindannelse i en menneskekropp er det balanse mellom de beinproduserende osteoblastene og beinnedbrytende osteoklastene. Lykkepillene ser ut til å forrykke denne balansen.

Forskerne har funnet ut at kroppens serotonin stimulerer osteoblastene slik at det foregår en sunn reproduksjon av beinceller. Dette kan være en av mekanismene som hindrer de fleste i å utvikle beinskjørhet. (...)

Trolig permanente skader
Skader på skjelettet er generelt permanente. Det finnes ikke legemidler som kan reversere skader forårsaket av andre medikamenter. Man vet at lykkepiller ”bygges inn” i beinmassen. Studier viser at mengden av pillens ulike substanser i kroppen øker lang tid etter at pasienten har sluttet med legemiddelet.

Barn på lykkepiller opplever hemmet vekst, noe som også er skjelettrelatert. (...)

Helsebombe?
Nordmenn har i utgangspunktet en svært høy forekomst av beinskjørhet. Og nå tar i tillegg hele 400 000 av oss lykkepiller. Vi kan i verste fall sitte på en helsebombe, der forekomsten av beinskjørhet øker betraktelig i årene som kommer.

Det er ikke forsket på langtidsvirkninger for beinmassen av SSRI-medikamenter. Ingen vet ennå hvor store skader lykkepiller kan medføre, eller hvor mange som kan være i faresonen. Men forskere i Nederland og i USA arbeider nå med å framskaffe slike data.

Skader på hjerteklaffene
NTNU-forskningen har også påvist en sammenheng mellom serotonin i blodet og skader på hjerteklaffene. Dette kalles det carcinoide syndrom. Gustafsson viser for første gang at overproduksjon av serotonin er direkte årsak til at skade oppstår på hjerteklaffene.

Hjerteklaffene sørger for at blodet går den riktige veien gjennom hjertet, og skade på disse medfører hjertesvikt. Halvparten av alle med det carcinoide syndrom – hvis de ikke opereres – dør av denne skaden på hjertet.

Oppdagelsen vil ha stor betydning for utvikling av nye behandlingsformer.

(Anm: osteopetrose sjeldsynt arveleg sjukdom der beinvevet er for tett, men likevel skjørt pga sviktande osteoklastfunksjon; marghola og andre beingangar kan smalna inn slik at det kjem blodmangel, nerveutfall m v; ein autosomal recessiv type fører til døden i barnealder, ein dominant type kan vera harmlaus; til grunn kan liggja mutasjon i gen for karboanhydrase; andre namn: Albers-Schønbergs sjukdom, marmorbeinsjukdommen. EN osteopetrosis ET [gr osteon bein + petra stein + -osis].

osteoblast; bindevevscelle som modnar til beindannande celle, blir etterkvart til osteocytt ved at ho blir innebygd i det beinvevet ho lagar; cella deltar i mineraltransporten i beinvev, ho stammar frå stroma i beinmargen, dannar kollagen som er hovuddelen av matrix i bein, alkalisk fosfatase som fremjar nedslag av kalsiumsambindingar, dessutan interleukin-6 og -11, GM-CSF m v; blir påverka av PHTrP, kalsitonin og kalsitriol. EN osteoblast. ET [gr osteon bein + blastos spire]

osteoklast; 1 ei stor, mangekjerna celle som fortærer beinvev (med surgjering og proteolytisk fordøying), ho stammar frå makrofagar i beinmargen og blir påverka av dei same vekstfaktorane og cytokinene som bloddannande celler; jf osteoklast-aktiverande faktor; 2 reiskap brukt ved oppattbryting av beinbrot
EN osteoclast. ET [gr osteon bein + klan bryta]

karsinoid; gulfarga, oftast godarta svulst av argentaffine celler i tarmkanal eller andre innvolar; svulsten skil ut serotonin og kan vera årsak til rier med hjartebank, varmeflager med raudning i huda (flushing), stundom diaré, høgresidig endokardfibrose, bronkokonstriksjon m v, d e karsinoid-syndromet; andre namn: argentaffinom, Kulkitsky-celletumor; jf serotonin og bradykinin som også kan verta utskilt frå svulsten. EN carcinoid; carcinoid tumor. ET [gr karkinos krabbe + eidos form].

syndrom; syndroma; eit sett av plager eller teikn som kjem i lag og høyrer til ein viss sjukdom eller tilstand; symptomkompleks. EN syndrome. ET [gr syndrome samløp]. (...)

(Anm: endokard; årehinna (endotelet) inne i hjartet og bindevevslaget under årehinna, indre hjartehinne. EN endocardium. ET [gr endon inne i + kardia hjarte]. Kilde: Norsk medisinsk ordbok.)

Lykkepiller kan øke risiko for benskjørhet
aftenposten.no 28.11.2005
Rundt 400.000 nordmenn bruker i dag såkalte lykkepiller. Nå viser ny forskning at pillene kan gi varige skader på skjelettet.

Barn på lykkepiller opplever hemmet vekst, som også har sammenheng med pillenes innflytelse på skjelettet.

- Lykkepiller- også kalt SSRI-medikamenter- hemmer aktiviteten til de benbyggende cellene. Samtidig øker den produksjonen av signalstoffer som stimulerer til økt nedbryting av benmassen, sier overlege Bjørn I. Gustafsson ved St. Olavs Hospital i Trondheim til forskning.no.

Han har påvist den medisinske sammenhengen ved cellestudier som en del av sitt doktorgradsarbeid.

Gustafssons studie dreier seg om medikamentet Prozac, men andre lykkepiller virker på samme måte. (...)

(Anm: osteopetrose sjeldsynt arveleg sjukdom der beinvevet er for tett, men likevel skjørt pga sviktande osteoklastfunksjon; marghola og andre beingangar kan smalna inn slik at det kjem blodmangel, nerveutfall m v; ein autosomal recessiv type fører til døden i barnealder, ein dominant type kan vera harmlaus; til grunn kan liggja mutasjon i gen for karboanhydrase; andre namn: Albers-Schønbergs sjukdom, marmorbeinsjukdommen. EN osteopetrosis ET [gr osteon bein + petra stein + -osis]. Kilde: Norsk medisinsk ordbok.)

Serotoninåterupptagshämmare misstänks öka risken för osteoporos
Läkartidningen 2005;102:2746-9
Sammanfattat
Skeletal remodellering kontrolleras inte bara av osteotropa hormoner utan också av signalsubstanser i nervsystemet. Sålunda härbärgerar benbildande osteoblaster och benresorberande osteoklaster bland annat receptorer för serotonin (5-HT).

Bencellerna uttrycker också det protein som svarar för serotoninåterupptag (5-HTT). Studier in vitro och in vivo visar att serotonin kan reglera bencellernas aktivitet. Merparten av tillgängliga data tyder på att hämning av 5-HTT, antingen genom att genen slagits ut hos möss eller genom farmakologisk inhibition med selektiva serotoninåterupptagshämmare (SSRI) hos möss eller människa, leder till minskad benmassa.

Även om det ännu inte har klarlagts om effekterna av SSRI på skeletal remodellering beror på en direkt eller en indirekt effekt på skelettet så antyder dessa observationer möjligheten att patienter som behandlas med SSRI kan ha ökad risk för sekundär osteoporos och skeletala frakturer. Det saknas dock för närvarande data från stora, välkontrollerade kliniska studier för att detta med säkerhet skall kunna fastslås. (...)

Two studies link SSRIs to substantial bone loss: patients taking the antidepressants had bone loss comparable to that associated with glucocorticoid tx
findarticles.com 1.12.2004
SEATTLE -- Use of selective serotonin reuptake inhibitors is associated with bone loss comparable to that associated with glucocorticoid therapy, according to the findings of two studies.

In the first study (involving nearly 6,000 men), the mean bone-mineral density (BMD) at the lumbar spine for the 158 participants using an SSRI at the time of a baseline dual energy x-ray absorptiometry scan was 4.6% lower than in nonusers, Elizabeth McKinstry Haney, M.D., said at the annual meeting of the American Society for Bone and Mineral Research.

By comparison, the 240 glucocorticoid users had a mean baseline BMD 2.9% lower than that of nonusers.

Relative to nonusers, mean total hip BMD was 3.9% lower in the SSRI users and 2.6% lower in the glucocorticoid users.

At the femoral neck, mean BMD was 4.5% lower for the SSRI users and 2.2% lower for the glucocorticoid users. (...)

- Serotoninets effekter på hjerte og benvev

Serotoninets effekter på hjerte og benvev (archive.org)
ntnu.no 5.11.2005
Hormonet serotonin produseres i hovedsak av de enterochromaffine (EC) cellene i mage/tarm-slimhinnen. I doktoravhandlingen sin ved Norges teknisk-naturvitenskapelige universitet NTNU beskriver overlege Björn I. Gustafsson (40) fra Lund i Sverige utseendet til disse cellene, belyst ved en nyutviklet metode. Han viser at EC-cellene har et utseende som er likt de serotoninproduserende nevroner som finnes i hjernen.

Overproduksjon gir alvorlig hjerteklaffsykdom
Ved det carcinoide syndrom produseres store mengder serotonin fra svulster som utgår fra EC-cellene. Symptomer som ses ved det carcinoide syndrom er diaré, rødme i huden og alvorlig hjerteklaffsykdom. Gustafsson viser for første gang at overproduksjon av serotonin er direkte årsak til at skade oppstår på hjerteklaffene. Det vises også at rotter som behandles med serotonin får økt benmasse og stivere ben.

«Lykkepiller» påvirker serotoninbalansen i hele kroppen
Dette er av stor betydning med tanke på det omfattende bruket av såkalte «lykkepiller» ved behandling av depresjon. Når slike medisiner brukes, endres mengden serotonin lokalt i hjernen, men serotoninbalansen påvirkes også i resten av kroppen. I cellestudier viser Gustafsson at serotonin synes å ha en positiv effekt på benomsetningen i motsetning till lykkepiller som synes å ha en negativ virkning.

Resultatene øker forståelsen for EC-cellenes funksjon i mage/tarm-kanalen. De åpner også for nye muligheter i utviklingen av medikamenter for å behandle pasienter med carcinoid hjertesykdom og benskjørhet. (...)

(Anm: Telomere length predicts cardiovascular disease. BMJ 2014;349:g4373 (08 July 2014).)

(Anm:  Leucocyte telomere length and risk of cardiovascular disease: systematic review and meta-analysis. BMJ 2014;349:g4227  (08 July 2014) .)

- Skal nærstudere slimhinden i tarmene og dens samspil med immunsystemet

Lundbeckfonden støtter forskning i immunforsvarets fejl
dagenspharma.dk 19.3.2015
William Winston Agace skal stå i spidsen, der skal finde mulige angrebspunkter for tarmsygdomme.

