Monthly Archives: April 2014

Sprifermin offers benefit for cartilage loss from knee osteoarthritis

April_Part 2_Orthopedic Surgery

In a new study in patients with osteoarthritis (OA) of the knee, at 12 months, total femorotibial cartilage thickness loss was reduced in sprifermin (recombinant human fibroblast growth factor 18)-treated knees compared to placebo-treated knees, with effects being significant in the lateral femorotibial compartment but not in the central femorotibial compartment.

Results published in Arthritis & Rheumatology, a journal of the American College of Rheumatology (ACR), showed that sprifermin dosed at 100µg reduced loss of cartilage thickness and volume in the total femorotibial joint and in the lateral knee compartment (outside of the knee).

The 2010 Global Burden of Disease Study estimates that OA affects 150 million people around the world, with the ACR reporting 27 million Americans over 25 years of age diagnosed with the disease. While OA is the most common cause of physical disability in older adults, studies suggest that the average age at diagnosis is 55 years. No medication or alternative treatment (glucosamine, chondroitin) has shown positive effects on preventing or reversing the structural changes of joint damage caused by OA.

“Currently, no structure-modifying treatment has been approved by U.S. or European Union regulatory bodies,” says lead researcher L.S. Lohmander, M.D., Ph.D., from Lund University in Sweden. “Our trial investigates the safety and efficacy of sprifermin in preventing loss of cartilage due to OA in the knee.”

This proof-of-concept double-blind trial recruited 192 knee OA patients who were randomized to single-ascending doses intra-articular injection of sprifermin or placebo (n= 24) or to multiple-ascending doses of sprifermin or placebo (n= 168). Doses of the drug were administered at 10, 30, and 100μg. Researchers measured cartilage thickness at 6 and 12 months using magnetic resonance imaging (MRI); joint space width by x-ray, and pain was scored using the Western Ontario McMaster Universities (WOMAC) OA index.

Of the patients recruited, 180 completed the trial and 168 were evaluated for cartilage changes. At 12 months, researchers found no change in the thickness of cartilage in the central medial femorotibial compartment in patients injected with sprifermin. However, a reduction in loss of total and lateral femorotibial cartilage thickness and volume was noted in patients injected with 100μg of sprifermin versus placebo. Narrowing of the joint space width was also reduced in the lateral femorotibial compartment for OA patients who received the same dose. The WOMAC pain score improved in all patients, with less improvement shown at 12 months for patients who received 100μg sprifermin compared to placebo.

Dr. Lohmander concludes, “While our trial found no reduction in cartilage thickness in the central femorotibial compartment among subjects in the treatment group, dose-dependent reductions in structural changes were found in participants treated with sprifermin.” The authors found no safety or injection-site issues with sprifermin. Additional clinical studies will be needed to replicate these findings and confirm the optimal dosing.

http://www.medicalnewstoday.com/releases/275618.php

 

Picture courtesy of ryortho.com

 

 

 

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Study of Norwegian students on the impact of computer time on bone mineral density

April_Part 1_Orthopedics_Pediatrics

In boys, higher screen time was adversely associated with bone mineral density (BMD) at all sites even when adjusted for specific lifestyle factors, according to results of a study presented at the World Congress on Osteoporosis, Osteoarthritis and Musculoskeletal Diseases.

The skeleton grows continually from birth to the end of the teenage years, reaching peak bone mass – maximum strength and size – in early adulthood. Along with nutritional factors, physical activity can also greatly impact on this process. There is consequently growing concern regarding the possible adverse effects of sedentary lifestyles in youth on bone health and on obesity.

The Norwegian study explored the hypothesis that greater computer use at weekends is associated with lower BMD. The data was obtained from 463 girls and 484 boys aged 15-18 years in the Tromsø region of Norway. The students participated in the Fit Futures study from 2010-2011 which assessed more than 90% of all first year high school students in the region.

BMD at total hip, femoral neck and total body was measured by DXA (dual-energy X-ray absorptiometry). Lifestyle variables were collected by self-administered questionnaires and interviews, including questions on time per day during weekends spent in front of the television or computer, and time spent on leisure time physical activities. The associations between BMD and screen time were analyzed in a multiple regression model that included adjustment for age, sexual maturation, BMI, leisure time physical activity, smoking, alcohol, cod liver oil and carbonated drink consumption.

Not surprisingly, the researchers found that boys spent more time in front of the computer than girls. As well as high screen time being adversely associated to BMD, in boys screen time was also positively related to higher body mass index (BMI) levels. In contrast to the boys, girls who spent 4-6 hours in front of the computer, had higher BMD than counterparts who spend less than 1.5 hours screen time each day – and this could not be explained by adjustments for the different parameters measured.

Lead author of the study Dr Anne Winther, Arctic University of Norway, Tromsø, stated, “Bone mineral density is a strong predictor of future fracture risk. Our findings for girls are intriguing and definitely merit further exploration in other studies and population groups. The findings for boys on the other hand clearly show that sedentary lifestyle during adolescence can impact on BMD and thus compromise the acquisition of peak bone mass. This can have a negative impact in terms of osteoporosis and fracture risk later in life.”

According to the International Osteoporosis Foundation (IOF), approximately one in five men over the age of fifty worldwide will suffer a fracture as a result of osteoporosis. Very low levels of awareness about osteoporosis risk and bone health in males has prompted IOF to focus on osteoporosis in men as a key World Osteoporosis Day theme in 2014.

 

http://www.medicalnewstoday.com/releases/275114.php

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