Lundbeckfonden har uddelt 45 mio. kr. til en ny stor forskningssatsning, der skal nærstudere slimhinden i tarmene og dens samspil med immunsystemet. Bevillingen går til forskningsprojektet ’Regional immune-modulation of mucosal inflammation’, der løber over fem år under ledelse af William Winston Agace, der er professor i slimhindeimmunologi i Sektion for Immunologi og Vaccinologi ved DTU Veterinærinstituttet. […]

- Inflammation ger benskörhet

Inflammation ger benskörhet
svd.se 21.2.2007
San Francisco En pågående kronisk inflammation är grundorsaken till nedbrytningen av skelettet vid benskörhet, eller osteoporos. Den nya förklaringen till sjukdomen framförs nu av ledande forskare. Nytänkandet öppnar för helt nya behandlingsmetoder. (...)

Denna teori ger en ny förklaring till hur den allt vanligare osteoporosen uppstår, något som hittills varit ett mysterium.

Nytänkandet kommer från flera internationella forskare som studerar det komplicerade samspelet mellan en myriad av ämnen i immunförsvaret, vissa skyddande och andra skadande, under olika förhållanden. Hittills är det främst så kallade autoimmuna sjukdomar som ledgångsreumatism och diabetes som stått i fokus där immunförsvaret löper amok och angriper den egna vävnaden.

Osteoporos kan nu visa sig ha samma bakgrund. De skadliga ämnen i immunförsvaret som pekas ut som ansvariga för nedbrytningen av benmassan vid osteoporos är i princip desamma som till exempel vid förstörelsen av ledbrosket vid reumatism. (...)

- Marevan

Beinskjør av blodfortynnende?
Spesialist i allmennmedisin Christian Anker
helsenett.no (2006)
Mennesker som bruker den blodfortynnende middelet Marevan i mer enn ett år kan ha en økt risiko for benbrudd sammenlignet med ikke-brukere. Det viser en ny amerikansk undersøkelse. (...)

- Evista

Study: Lilly's Evista may increase risk of fatal strokes
indystar.com 13.6.2006
INDIANAPOLIS -- Eli Lilly and Co.'s popular osteoporosis drug, Evista, may increase the risk of blood clots and fatal strokes in older women, a finding that may discourage its use to prevent bone-thinning in some patients. Women who took Evista had a 49 percent increase in their risk of dying of stroke, compared with those taking a placebo, a study found. Their chance of getting blood clots from using the drug rose by 44 percent in the research, which involved 10,101 women in 26 countries.

Patients will have to balance those risks against protection Evista offers against osteoporosis and breast cancer, said Lori Mosca, director of preventive cardiology at New York Presbyterian Hospital, who wrote the study. Women in the study who took Evista were 44 percent less likely to develop breast cancer, a finding that mirrored previous studies. The study will appear today in the New England Journal of Medicine.

Evista, launched in 1998, is one of Lilly's best-selling drugs, with sales last year of $1 billion. Lilly has said it plans to seek Food and Drug Administraton approval to market it as a breast cancer preventative. (Bloomberg) (...)

- Legemidler mot kreft

Children With Cancer at Risk for Fragile Bones
healthfinder.gov 26.2.2007
Lack of exercise plus treatment side effects are to blame, experts say

MONDAY, Feb. 26 (HealthDay News) -- Children battling cancer may also have weaker bones, new research shows.

Normally, bones maintain their strength by balancing the processes of laying down materials that give bone its strength and breaking bone down. But certain factors, including menopause, drugs, diet and physical exercise, can influence bone strength.

Studies have shown that children with cancers have multiple risk factors for osteoporosis and bone fractures.

In their report, to be published in the April 1 issue of Cancer, researchers from McMaster University in Hamilton, Ontario, Canada, reviewed the topic of pediatric cancer, bone loss and management. (...)

Bisfosfonater skyddade inte mot bröstcancer
dagensmedicin.se 13.8.2014
Observationsstudier har antytt att benskörhetsläkemedel av typen bisfosfonater kan minska insjuknandet i bröstcancer. Men det sambandet får inget stöd i en ny analys av randomiserade studier. (...)

Forskarna tror att de tidigare positiva resultaten kan ha berott på att det varit kvinnor med i grunden lägre risk för bröstcancer som också tagit bisfosfonater i större utsträckning. (...)

- Osteoarthritis may be a sign of faster "biological ageing"

Osteoarthritis 'caused by biological ageing'
netdoctor.co.uk 2.10.2006
Osteoarthritis may be a sign of faster "biological ageing" in people, new research has suggested.

Researchers at St Thomas' Hospital in London examined 1,100 people, mostly female twins aged between 30 and 79, for the degenerative inflammatory bone disease.

As well as taking x-rays of their hands, where the common form of arthritis is often found, researchers also examined the participants' white blood cells to determine the length of their telomeres – the lengths of DNA which cap chromosomes and which are understood to shorten with biological ageing.

The scientists' findings confirmed that the older a person was, the shorter their telomeres were.

But researchers also found that telomere lengths were found to be significantly shorter in the 160 people suffering from osteoarthritis in their hands, even after taking into account influential factors such as age, sex, smoking and conditions such as obesity.

According to a report on the study, shortly to be published in the Annals of the Rheumatic Diseases, all those found with osteoarthritis were aged over 50 and the amount of telomere shortening in sufferers was found to be equivalent to that accrued over 11 years in healthy people. (...)

(Anm: Short telomeres suggest higher cancer risk. BMJ 2010;341:c3690 (13 July).)

- Granulocyte colony-stimulating factor (G-CSF)

Cancer Drug May Harm Bone
healthfinder.gov 22.1.2007
Mouse study shows the growth factor is linked to bone loss

MONDAY, Jan. 22 (HealthDay News) -- Granulocyte colony-stimulating factor (G-CSF) -- a medication commonly used to help reduce the toxic effects of chemotherapy in cancer patients -- also caused bone loss and promoted tumor growth in the bones of mice, a new study finds.

As a result of their findings, the researchers urged that doctors closely monitor cancer patients' bone health during chemotherapy. The study appears online in the journal Blood, and was expected to be published in an upcoming print issue. (...)

- Anoreksi dobler faren for benbrudd

Anoreksi dobler faren for benbrudd
mozon.no 12.6.2006
(...) Til og med flere år etter at en person har fått diagnosen anoreksi, kan risikoen for benbrudd være fordoblet sammenlignet med friske personer.
Over 4000 personer med spiseforstyrrelser deltok i den danske studien fra 2002. Studien ble gjengitt i tidsskriftet The International Journal of Eating Disorders.

Permanente skader?
Funnene tyder på at skader som er påført beinmassen som en følge av spiseforstyrrelser i verste fall kan være permanente.

- Men det kan også bety at pasientene i studiet fortsatt kjemper med spiseforstyrrelser, og at dette hindrer beinmassen i å gjenoppbygge styrke, rapporterer forskerne ved Århus universitet til Reuters Health.

Tidligere studier har vist at personer med spiseforstyrrelser som anoreksi eller bulimi kan lide av svak beinbygging på grunn av dårlig ernæring. Eksperter sier dette kan øke risikoen for beinskjørhet og brudd. (...)

(Anm: Mutation causes mice to behave as if they have an eating disorder (medicalnewstoday.com 10.4.2015).)

- (ONJ), or “jawbone death”

Jawbone Death a Risk to Consumers of Certain Osteoporosis Drugs
newsinferno.com 11.10.2006
A new warning from the Pennsylvania Dental Association (PDA) says that patients who take a class of drugs known as bisphosphonates are susceptible to a side effect called osteonecrosis of the jaw (ONJ), or “jawbone death.” Bisphosphonates are commonly used in the treatment of osteoporosis, and the class includes the oral medications Fosamax, Actonel, and Boniva and the intravenous drugs Aredia, Bonefos, Didronel, and Zometa. More than 1,000 cases of ONJ have been reported in patients who have been administered this class of drugs.

According to the PDA, “The patients represented in this series of case reports were preponderantly female and typically presented with bone pain, non-healing extraction sockets, or exposed bone…. Symptoms of ONJ include, but are not limited to, pain, swelling, or infection of the gums or jaw; gums that are not healing; loose teeth; numbness or a feeling of heaviness in the jaw, drainage, and exposed bone.” Patients are urged to notify their dental professionals if they’ve undergone bisphosphonate treatment, and those who have should pursue regular dental-hygiene evaluations. (...)

- Fettceller påvirket stoffskiftet i benbygningen

Overraskende om skjelettet
forskning.no 13.8.2007
(...) - Regulerer stoffskiftet
- Jeg var overrasket over hvor omfattende funnene var. Det ser ut til at skjelettet er en reostat som regulerer stoffskiftet, sier Gerard Karsenty til Nature. (...)

Karsenty er entusiastisk, men nøye med å påpeke at man må forske mer for å finne ut akkurat hvor mye disse hormonene har å si for kroppen. (...)

Newtonsk premiss
Bakgrunnen for oppdagelsen er at Karsenys forskning tidligere hadde vist at fettceller påvirket stoffskiftet i benbygningen. (...)

(Anm: Antidepressive medikamenter påvirker kroppens fettproduksjon. (...) På det molekylære planet tok Ræder i bruk cellestudier og moderne genteknologiske metoder for å vise at de store gruppene av psykiatriske medisiner (antipsykotika og antidepressiva, inkludert SSRI-medikamenter) virker på fettomsetningen i kroppen gjennom en transkripsjonsfaktor kalt SREBP (steroid reseptor-element bindende protein). SREBP er meget viktig for å regulere produksjon både av kolesterol og av ulike fett-stoffer i kroppens celler. Kolesterol og andre fett-stoffer er viktig for at nevroner skal utvikle seg og fungere normalt, men har også en rolle i utviklingen av hjerte- og karsykdom. (...) NY DOKTORGRAD (uib.no (23.9.2006).)

- Epilepsilegemidler

Epilepsy Drug Increases Bone Loss (Epilepsilegemiddel øker tap av benmasse)
medpagetoday.com 28.4.2008
NEW YORK, April 28 -- The commonly used epilepsy drug phenytoin (Dilantin, Phenytek) may cause significant bone loss for women in as little as a year, researchers found.

Phenytoin was associated with a 2.6% decrease in bone density in the femoral neck of the hip whereas other epilepsy drugs were not associated with change at any site tested during a year of treatment, reported Alison M. Pack, M.D., of Columbia University here, and colleagues in the April 29 issue of Neurology. (...)

Diverse artikler

Benskjørhet er blitt folkesykdom blant norske kvinner
tv2nyhetene.no 25.8.2014
Alt for få brudd-pasienter over 50 år blir tilbudt utredning og behandling for beinskjørhet. (...)

Diagnose
For å diagnostisere osteoporose foretas det en bentetthetsmåling, en røntgenundersøkelse. 

– Undersøkelsen tar 5-10 minutter, er smertefri og innebærer ingen risiko. Det er per i dag den best egnede metoden for å måle benstyrke og vurdere risiko for brudd, forklarer May-Britt Stenbro, sykepleier ved Osteoporoseenheten, Drammen sykehus.

 I følge Norsk Osteoporoseforbund så oppfordres man å ta en beintetthetsmåling hvis man har hatt et brudd og er over 50 år. Les mer om osteoporose her.

Behandling
Professor og spesialist Erik Fink Eriksen presiserer at det i dag finnes meget effektive behandlinger, som kan redusere risiko for brudd med opp til 90%.

– Ikke mange andre medisiner vi bruker har så stor effektivitet. (…)

Alendronate, a bisphosphonate, increased upper and lower gastrointestinal bleeding: risk factor analysis from a nationwide population-based study.
Osteoporos Int. 2014 Feb 25. [Epub ahead of print]
Patients receiving alendronate for osteoporosis carry a significantly higher risk of developing upper gastrointestinal bleeding (GIB) and lower GIB (hazard ratio 1.32 and 1.84, respectively) after adjusting for potential confounding factors such as age, gender, co-morbidity, and some medications. The risk factors associated with GIB were further analyzed.

INTRODUCTION: Patients receiving alendronate, a type of bisphosphonate, for osteoporosis have a higher risk of developing upper gastrointestinal bleeding (UGIB). Whether patients receiving alendronate also have a higher risk of lower gastrointestinal bleeding (LGIB) has not been studied. In this study, we investigated the association between GIB and alendronate use and to identify the possible risk factors of GIB among alendronate users.

METHODS: Using the National Health Insurance (NHI) Research Database of Taiwan, 3,000 alendronate users and 12,000 age-, sex-, and enrollment time-matched controls were extracted for analysis from a cohort data set of 1,000,000 randomly sampled subjects. Cox proportional hazard regression models were used to identify the risk factors for UGIB and LGIB in all enrollees and alendronate users after adjustments for age, gender, comorbidity (hypertension, diabetes mellitus, coronary heart disease, heart failure, chronic renal disease, chronic obstructive pulmonary disease, peptic ulcer, and cirrhosis), and medications (nonsteroidal anti-inflammatory drugs [NSAIDs], aspirin, steroids, clopidogrel, ticlopidine, warfarin, and selective serotonin reuptake inhibitors).

RESULTS: During a median of 1.30-year follow-up, patients receiving alendronate had significant higher risk of UGIB and LGIB after adjusting for age, gender, and potential confounding factors such as comorbidity and medications. Age, chronic renal disease, NSAID, and clopidogrel use may be independent risk factors for UGIB among alendronate users. Age, male gender, clopidogrel, and ticlopidine use may be independent risk factors for LGIB among alendronate users.

CONCLUSION: Patients receiving alendronates seemed to carry a higher risk for UGIB and LGIB, respectively, after adjustment for age, sex, underlying comorbidity, and certain medications. (...)

(Anm: NSAID Use Is Associated with Elevated Risk for Bleeding in Patients with Atrial Fibrillation Receiving Antithrombotic Therapy Ann Intern Med 2014 Nov 18; 161:690.)

(Anm: Värktabletter kopplas till hjärtproblem. Det finns ett samband mellan en högre risk för hjärtsvikt och medicinering med värktabletter som Voltaren, Ipren och Magnecyl, enligt en ny stor studie. Studien som publicerats i British Medical Journal visar att personer, som inom de senaste 14 dagarna tagit så kallade NSAID-läkemedel, har en 19 procent högre risk för att tas in på sjukhus för hjärtsvikt, jämfört med personer som tagit tabletterna längre tillbaka i tiden. (dagensmedicin.se 30.9.2016).)

(Anm: Mange NSAID knyttet til hjertefeil. Many NSAIDs Associated With HF. 'A clear risk to some... and tighter regulation is justified'. (…) For the individual drugs, odds ratios ranged from 1.16 (95% CI 1.07-1.27) for naproxen to 1.83 (95% CI 1.66-2.02) for ketorolac, and were significant for the following: Diclofenac – Ibuprofen – Indomethacin – Ketorolac – Naproxen – Nimesulide – Piroxicam – Etoricoxib - Rofecoxib (medpagetoday.com 29.9.2016).)

(Anm: Kardiovaskulære risici ved behandling med nonsteroide antiinflammatoriske lægemidler (NSAID). KONKLUSION NSAID-behandling er associeret med en lang række kardiale komplikationer i form af destabilisering af blodtryksbehandling, hjertesvigt, myokardieinfarkt, atrieflimren, venøs tromboemboli, blødning ved kombinationsbehandling med antitrombotika og pludselig hjertedød. Selv korttidsbehandling synes at være associeret med en øget risiko, og særligt diclofenac har en uheldig risikoprofil. Dertil kommer, at der er en dosisrelateret øgning i de kardiovaskulære risici forbundet med NSAID-behandling, hvorimod den terapeutiske og smertestillende effekt ikke øges tilsvarende. NSAID-behandling frarådes derfor til patienter med hjerte-kar-sygdom, og anvendelse af diclofenac frarådes generelt. Ugeskr Læger 2016;178:V08160612.)

(Anm: Using NSAIDs during a cold may increase heart attack risk. Taking ibuprofen or other nonsteroidal anti-inflammatory drugs to help relieve cold or flu symptoms may seem harmless, but new research suggests otherwise. It could increase the risk of heart attack. Study co-author Dr. Cheng-Chung Fang, of the National Taiwan University Hospital, and colleagues recently reported their findings in The Journal of Infectious Diseases. (medicalnewstoday.com 6.2.2017).)

(Anm: NSAIDs offer little benefit for spinal pain, review finds. Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen offer little more clinical benefit to patients with spinal pain than a placebo, a systematic review and meta-analysis has found. The review of 35 randomised placebo controlled trials involving 6065 people, published in the Annals of the Rheumatic Diseases,1 found that NSAIDs did provide some relief from pain and disability but found little evidence that they were more effective than placebo. Researchers found that, in every six patients treated with an NSAID, only one would benefit. BMJ 2017;356:j605 (Published 06 February 2017).)

(Anm: Demente rammes i højere grad af hjerte-kar-sygdom. Hjerteforeningen følger ministerens arbejde med handlingsplan om demens, der er essentiel for hjertepatienter også. Demens og hjerte-kar-sygdomme har fælles risikofaktorer, siger forskningschef. (hjerteforeningen.dk 3.10.2016).)

(Anm: NSAID-preparat farligt efter hjärtinfarkt. Antiinflammatoriska läkemedel av NSAID-typen är farligt ihop med blodförtunnare efter hjärtinfarkt. (lakemedelsvarlden.se 25.2.2015).)

(Anm: Vanlige smertestillende «øker risiko for hjertesvikt". (Common painkillers 'increase heart failure risk' (…) The British Medical Journal study looked at 10 million people, aged 77 on average, who took the drugs. (…) 'Use with caution' The British Heart Foundation (BHF) said patients should be on the lowest dose possible of NSAIDs for the shortest possible time.) (bbc.com 29.9.2016).)

(Anm: Vanlige smertestillende knyttet til svak økning i risiko for hjerteinfarkt. Common Painkillers Tied to Slight Rise in Heart Attack Risk. TUESDAY, May 9, 2017 (HealthDay News) -- Commonly used painkillers such as Motrin, Advil and Aleve might increase your risk for heart attack, even in the first week of use, a new study suggests. Overall, these drugs and others known as nonsteroidal anti-inflammatory drugs (NSAIDs) increase the risk of a heart attack by 20 to 50 percent, compared with not using them, researchers found. (medicinenet.com 9.5.2017).)

(Anm: Non-steroidal anti-inflammatory drugs and risk of heart failure in four European countries: nested case-control study. (…) Conclusions The risk of hospital admission for heart failure associated with current use of NSAIDs appears to vary between individual NSAIDs, and this effect is dose dependent. This risk is associated with the use of a large number of individual NSAIDs reported by this study, which could help to inform both clinicians and health regulators. BMJ 2016;354:i4857 (Published 28 September 2016).)

(Anm: Gigtmedicin skal bruges med omtanke til hjertepatienter. (…) Læger, der udskriver gigtmedicin af typen NSAID (non-steroide anti-inflammatoriske lægemidler), bør være særligt opmærksomme på, at denne type medicin giver en øget risiko for hjertesygdomme hos patienter. Det drejer sig specifikt om produkterne Diclofenac, Ibuprofen og Naproxen. I produktresumeerne for de nævnte produkter, står det udførligt beskrevet, at disse midler er kontraindicerede ved svær hjerteinsufficiens. (laegemiddelstyrelsen.dk 17.3.2016).)

(Anm: Potential Hazards of Adding Nonsteroidal Anti-inflammatory Drugs to Antithrombotic Therapy After Myocardial Infarction. Time for More Than a Gut Check. JAMA. 2015;313(8):801-802. (February 24).)

Risk of Serious Atrial Fibrillation and Stroke With Use of Bisphosphonates: Evidence From a Meta-analysis
Chest. 2013 Oct;144(4):1311-22. doi: 10.1378/chest.13-0675.
BACKGROUND: Clinical studies have suggested an association between bisphosphonate use and the onset of atrial fibrillation (AF). However, data on the risk of developing AF, stroke, and cardiovascular mortality with the use of bisphosphonate are conflicting. The objective of this study was to evaluate the risk of serious AF (events that required hospital admission), stroke, and cardiovascular mortality with the use of bisphosphonates through a systematic review of the literature.

METHODS: We searched the PubMed, CENTRAL, and EMBASE databases for observational studies and randomized controlled trials (RCTs) on the use of bisphosphonates from 1966 to April 2012 that reported the number of patients who developed serious AF, stroke, and cardiovascular mortality at follow-up. The random-effects Mantel-Haenszel test was used to evaluate relative risk-adverse cardiovascular outcomes with the use of bisphosphonates.

RESULTS: Six observational studies (n = 149,856) and six RCTs (n = 41,375) were included for analysis. On pooling observational studies, there was an increased risk of AF (OR, 1.27; 95% CI, 1.16-1.39) among bisphosphonate users. Further, analysis of RCTs revealed a statistically significant increase in the risk of serious AF (OR, 1.40; 95% CI, 1.02-1.93) and no increase in the risk of stroke (OR, 1.07; 95% CI, 0.85-1.34) or cardiovascular mortality (OR, 0.92; 95% CI, 0.68-1.26) with the use of bisphosphonates.

CONCLUSIONS: Evidence from RCTs and observational studies suggests a significantly increased risk of AF requiring hospitalization, but no increase in risk of stroke or cardiovascular mortality, with the use of bisphosphonate. (...)

Bisphosphonate-associated osteonecrosis of the external auditory canal.
J Laryngol Otol. 2013 Jul;127 Suppl 2:S51-3 Epub 2013 May 15
Background: Osteonecrosis is a benign condition characterised by necrotic exposed bone, and is associated with bisphosphonate use. Osteonecrosis of the external auditory canal is rare, with only a few reported cases. Method: Two case reports of temporal bone osteonecrosis are presented. Results: A 64-year-old man with a history of immunoglobulin G kappa multiple myeloma developed a right external auditory canal ulcer 6 years after commencement on clodronate. A 72-year-old woman taking alendronate for osteoporosis, initially diagnosed and treated for right-sided otitis externa, was found to have underlying exposed bone in the right external auditory canal, with a computed tomography scan confirming destruction of the temporal bone. Conclusion: With increasing use of both oral and intravenous bisphosphonates in the community for benign conditions such as osteoporosis and for malignant conditions such as breast cancer and multiple myeloma, the diagnosis of bisphosphonate-associated osteonecrosis should always be considered in patients with a temporal bone lesion, and a relevant drug history taken. (...)

Osteonecrosis of the external auditory canal associated with oral bisphosphonate therapy: case report and literature review
Otol Neurotol. 2013 Feb;34(2):209-13
OBJECTIVE: To present the first case of a patient with oral bisphosphonates-associated ear canal osteonecrosis (BPECO), review previously published cases, and suggest a definition of BPECO.

PATIENT: A 79-year-old woman with left otorrhea and earache was treated for otitis externa for 2 months. The examination revealed a deep floor of the left ear canal defect. The bisphosphonates were discontinued. By the end of the 6-week-course of intravenous antibiotics, the bone defect progression ceased. Already a month later, the defect was lined from approximately 50%. Unfortunately, the patient was lost to follow-up at this stage. She was on oral bisphosphonates for 10 years for severe osteoporosis. She had never been exposed to radiotherapy or had any surgery in the left ear. She admitted to be a habitual cotton bud user for aural toilet.

RESULTS: A CT scan showed an aggressive lobulated mass consistent with carcinoma. A biopsy suggested osteomyelitis with no evidence of malignancy. The final diagnosis was agreed to be the first case of oral BPECO. Intervention: Debridement, intravenous antibiotics, and cessation of bisphosphonates

CONCLUSION: The BPECO is not very well-known clinical diagnosis among ENT surgeons and, therefore, often misdiagnosed for ear canal cholesteatoma, malignant otitis externa, or temporal bone malignancies. It seems reasonable to re-review patient's medical history with focus on BP medication in cases with negative biopsy. Although the BP osteonecrosis is a rare phenomenon, the large volume of BP prescription makes the number of patients at risk significant. (...)

Blodpropp- og hjertemedisin kan gi beinskjørhet
forskning.no 13.2.2013
Verdens nest mest brukte legemiddel kan øke risikoen for beinskjørhet.

Blodfortynnende medisin som gis til millioner av pasienter ser ut til å øke risikoen for beinskjørhet.

En stor dansk studie peker for første gang på at behandling mot blodpropp og hjertesykdommer har en alvorlig bivirkning.

Legemiddelet Plavix blir gitt til millioner av mennesker i en rekke ulike land. Men nå viser danske forskere at den blodfortynnende medisinen antagelig øker risikoen for beinskjørhet.

– Det ser ut til at risikoen er økt med om lag 50 prosent, primært hos de som har tatt medisinen i mer enn et år. Det er veldig interessant fordi det er et av de mest solgte medikamentene i verden. Den skadelige effekten kan være svært stor, sier Niklas Rye Jørgensen, overlege ved Glostrup Hospital. (...)

(Anm: Clopidogrel and the risk of osteoporotic fractures: a nationwide cohort study. Journal of Internal Medicine 213;272(4):385–393 (October 2012).)

(Anm: Clopidogrel (Plavix), a P2Y12 receptor antagonist, inhibits bone cell function in vitro and decreases trabecular bone in vivo. Journal of Bone and Mineral Research 213;27(11):2373–2386 (November 2012).)

Blodfortynner kan gi benskjørhet
aftenposten.no 8.2.2013
Planix er verdens nest mest foreskrevne medikament, og anvendes som behandling mot blodpropp og hjertesykdom. Nå viser en dansk studie at medikamentet kan gi økt risiko for osteoporose. Det er virkestoffet clopidogrel som mistenkes for å ha den uheldige effekten. Undersøkelsen omfattet 70 000 dansker som ble behandlet med clopidogrel gjennom tiåret 1998-2008. De fikk sykdomsutviklingen sammenholdt med en kontrollgruppe på 230 000 personer. Man fant at risikoen for å knekke hofter og håndledd, samt at ryggsøylen falt sammen, økte med opp til 50 prosent blant de som fikk medikamenter som inneholdt clopidogrel. Forskerne bak studien advarer imidlertid mot å slutte å bruke Planix, fordi man ikke kan si sikkert om det er noen årsakssammenheng. Det kan tenkes at pasienter som får skrevet ut medisinen, er særlig utsatt av andre årsaker. Studien er publisert i Journal of Internal Medicine. (...)

Den internasjonale osteoporosedagen 20. oktober:
La ditt første brudd bli ditt siste!

fhi.no 19.10.2012
Hvert 30. minutt brekker en hofte eller et håndledd i Norge. Benskjørhet (osteoporose) er en medvirkende faktor ved de fleste brudd hos eldre. Benskjørhet merkes ikke før det skjer et brudd. Etter et brudd i 50-60-årsalder, bør de fleste snakke med sin fastlege om å få tatt en benmassemåling. Lav benmasse og et tidligere brudd gir betydelig økt risiko for et nytt brudd. Men nye brudd kan forebygges både med legemidler og andre tiltak.

Den internasjonale osteoporosedagen arrangeres hvert år 20. oktober. I år er slagordet: La ditt første brudd bli det siste! Dette er en global aksjon for å bryte den onde bruddsirkelen osteoporosepasienter opplever, med gjentatte brudd.

En norsk studie Folkehelseinstituttet har deltatt i, som nettopp er presentert på en stor osteoporosekonferanse i USA, viser at 10-15 prosent av dem med hoftebrudd, får et nytt hoftebrudd i løpet av ti år. Risikoen er spesielt høy det første året etter bruddet. (...)

Når seponere bisfosfonater?
Tidsskr Nor Legeforen 2012; 132:1630-2 (7.8.2012)
De seneste årene har man observert sjeldne, men alvorlige bivirkninger under langtidsbehandling med bisfosfonater. I denne artikkelen drøfter vi om og når det er grunnlag for å seponere bisfosfonat. (...)

Middel mod brystkræft kan skade knogler
dagenspharma.dk 13.2.2012
Aromasin, der forebygger udviklingen af brystkræft, ser ud til også at forværre aldersrelateret knogleskørhed. Det fremgår af et studie offentliggjort i tidsskriftet The Lancet Oncology.

Exemestane virker ved at blokere dannelsen af østrogen, hvilket sænker væksten af den udbredte form for brystkræft, der har østrogenreceptorer. Trods lægemidlets væsentlige forebyggende kræfteffekt, har dets negative indflydelse på knogleporøsitet og knoglebrud vakt bekymring.

Studiet, der ville undersøge, hvor effektivt exemestane forebygger brystkræft, inkluderede mere end 4.500 raske postmenopausale kvinder, der var i højrisikogruppen for at udvikle kræftformen.

En undergruppe på 350 kvinder uden knogleskørhed, blev tildelt enten exemestane eller placebo, og kvindernes knogletæthed blev målt i de to grupper. På trods af, at exemestane sænkede risikoen for brystkræft med 65 pct. i forhold til placebo, oplevede kvinderne på exemestane et markant tab af knogletæthed i arme og ben. Konklusionen var, at exemestane forværrer den aldersrelaterede nedbrydning af knoglerne med op til tre gange så meget som placebo, selv hos kvinder med et tilstrækkeligt indtag af kalcium og D-vitamin.

Forskerne pointerer, at kvinder, der overvejer exemestane som forebyggende middel mod brystkræft, bør blive monitoreret for knogletæthed og modtage tilskud af kalcium og D-vitamin. Det næste skridt er, at undersøge langtidsrisikoen af kræftlægemidlet på knoglebrud. (...)

(Anm: Bone density and structure in healthy postmenopausal women treated with exemestane for the primary prevention of breast cancer: a nested substudy of the MAP.3 randomised controlled trial. The Lancet Oncology 2012 (Early Online Publication, 7 February 2012).)

Bisphosphonate Use and Atypical Fractures of the Femoral Shaft
N Engl J Med 2011; 364:1728-1737 (May 5)
Background Studies show conflicting results regarding the possible excess risk of atypical fractures of the femoral shaft associated with bisphosphonate use. (...)

Conclusions These population-based nationwide analyses may be reassuring for patients who receive bisphosphonates. Although there was a high prevalence of current bisphosphonate use among patients with atypical fractures, the absolute risk was small. (Funded by the Swedish Research Council.) (...)

Study raises new concerns about safety of calcium
seattletimes.nwsource.com 19.4.2011
A study is raising new questions about the safety of calcium, which many women take to protect their bones.

An analysis of data collected about more than 16,000 women who participated in the landmark Women's Health Initiative found that those who started taking calcium as part of the study were at increased risk for heart attacks and strokes.

The federally funded Women's Health Initiative is the big study that, among other things, stunned doctors and women in 2002, when it determined that the risks of taking hormones for menopause outweighed the benefits.

When the data from that study were originally analyzed, it found no increased risk for heart problems among women taking calcium and vitamin D. But most of the women in the study were already taking calcium on their own, which may have hidden any risks.

So Ian Reid of the University of Auckland and his colleagues reanalyzed the data to try to take that into account. The new analysis of data from 16,718 women, published in the British medical journal known as BMJ, found that the women who were not taking calcium when the study started but began taking it when they got into the research project were at 13 to 22 percent increased risk. The risk occurred regardless of whether the women were taking calcium alone or combined with vitamin D, the researchers found.

The researchers also analyzed data from 13 other studies involving 29,000 people all together and found increases in the risk for heart attacks and strokes among those taking calcium. (...)

(Anm: Vitamin D 'aids the immune system to fight colorectal cancer' (medicalnewstoday.com 18.1.2015).)

(Anm: Immune system link to dementia. An out of control immune system has been identified as a possible cause of neurodegenerative diseases such as Alzheimer's. Researchers at the University of Adelaide in South Australia have assembled strong evidence to suggest the body's immune system can develop an inflammatory response that kills brain cells. Research Assistant Danielle Fornarino said millions of people were affected by neurodegenerative diseases and dementia but there had previously been no definitive cause. (medicalnewstoday.com 13.5.2016).)

(Anm: Found: A potential new way to sway the immune system. A new international collaboration involving scientists at The Scripps Research Institute (TSRI) opens a door to influencing the immune system, which would be useful to boost the effectiveness of vaccines or to counter autoimmune diseases such as lupus and rheumatoid arthritis. The research, published in The Journal of Experimental Medicine, focused on a molecule called microRNA-155 (miR-155), a key player in the immune system's production of disease-fighting antibodies. "It's very exciting to see exactly how this molecule works in the body," said TSRI Associate Professor Changchun Xiao, who co-led the study with Professor Wen-Hsien Liu of Xiamen University in Fuijan province, China. (medicalnewstoday.com 3.8.2016).)

(Anm: TSRI researchers find 'lead actors' in immune cell development. A new study, led by scientists at The Scripps Research Institute (TSRI), reveals a surprising twist in immune biology. The research in animal models suggests that members of a cluster of microRNAs (miRNAs) - small non-coding RNA molecules that play a role in regulating gene expression - work together throughout the different stages of immune cell generation. (medicalnewstoday.com 2.8.2016).)

Protonpumpshämmare minskar skyddet mot fraktur
lakemedelsvarlden.se 23.2.2011
Vanliga protopumpshämmare som omeprazol försämrar behandlingen mot benskörhet. Det visar en dansk studie.

Studien visar att patienter som behandlas med alendronat för osteoporos och som samtidigt använder protonpumpshämmare, som omeprazol och ezomeprazol har större risk för höftfrakurer än patienter som inte använder protonpumpshämmarna. (...)

Merck Wins Lawsuit Brought by Fosamax Patient
pharmpro.com 15.2.2011
NEW YORK (AP) — Merck has won a third lawsuit brought by a patient who said the company's former blockbuster osteoporosis drug Fosamax caused dental and jaw problems.

The company faces more than a thousand lawsuits brought by patients who say they developed jaw and dental problems including osteonecrosis of the jaw — or rotting of the jawbone — after using Fosamax. Merck has now won three of the four lawsuits that have gone to trial.

On Monday the company said a jury in the Superior Court for Atlantic County, N.J., found that Fosamax did not cause the patient's dental and jaw problems. The patient used Fosamax from 1999 to 2006, and suffered jaw problems after having a tooth removed in December 2005. Merck said the woman's history of dental problems and use of steroid medications contributed to those problems. (...)

Benskörhet kopplas till övervikt
sverigesradio.se 30.11.2010
Tidigare har forskare trott att överviktiga kvinnor löper mindre risk att drabbas av benskörhet - eftersom det extra fettet på något vis skulle skydda skelettet. Men nu visar en ny amerikansk studie att för mycket fett kan vara negativt för benhälsan.

En viktig faktor är var på kroppen det extra fettet sitter. Till exempel så såg forskarna inte någon koppling mellan mycket underhudsfett och benskörhet. Däremot när det kom till kvinnor med bukfetma, då fettet samlas kring tarmarna och organen i magen, så såg de en ökad risk.

Den nya studien kopplar ihop ännu ett hälsoproblem med övervikt, tillsammans med bland annat hjärt- kärlsjukdom, astma och diabetes.
Studien presenterades på the Radiological Society of North Americas årliga möte. (...)

Bone loss more common in HIV
reuters.com 11.11.2010
It's unclear exactly why people with HIV are more likely to experience bone loss, study author Dr. Anna Bonjoch of the Lluita contra la SIDA Foundation in Barcelona, Spain, told Reuters Health.

HIV-positive people have the same risk factors as anyone else, but the virus itself may affect bones, as may some drugs used to treat it. However, the fact that some drugs may increase the risk does not mean people should opt out of taking them, she cautioned.

"To stop the treatment is not an option," Bonjoch, whose findings appear in the journal AIDS, said in an e-mail. (...)

Common Prostate Cancer Treatment Associated With Bone Decay
sciencedaily.com 8.10.2010
ScienceDaily (Oct. 8, 2010) — Using novel technology allowing "virtual bone biopsies" researchers have found that a common treatment for prostate cancer called androgen deprivation therapy (ADT) is associated with structural decay of cortical and trabecular bone. The study has been accepted for publication in The Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM).

Prostate cancer is the second most common cancer in men worldwide and estimates suggest there are currently 600,000 men in the United States with the condition who are being treated with ADT. Prostate cancer relies upon male hormones for its growth and ADT is a common treatment because it suppresses or blocks the production or action of male sex hormones. This is the first study to examine changes in bone structure during ADT. (...)

Kols kan gi beinskjørhet
Tidsskr Nor Legeforen 2010; 130:1586 (26.8.2010)
De med kronisk obstruktiv lungesykdom har mindre kalk i skjelettet enn befolkningen ellers. Sykdommen i seg selv kan være årsak til osteoporose.

Det er konklusjonen i Aina Kjenslis avhandling Brittle bones and small lungs.

– Pasientene med kronisk obstruktiv lungesykdom (kols) mister kalkmasse blant annet på grunn av behandlingen med kortison. Vi fant at også de som ikke fikk kortisonbehandling hadde osteoporose. Dermed ser det ut til at kols i seg selv også kan være en årsak. Grunnen til dette vet man ikke, men en teori er systemisk inflammasjon. I tillegg er det andre kjente årsaker som røyking, inaktivitet og undervekt, sier Kjensli. (...)

Lång användning av bisfosfonater kan öka frakturrisk
lakemedelsvarlden.se 11.3.2010
Kvinnor som behandlas med bisfosfonater under mer än fyra år kan få en ökad risk att drabbas av atypiska lårbensfrakturer. Det visar data som presenterats vid årsmötet för en amerikansk ortopedorganisation.

Kvinnor som passerat klimakteriet löper en ökad risk att drabbas av benskörhet. För att förebygga frakturer kan dessa behandlas med bland annat bisfosfonater. Men ny forskning visar att behandlingen kan ge en motsatt effekt om den pågår under en längre tid. (...)

Might Surgical Weight Loss Put Bones at Risk?
health.yahoo.com 1.1.2010
- FRIDAY, Jan. 1 (HealthDay News) -- When diet and exercise attempts haven't worked, increasing numbers of overweight people have turned to bariatric, or weight-loss, surgery to shed pounds.

But research reported in 2009 pointed to an unintended result: One of every five people who had bariatric surgery had broken a bone within a few years.

Were the breaks a result of the surgery? Or of the weight loss that followed? Might they have been related to something going on in the body, either before or after the surgery? Or might something else altogether have been at work?

The answers remain unclear. (...)

Elderly Who Use Psych Meds at Risk for Falls (Eldre som bruker legemidler mot psykiske lidelser er utsatt for fallrisiko)
depression.about.com 30.11.2009
Elderly persons who use psychotropic medications such as antidepressants and sedatives may be at greater risk for falls, according to a report in the November 23, 2009 issue of Archives of Internal Medicine.

This finding is significant, says the authors, because more than 30% of seniors will fall at least once a year, and falls and their complications are the fifth-leading cause of death among the elderly in the developed world. (...)

Meta-analysis of the Impact of 9 Medication Classes on Falls in Elderly Persons (Metaanalyse av innvirkning av ni legemiddelklasser på fall hos eldre personer)
Arch Intern Med. 2009;169(21):1952-1960 (November 23)
Background There is increasing recognition that the use of certain medications contributes to falls in seniors. Our objective was to update a previously completed meta-analysis looking at the association of medication use and falling to include relevant drug classes and new studies that have been completed since a previous meta-analysis. (...)

Konklusjon Bruken av beroligende midler og sovemidler, antidepressiva, og benzodiazepiner viste en signifikant forbindelse til fall hos eldre personer. (Conclusion The use of sedatives and hypnotics, antidepressants, and benzodiazepines demonstrated a significant association with falls in elderly individuals. (...)

Flere beinskjøre i Bergen enn i Tromsø
vg.no 22.11.2009
Dobbelt så mange kvinner over 60 år i Bergen er beinskjøre, sammenlignet med medsøstrene i Tromsø. Blant eldre menn er det 50 prosent flere beinskjøre i Bergen enn i Tromsø.

Det viser tall fra undersøkelser som er gjort på mer enn 5.000 personer i hver av de to byene. Cand.scient. Tone Omsland tar i neste uke doktorgrad ved Institutt for allmenn - og samfunnsmedisin ved Universitetet i Oslo på «Regionale forskjeller i beintetthet og risikofaktorer for brudd i Norge». Hun har brukt og samordnet data fra Tromsø, Bergen, Oslo og Nord-Trøndelag. (...)

Hjärtsjukdom kan ge höftbensbrott
sr.se 21.10.2009
Den som drabbas av hjärtsjukdom bryter ofta senare i livet höftbenet, visar statistiska studier av vilka sjukdomar som drabbat alla svenska tvillingar. (P1 Vetenskapsradion) (...)

Heart Disease Linked to Hip Fracture Risk
ivanhoe.com 21.10.2009
(Ivanhoe Newswire) -- A new study finds the risk of hip fracture increased significantly following a diagnosis of cardiovascular disease (CVD).

CVD and osteoporosis, which are common in elderly individuals, have been regarded as independent age-related disorders. Research has suggested, however, that there may be common mechanisms that cause these diseases. Stroke is a well-documented risk factor for hip fracture, but it is uncertain whether other CVDs may increase the risk of future hip fracture. (...)

Får ikke forebygge benbrudd på blå resept
abcnyheter.no 20.10.2009
(...) Han forklarer videre at hver enkelt selv kan gjøre mye for å forebygge benskjørhet med godt kosthold, D-vitamin og mosjon.

- Men når det gjelder benskjørhet er det meste genetisk, så man kan ikke ta bort risikoen helt, sier Eriksen.

- 100.000 mennesker får medisiner mot høyt blodtrykk på blå resept, men vi kan ikke gi medisiner som vil forebygge brudd og smerter på blå resept, fortsetter han.

Eriksen synes dagens ordning både er urettferdig og lite helseøkonomisk fornuftig. (...)

Incidence and Mortality of Hip Fractures in the United States
JAMA. 2009;302(14):1573-1579 (October 14)
Context Understanding the incidence and subsequent mortality following hip fracture is essential to measuring population health and the value of improvements in health care. (...)

Conclusion In the United States, hip fracture rates and subsequent mortality among persons 65 years and older are declining, and comorbidities among patients with hip fractures have increased. (...)

Exercise Boosts Bone Density in Breast-Feeding Moms
healthfinder.gov 8.10.2009
Lactation depletes calcium stores, but working out can minimize risks, research shows.

THURSDAY, Oct. 8 (HealthDay News) -- New moms who breast-feed may need exercise -- including cardiovascular activity and strength training -- to fight off a loss of bone density caused by lower levels of calcium, research shows.

A new study published in the October issue of Medicine & Science in Sports & Exercise found that new mothers who didn't exercise lost about 7 percent of the bone mineral density in their lower spine after giving birth. The findings come from an analysis of 20 women whose bone density was tested between four and 20 weeks post-partum. (...)

Atypical antipsychotic use and risk of fracture in persons with Parkinsonism (Bruk av atypiske antipsykotika og risiko for brudd hos personer meed Parkinsonisme)
Mov Disord. 2009 Jul 30. [Epub ahead of print]
Our objective was to estimate the effect of atypical antipsychotics (AAs) on the rate of fractures in a parkinsonism population. (...)

Use of an AA was associated with a higher rate of fracture in persons with parkinsonism. Prescribers must be cautious when using these agents in elderly persons with parkinsonism. (c) 2009 Movement Disorder Society. (...)

Serotonin Rising
Correction to Rosen, N Engl J Med 360(10):957-959 March 5, 2009.
N Engl J Med 2009; 360:2580-2582 (June 11)
To the Editor: Rosen's Perspective article (March 5 issue)1 highlights recent findings that gut-derived serotonin inhibits bone formation by stimulating serotonin receptors on the preosteoblast.2 A critical question is whether serotonin is delivered to bone in some blood element or as free plasma serotonin. The serum serotonin measurements used by Yadav and colleagues2 reflect an undefined proportion of the platelet pool and say nothing about the minuscule and often mismeasured free plasma concentrations.3

If the platelet is the delivery vehicle, it is paradoxical that increased platelet serotonin levels in Lrp5-knockout animals and patients with osteoporosis pseudoglioma lead to bone loss,2 whereas treatment with selective serotonin-reuptake inhibitors (SSRIs), which lowers platelet serotonin levels by 80 to 95%, also reduces bone mass.4 The apparent requirement for maternally derived serotonin in mammalian embryogenesis5 poses a similar puzzle: How can gestational SSRI treatment markedly reduce maternal platelet serotonin levels without disrupting embryonic development? Perhaps local tissue uptake and release are crucial in regulating exposures. Finally, given the apparent inhibitory role of serotonin (however delivered) in bone formation,1,2 it is puzzling that the carcinoid syndrome has not been commonly associated with osteoporosis. (...)

(Anm: Know the symptoms of carcinoid syndrome. You can start by knowing what to look for and learning how to treat these symptoms. (carcinoidsyndrome.com).)

Link Between Atrial Fibrillation, Bisphosphonates Still Cloudy
medpagetoday.com 9.4.2009
SAN FRANCISCO, April 9 -- Although bisphosphonates may increase the risk of serious atrial fibrillation, the evidence isn't strong enough to outweigh the benefits of using the drugs to treat osteoporosis, researchers said.

Instead, the researchers suggested that physicians monitor their bisphosphonate patients for signs of AF, and be cautious about using it with patients who are at minimal risk for bone fracture and relatively high risk for AF. (...)

Bisphosphonate associated osteonecrosis of the jaw.
J Rheumatol. 2009 Mar;36(3):478-90.
(...) Prospective data evaluating the incidence and etiologic factors are very limited. In oncology patients receiving high-dose intravenous BP, ONJ appears to be dependent on the dose and duration of therapy, with an estimated incidence of 1%-12% at 36 months of exposure. In osteoporosis patients, it is rare, with an estimated incidence < 1 case per 100,000 person-years of exposure. The incidence of ONJ in the general population is not known. (...)

Serotonin Rising — The Bone, Brain, Bowel Connection
NEJM 2009;360:957-959 (March 5)
In a recent article, Yadav et al.1 elucidated the regulation of gut-produced serotonin by low-density lipoprotein receptor–related protein 5 (Lrp5) and the deleterious effect of serotonin on bone mass. This discovery reflects the rapid advances taking place in bone biology and lends support to three newly understood facts about skeletal physiology. (...)

Benskjør av drikkevannet?
aftenposten.no 15.2.2009
Ingen land har så stor andel benskjøre kvinner og menn som Norge – og ennå har ingen forstått hvorfor. Kan svaret på gåten ligge i noe så enkelt som drikkevannet vårt? Forskerne holder muligheten åpen. (...)

I Norge er nemlig drikkevannet vårt for det aller meste hentet fra overflatevann og vann fra elver og bekker. Bare en liten andel av befolkningen får vannforsyning fra grunnvann. Nedover i Europa er situasjonen motsatt: De har ikke samme tilgang som oss til rent overflatevann, og omtrent alt drikkevann hentes opp fra grunnen.

–Grunnvann er hardt, og inneholder langt mer mineraler, som kalsium og magnesium, enn overflatevannet gjør. Norge består dessuten i av kalsiumfattige bergarter. Så til tross for vårt høye forbruk av melkeprodukter, tyder mye på at vi nordmenn får i oss altfor lite kalsium sammenlignet med folk i andre europeiske land. Vannet inngår jo også i all drikke og grønnsaker som dyrkes, så den jevne europeer får hele tiden påfyll av små doser kalsium, fremholder Nore. (...)

Bisphosphonates Boost Rather than Decrease Osteoclast Count
medpagetoday.com 2.1.2009
LITTLE ROCK, Ark., Jan. 2 -- The bone-preserving effects of long-term therapy with an oral bisphosphonate may result from an unsuspected mechanism involving formation of giant osteoclasts, investigators here reported. (...)

The finding emerged from a retrospective review of 51 bone-biopsy specimens obtained from healthy postmenopausal women who participated in a placebo-controlled, dose-ranging study of alendronate (Fosamax).

The clinical efficacy of nitrogen-containing bisphosphonates is widely attributed to the drugs' ability to decrease the osteoclast population by induction of apoptosis. Usually, apoptotic osteoclasts are rapidly ingested by bone marrow phagocytes, the authors said.

Yet among patients assigned to 10 mg of alendronate, the osteoclast count increased by a factor of 2.6 compared with the placebo group (P<0.01). Moreover, the osteoclast count increased with the cumulative dose of the drug (P<0.01). (...)

Osteoporosis Drug Increases Risk of Dental Complications
medpagetoday.com 2.1.2009
LOS ANGELES, Jan. 2 -- Even short-term use of oral alendronate (Fosamax) can increase the risk of osteonecrosis of the jaw as a complication of dental procedures, researchers here said. (...)

(Anm: Oral bisphosphonate use and the prevalence of osteonecrosis of the jaw: An institutional inquiry. J Am Dent Assoc 2009; 140: 61-66.)

(Anm: osteonecrosis; osteonekrose; tap av livsevna i beinvev, beinmorskning, beinnekrose; årsaker kan vera sviktande blodforsyning (beinvevsinfarkt), beinbrot, luksasjon, osteomyelitt, metastasar, cytostatikabehandling, kronisk alkoholmisbruk, prednisonbehandling m v; sjå sekvester, aseptisk beinnekrose, dykkarsjuke, kaputnekrose EN osteonecrosis ET [gr osteon bein + nekros død + -osis tilstand] Kilde: Norsk medisinsk ordbok.)

FDA: No link between bone drugs and heart problems
forbes.com 12.11.2008
Government health officials said Wednesday they have found no clear link between popular bone-strengthening drugs and irregular heart rhythms during an ongoing safety review.

The Food and Drug Administration advised doctors and patients to continue taking the drugs under investigation, including Merck & Co.'s Fosamax and Novartis AG's Reclast.

The agency began investigating the medications last October, after two studies showed increased rates of irregular heart beats in women taking the drugs for osteoporosis, a condition which primarily affects post-menopausal women and can cause debilitating bone fractures and thinning. (...)

Heart Failure Linked to Higher Hip Fracture Risk
medpagetoday.com 20.10.2008
(...) Patients ages 65 and older who presented to an emergency room for heart failure were four times more likely to suffer a fracture over the next year than patients with other cardiovascular diseases (OR 4.0, 95% CI 3.0 to 5.2), Justin Ezekowitz, M.B.B.Ch., of the University of Alberta here, and colleagues reported online in Circulation: Journal of the American Heart Association.

The risk of hip fracture specifically was increased 6.3-fold (95% CI 3.4 to 11.8). (...)

Bisphosphonates Cause Rare Eye Inflammation
healthfinder.gov 24.9.2008
Finding just latest in list of potential adverse events for bone-saving medications. (...)

Though exceedingly rare -- only four cases have been reported in the medical literature -- inflammatory eye disease may occur soon after an injection of a bisphosphonate, according to a letter in the Sept. 25 issue of the New England Journal of Medicine (NEJM).

"Physicians should be aware of this rare complication of bisphosphonates," wrote the Australian doctors who authored the letter. "Bisphosphonate infusions should be used with caution, or avoided altogether, in patients with acute ocular inflammation or a history of inflammatory eye disease or uveitis." (...)

Medications included in this class of drugs include alendronate (Fosamax), etidronate (Didronel), ibandronate (Boniva), pamidronate (Aredia), risedronate (Actonel), tiludronate (Skelid) and zoledronic acid (Reclast, Zometa). (...)

Not all potential side effects of bisphosphonates resolve so quickly, however. One of the most serious complications arising from the use of these medications is osteonecrosis of the jaw (ONJ). Symptoms of ONJ include pain, exposed bone and loosening of the teeth, according to the American Dental Association. (...)

Another potential side effect from these medications is an unusual type of fracture of the thigh bone that many women didn't even know occurred, according to the researchers who first reported this side effect in the March 20 issue of the New England Journal of Medicine. (...)

FDA staff note deaths in Pfizer bone drug study
reuters.com 4.9.2008
WASHINGTON (Reuters) - Osteoporosis patients given a low dose of an experimental Pfizer Inc pill were more likely to die within five years than others who got a placebo, U.S. drug reviewers said in an analysis released on Thursday.

An increased death rate for women who took the highest dose of the drug Fablyn was not statistically significant in the company study, Food and Drug Administration reviewers said. That means the difference could have been due to chance. (...)

Cola May Be Bad to the Bones
healthfinder.gov 28.4.2008
Research suggests the beverage contributes to osteoporosis.

SATURDAY, April 26 (HealthDay News) -- While enjoying a cola or two every day might seem harmless enough, recent research suggests that those tasty drinks could be compromising your bone health. (...)

Results of the study were published recently in the American Journal of Clinical Nutrition. (...)

Another important way to prevent osteoporosis, according to Raisz, is to exercise. (...)

Heart Failure Drugs Linked to Hip Bone Loss in Older Men
healthfinder.gov 15.4.2008
Loop diuretics more than double risk for fractures, study finds. (...)

"Our findings suggest that health care providers should take into account loop diuretic use when evaluating older men for risk factors for bone loss and fracture risk," they said.

The study was published in the April 14 issue of the Archives of Internal Medicine. (...)

Beinskjøre er redde for å gå ut
dagbladet.no 27.3.2008
Men trim forebygger «sprøhet».
HOLDER SEG HJEMME: Eldre beinskjøre mennesker blir sittende isolert hjemme om vinteren fordi de er redde for glatte fortau. Men de fleste brudd skjer i hjemmet. (...)

Thyroid Hormone Could One Day Treat Osteoporosis (Thyreoideahormon kan en dag behandle benskjørhet)
healthfinder.gov 10.3.2008
Animal experiments show thyroid stimulating hormone prevented bone loss. (...)

"We found that TSH, which is a hormone that was thought to be exclusively involved in the release of thyroid hormones, which are essential for the homeostasis of the body, can directly affect bone remodeling," said lead researcher Dr. Mone Zaidi, a professor of medicine and physiology and director of the Mount Sinai Bone Program at Mount Sinai School of Medicine in New York City.

TSH inhibits the process of bone reabsorption by the body, Zaidi said. "This is a process that is fundamental for the renewal of the skeleton. Throughout life, old bone is replaced by new bone," he said. "Osteoporosis occurs when this process is exaggerated, and bone removal outpaces bone replacement." (...)

The findings were published in the March 10 issue of the Proceedings of the National Academy of Sciences. (...)

Stærkt stigende hyppighed af hoftebrud i Danmark fra 1977 til 1999
Ugeskr Læger 2008;170(8):621 -623
Konklusion: Antallet af hoftebrud er steget frem til ca. 1995 i Danmark for herefter at stagnere. På grund af det høje antal hoftebrud er der brug for en multifacetteret strategi, der omfatter almen praksis, hjemmepleje, plejehjem, ortopædkirurgien og de medicinske specialer, for at nedbringe antallet af hoftebrud. (...)

Fosamax Users Seek Class-Action Status
biz.yahoo.com 30.11.2008
Fosamax Users See Class-Action Status Against Osteoporosis Drug
NEW YORK (AP) -- Lawyers for Fosamax users who believe their jaws were damaged by the osteoporosis drug on Friday asked a federal judge to order Merck & Co. to provide a dental monitoring program for the drug's users.
The lawyers made the suggestion to U.S. District Judge John F. Keenan as they argued for the case to be certified as a class-action, in order to pursue claims by users who believe the drug caused osteonecrosis of the jaw, a condition in which portions of the jaw bone die, sometimes leaving the bone exposed. (...)

Shifting the focus in fracture prevention from osteoporosis to falls
BMJ 2008;336:124-126 (19 January)
Preventing fractures in older people is important. But Teppo Järvinen and colleagues believe that we should be putting our efforts into stopping falls not treating low bone mineral density (...)

Summary points
Falling, not osteoporosis, is the strongest single risk factor for fractures in elderly people (...)
General practitioners should shift the focus in fracture prevention by systematically assessing risk of falling and providing appropriate interventions to reduce the risk (...)

Watchdog under fire over 'dead jaw' drug fears
abc.net.au 12.12.2007
Law firms are urging victims to join a class action against pharmaceutical giant Merck, manufacturer of the most popular of the drugs, Fosamax (...)

The Therapeutic Goods Administration (TGA), is under fire after revelations that pharmaceutical companies failed to provide adequate warnings about a ghastly side effect from a range of popular drugs which treat osteoporosis and cancer.
Last night ABC TV's The 7.30 Report revealed that increasing numbers of Australians are falling victim to a side effect known as osteonecrosis of the jaw. (...)

Bisphosphonates marketed as Alendronate (Fosamax, Fosamax Plus D), Etidronate (Didronel), Ibandronate (Boniva), Pamidronate (Aredia), Risedronate (Actonel, Actonel W/Calcium), Tiludronate (Skelid), and Zoledronic acid (Reclast, Zometa)
fda.gov 1.1.0.2007
[Posted 10/01/2007] FDA issued an early communication about the ongoing review of new safety data regarding the association of atrial fibrillation with the use of bisphosphonates. Bisphosphonates are a class of drugs used primarily to increase bone mass and reduce the risk for fracture in patients with osteoporosis, slow bone turnover in patients with Paget’s disease of the bone, treat bone metastases, and lower elevated levels of blood calcium in patients with cancer. (...)

Diabetes drug may hike osteoporosis risk
New research finds long-term use of Avandia can lead to brittle bones

msnbc.msn.com 2.12.2007
WASHINGTON - The popular diabetes drug marketed as Avandia may increase bone thinning, a discovery that could help explain why diabetics can have an increased risk of fractures.

New research raises the possibility that long-term treatment with rosiglitazone, as Avandia is also called, could lead to osteoporosis. The diabetes drug is used to improved response to insulin.

While bones seem solid, they constantly are being broken down and rebuilt by the body. Researchers found that in mice, the drug increased the activity of the cells that degrade bones, according to a report in this week’s online issue of Nature Medicine. (...)

Depression Linked to Bone Loss in Younger Women
healthfinder.gov 26.11.2007
Finding could aid efforts to prevent osteoporosis, researchers say.

MONDAY, Nov. 26 (HealthDay News) -- Premenopausal women struggling with depression have lower bone mass than do non-depressed women in the same age range, a new study found.

The bone loss was most pronounced in certain regions of the hip, which is troubling given that hip fractures are one of the most serious -- and potentially fatal -- consequences of osteoporosis. (...)

Varningar för nytt benskörhetsmedel
lakemedelsvarlden.se 19.11.2007
Benskörhetsläkemedlet Protelos kan ge allvarliga biverkningar på huden. Europeiska läkemedelsverket har gått igenom de fall som hittills rapporterats in och varnar nu för biverkningarna. (...)

(Anm: Protelos försvinner från marknaden den 1 september 2017 Marknadsförande företag har meddelat den europeiska läkemedelsmyndigheten EMA att de slutar marknadsföra och tillhandahålla läkemedlet Protelos. Skälet är sjunkande försäljning. Läkemedlet Protelos är godkänt för behandling av svår osteoporos med hög risk för frakturer, när andra läkemedel som är godkända för behandling av osteoporos inte kan användas. Marknadsförande företag kommer att sluta marknadsföra Protelos och det finns därefter inget läkemedel kvar på marknaden med den aktiva substansen strontiumranelat. Läkemedelsverket har tidigare informerat om risken för hjärtkärlbiverkningar med Protelos och användningen har stramats upp. Se information under "Relaterad information" i högermarginalen. (lakemedelsverket.se 1.9.2017).)

Måling av østrogen identifiserer ikke økt risiko for beinbrudd
Tidsskr Nor Lægeforen 2007; 127: 2494 (4.10.2007)
Beinskjørhet er et folkehelseproblem, og Norge har verdens høyeste forekomst av brudd. Østrogen er viktig i beinomsetning, men hva det betyr for beinhelsa i en befolkning, er uklart. (...)

Prozac May Weaken Kids' Bones
cbsnews.com 11.11.2004
Latest Bad News For SSRI Antidepressant Use In Children (...)

SSRI Use in Older Women Linked to Accelerated Hip Bone
medscape.com 6.7.2007
July 6, 2007 — In a large observational study of older women — the Study of Osteoporotic Fractures (SOF) — the use of selective serotonin reuptake inhibitor (SSRI) antidepressants but not tricyclic antidepressants (TCAs) was associated with increased hip bone loss.

The study is published in the June 25 issue of the Archives of Internal Medicine. (...)

Aging: Some Antidepressants Tied to Bone Loss, Findings Show
VITAL SIGNS
nytimes.com 10.7.2007
Two new studies have found that the use of the antidepressants called S.S.R.I.’s is associated with an increased rate of bone density loss in older people. (...)

SSRIs Chase Depression But Bones May Pay Price
medpagetoday.com 27.6.2007
(...) In an almost five-year longitudinal study, women taking SSRIs lost twice as much bone density at the hip compared with women taking other antidepressants or none at all, said Susan J. Diem, M.D., of the University of Minnesota here, and colleagues.

The findings emerged from a prospective cohort study of 2,722 community-dwelling older women (mean age 78.5 years) enrolled in the Study of Osteoporotic Fractures.

The women were recruited from 1997 through 1999. Depressive symptoms were identified using a cutoff score of at least six on the Geriatric Depression Scale. SSRIs included a range of drugs, such as Prozac, Paxil, and Zoloft.

After adjustment for potential confounders, at a mean 4.9 years from baseline, among 198 (7.3%) of the SSRI users, bone mineral density at the hip decreased 0.82% per year (P<0.001). (...)

(Anm: Konfunder – ikke confounder – på norsk. Et av de viktigste begrepene i epidemiologi er «confounder». På norsk bør det skrives «konfunder». Når noen påstår at en faktor A er årsak til en effekt B, lurer vi på om det finnes en faktor som kan påvirke både A og B og derved tilsløre en reell årsakssammenheng (1). Denne faktoren kalles på engelsk «confounder» eller «confounding factor». Det dreier seg om kjente eller ukjente bakenforliggende forhold som kan påvirke utfallet og som er ulikt fordelt mellom eksponerte og ikke-eksponerte (2). Eksempel: Er vindrikking (faktor A) årsak til bedre helse (effekt B)? Kanskje, men det finnes selvsagt en rekke bakenforliggende variabler, f.eks. sosial klasse, som kan være den egentlige forklaringen. Vi kan også snakke om spuriøs sammenheng. Det er betegnelsen på en skinnsammenheng som fremstår som ekte årsakvirkning-forhold, men ikke er det. Det er en bakenforliggende variabel, en «confounder», som er den egentlige årsaken til sammenhengen (3, 4). Tidsskr Nor Legeforen 2013; 133:2280  (12.11.2013).)

Antidepressants Linked to Bone Loss
healthfinder.gov 25.6.2007
2 studies turn up similar results in both women and men.
(SOURCES: Susan J. Diem, M.D., assistant professor of medicine, University of Minnesota School of Medicine, Minneapolis; June 25, 2007, Archives of Internal Medicine)

MONDAY, June 25 (HealthDay News) -- Older men and women who take the class of antidepressants known as selective serotonin reuptake inhibitors may have an increased rate of bone loss. (...)

"People currently on SSRIs should not stop their medicines based on these findings," said Dr. Susan Diem, lead author of the study looking at women, and assistant professor of medicine at the University of Minnesota School of Medicine. "These findings are preliminary, and further research is needed before any firm conclusions can be drawn."

The results of both studies are published in the June 25 issue of Archives of Internal Medicine. (...)

Commonly used antidepressants linked to bone loss in older adults
insidermedicine.ca 25.6.2007
(Insidermedicine) Men and women taking antidepressant medications, known as selective serotonin reuptake inhibitors, may experience increased bone loss, according to two articles published in the Archives of Internal Medicine. (...)

It was found that unlike tricyclic antidepressant use, taking SSRIs was associated with an increased rate of hip bone loss.

One potential explanation is that SSRIs may affect the function of osteoclasts and osteoblasts, bone cells that are responsible for breaking down and rebuilding bone. (...)

Kjønnshormoner varsler ikke beinskjørhet
forskning.no 21.6.2007
Måling av østrogennivåer kan ikke brukes for å identifisere kvinner og menn med økt risiko for beinskjørhet.

Åshild Bjørnerem forsket på sammenhengen mellom beinskjørhet og østrogennivå. (...)

Likevel innsyn i dokumentasjon av generika?
Tidsskr Nor Lægeforen 2007; 127: 1669 (14.6.2007)
Sivilombudsmannen støtter kravet om innsyn i dokumentasjon for generiske legemidler og ber departementet vurdere vedtaket om alendronatgenerika på ny. (...)

Depression-osteoporosis link still unclear
uk.reuters.com 11.6.2007
NEW YORK (Reuters Health) - Older women who take certain antidepressants are at increased risk of fracturing a bone, but it's not clear whether the association is due to the drugs, depression itself, or some other factor, according to a new report in the Harvard Women's Health Watch.

Nevertheless, while women shouldn't stop taking antidepressant drugs for the sole reason of protecting their bones, those who suffer from depression should get their bone mineral density (BMD) checked out, the report's authors state. (...)

Nevertheless, the Harvard newsletter article authors point out that there have been reports since the 1990s linking depression in women, even younger women in whom thinning bones is relatively rare, to lower bone mineral density (BMD). One of these studies found depressed women had higher levels of the stress hormone cortisol, which contributes to bone loss. (...)

Antidepressant Use May Boost Fracture Risk, From Harvard Women's Health Watch
medicalnewstoday.com 30.5.2007
Evidence is accumulating that depression is a risk factor for osteoporosis, reports the June 2007 issue of Harvard Women's Health Watch. A recent study found that people ages 50 and over who regularly took antidepressants called selective serotonin reuptake inhibitors (SSRIs) had double the rate of fractures as people not using such medications. Other research points to depression itself as a source of endocrine changes that can damage bone. (...)

Evidence is accumulating that depression is a risk factor for osteoporosis, reports the June 2007 issue of Harvard Women's Health Watch. A recent study found that people ages 50 and over who regularly took antidepressants called selective serotonin reuptake inhibitors (SSRIs) had double the rate of fractures as people not using such medications. Other research points to depression itself as a source of endocrine changes that can damage bone. (...)

Benskörhet kostar miljarder
netdoktor.passagen.se 4.6.2007
Frakturer vilka orsakas av benskörhet kostade samhället 5,4 miljarder kronor under 2006. Det visar en studie från bland annat Karolinska Institutet.

orskarna har, vid sidan för direkta vårdkostnader även inkluderat kostnader för sjukskrivning, produktionsbortfall och liknande. Den största kostnadsbördan drabbas kommunerna som enligt beräkningarna får ta 66 procent av kostnaderna för osteoporosfrakturer. (...)

Bone drugs may lead to irregular heart rhythms
msnbc.msn.com 2.5.2007
Findings involve small number of women who take Reclast, Fosamax

Two research reports suggest a possible link between two bone-building drugs and irregular heart rhythms in a small number of women who take the medicine.

The signs of a problem were more pronounced with Reclast, a drug made by Novartis AG and given through a once-a-year, 15-minute intravenous infusion. But there was a hint of similar trouble in a few women who took the leading osteoporosis pill, Fosamax by Merck & Co. The two drugs are in the same class. (...)

Cystic Fibrosis Can Harm Kids' Bones
healthfinder.gov 1.5.2007
Other risk factors may aggravate the condition, findings show (...)

Astronauter blir benskjøre
vg.no 22.1.2007
Astronauter har tolv ganger så stort tap av benmasse som postmenstruelle kvinner. (...)

Benskörhet fall för tandläkaren
svd.se 7.1.2007
Låt en extra röntgenbild av käken vid tandläkarbesöket avslöja om patienten lider av benskörhet. Det föreslår en grupp tandläkare i fem länder, däribland Sverige. Urkalkningen ger ofta problem även med tänderna. (...)

Idén är att dra nytta av att de flesta regelbundet går för att få sina tänder undersökta.

Med modern teknik går det att mer eller mindre automatiskt ta en bild som visar tätheten i benet i underkäken. (...)

Osteoporosis Drug has Lasting Effects
ivanhoe.com 27.12.2006
-- Five years may be long enough for some women taking alendronate (Fosamax) to treat osteoporosis. (...)

SOURCE: The Journal of the American Medical Association, 2006;296:2927-2938, 2968-2969. (...)

Cola skader kvinders knogler
bt.dk 8.10.2006
Cola er skadeligt for kvinders knogler og øger risikoen for knogleskørhed. Det viser en ny amerikansk undersøgelse. (...)

Cola-ingrediensen fosforsyre er måske skyld i forbindelsen, men det er ikke bevist.

- Vi tror, at når cola bliver drukket dagligt, så bliver der skabt et syreholdigt miljø i blodet. Blodet trækker derefter calcium ud af knoglerne for at skabe en balance i blodet. Men den påstand er kontroversiel, siger professoren bag undersøgelsen. (...)

Drinking cola linked to loss of bone density
netdoctor.co.u 6.10.2006
Drinking cola could cause a reduction of bone density in women, leading to an increased risk from osteoporosis, new research suggests.

In a US study, it was found that drinking as little as four cans of cola a week led to significantly lower bone mineral density in women, although similar effect was found in men.

A total of 2,500 subjects were used in the study, carried out be researchers from the Jean Mayer Human Nutrition Research Centre. (...)

Study: Osteoporosis Shot Reduces Breaks
forbes.com 16.9.2006
An experimental treatment for bone-thinning osteoporosis appears to prevent spine and hip fractures even though it is given only once a year, eliminating the need for a strict daily pill regimen, preliminary data show.

Reclast, given as an annual, 15-minute infusion, reduced risk of new spine fractures by 70 percent and of hip fractures by 40 percent, according to data supplied by maker Novartis Pharmaceuticals Corp. The drug, chemically known as zoledronic acid, also reduced the risk of fractures elsewhere, according to a just-completed, international study of 7,736 postmenopausal women with osteoporosis.

Side effects were generally minor and short-lived, said Novartis, of East Hanover, N.J.

The data, from final-stage human testing, was to be presented Saturday at the annual meeting of the American Society of Bone and Mineral Research in Philadelphia.

"This is very good news," said Dr. Ethel Siris (SEYE' riss), president of the National Osteoporosis Foundation and director of the Osteoporosis Center at Columbia University. (...)

Sally Field Brings Osteoporosis to Center Stage
healthfinder.gov 21.4.2006
'Norma Rae' star takes on another fight, this time for bone health.

According to the Foundation for Osteoporosis Research and Education (FORE), 44 million Americans -- 80 percent of them women -- now face the prospect of serious bone loss. Ten million patients are already diagnosed with the illness, while another 34 million suffer from low bone density, which can lead to osteoporosis.

If left unchecked, this progressive and initially painless disease leads to increasing bone fragility that can ultimately result in fractures -- most commonly of the hip, spine and wrist. Height loss, severe back pain and long-term disability can result, often requiring hospitalization and surgery. (...)

D-vitamin hjelper mot benskjørhet
dagbladet.no 27.12.2005
Åsa Rytter Evensen Bydelsoverlege
I Norge finnes ca. 250 000 benskjøre kvinner. De færreste vet selv om det. På en konferanse i Dublin var det full enighet om at en daglig dose D-vitamin er et enkelt tiltak i forebyggelse av brudd og bedring av livskvalitet.

SAMMEN MED EKSPERTER fra hele Europa har jeg deltatt på en konferanse i Dublin der hensikten var å komme til enighet om betydningen av D-vitamin i forebyggelse og behandling av osteoporose/benskjørhet. I sitt foredrag sa lederen for den irske osteoporoseforeningen, professor O% Brien, at «benskjørhet er en sykdom som, når den fører til brudd, representerer en enorm medisinsk, sosial og økonomisk belastning for ethvert samfunn. Pasienter med osteoporose belegger til enhver tid akuttsenger på landets sykehus.»

I Norge er gjennomsnitts liggetid for benbrudd på grunn av benskjørhet 12,7 dager. Det betyr at minst 250 sykehussenger er belagt av en osteoporosepasient til enhver tid. Lårhalsbrudd alene koster årlig 1,3 milliarder kroner i Norge. (...)

(Anm: Halvdelen af alle nyfødte mangler D-vitamin. Mangel på D-vitamin kan give spædbørn nedsat vækst og svage knogler. (dr.dk 5.1.2016).)

(Anm: D-vitaminer mot irritabel tarm. En ny studie viser at mange med irritabel tarm også har mangel på vitamin D. Irritabel tarm (IBS) er en forstyrrelse i tarmens funksjon. Kjennetegnene er magesmerter, ubehag, oppblåsthet og forstyrret avføringsmønster med diaré eller forstoppelse. (nhi.no 13.1.2016).)

(Anm: D-vitaminer under graviditeten kan mindske risiko for ADHD. Hvis mor tager D-vitaminer, når hun er gravid, ser det nemlig ud til at give færre tegn på ADHD, viser et nyt studie fra Odense Børnekohorte. Det skriver Syddansk Universitet (SDU) i en pressemeddelelse. (videnskab.dk 4.10.2016).)

Flitigt fikande ökar frakturrisk
unt.se 10.5.2006
Kvinnor som dricker minst fyra koppar kaffe per dag drabbas oftare än andra kvinnor av frakturer, i synnerhet om de dessutom konsumerar låga mängder kalk.

Det framgår av en ny svensk studie, som publiceras i nätupplagan av facktidskriften Osteoporosis International.

— Våra resultat talar för att ett högt intag av kaffe kan måttligt öka risken för benskörhetsfrakturer. Men vi vet ännu alldeles för litet om detta samband för att kunna gå ut med några särskilda rekommendationer kring kaffedrickande, säger Helena Hallström, toxikolog vid Livsmedelsverket i Uppsala.

Studien, som genomförts i samarbete med forskare vid Akademiska sjukhusets ortopedklinik och Karolinska Institutet i Stockholm, bygger på uppgifter om nära 32 000 medelålders och äldre kvinnor i Uppsala. (...)

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