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References

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Case Study Answers

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Evidence bases atricle

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QJM: An International Journal of Medicine | Oxford Academic

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QJM publishes peer-reviewed articles on internal medicine, which promote medical science and practice. The journal accepts original papers, editorials, reviews, commentary papers to air controversial issues, and correspondence.

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Case Study

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All joints consist of bone, particularly subchondral bone to which the articular cartilage is attached. This articular cartilage is lubricated, smooth tissue that protects the bone from damage from physical activity. Between the articular cartilage of the bones forming the joint is a space called the joint space, that allows for movement. To aid in fluidity, each joint contains synovial fluid to help lubricate and protect the joint's movement. With osteoarthritis, the articular cartilage breaks down, leading to progressive damage to the underlying bone and eventual formation of osteophytes (bone spurs) that protrude into the joint space. The result is that the joint space is narrowed, leading to decreased joint movement and potential for more damage. Consequently, the joint can progressively degenerate.

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Osteoporosis is characterized by reduced bone mass, deterioration of bone matrix, and diminished bone architectural strength. Normal homeostatic done turnover is altered; the rate of bone resorption that is maintained by osteoclast is greater than the rate of bone formation that is maintained by osteoblasts, resulting in a reduced total bone mass. The bones become progressively porous, brittle, and fragile; they fracture easily under stresses that would not break normal bone. This occurs most commonly as compression fractures of the thoracic and lumbar spine, hip fractures, and Colles fractures of the wrist. These fractures may be the first clinical manifestation of osteoporosis

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NCLEX Answers

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New osteoporosis medication

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Early results indicate romosozumab can rebuild bone
From the WebMD Archives

By Dennis Thompson

HealthDay Reporter

THURSDAY, Jan. 2, 2014 (HealthDay News) -- A new medication for osteoporosis prompts the body to rebuild bone and could potentially strengthen the skeleton against fractures, researchers report.

The experimental drug, romosozumab, frees the body's ability to stimulate bone production by blocking biochemical signals that naturally inhibit bone formation, explained Dr. Michael McClung, founding director of the Oregon Osteoporosis Center in Portland, Ore.

The treatment is one-and-a-half to three times more effective than current osteoporosis drugs in rebuilding bone density at the lumbar spine, according to clinical trial results McClung and his colleagues reported in the Jan.1 online edition of the New England Journal of Medicine.

"Most osteoporosis drugs work by stopping the progression of bone loss, but they don't have the capability of rebuilding the skeleton," McClung said. "This really is a new day in the consideration of how we treat osteoporosis, with the capability of truly stimulating bone production and rebuilding the skeleton, not simply keeping it from getting worse."

More research is needed, however, before romosozumab is approved to treat osteoporosis, a serious bone-thinning disease, in the United States.

The new drug uses an antibody to block the function of sclerostin, a protein the body produces to naturally inhibit bone growth.

Without sclerostin, overactive bone growth might clamp off nerves or end up fusing the spinal column, said Dr. Robert Recker, president of the National Osteoporosis Foundation and director of the Osteoporosis Research Center at Creighton University in Omaha, Neb.

But sclerostin also prevents people with osteoporosis from building additional bone density to replace the bone that has been lost.

The antibody romosozumab binds to sclerostin and prevents its signal, which allows pro-bone-growth signals to proceed uninterrupted, the researchers explained.

This phase 2 clinical trial involved more than 400 postmenopausal women aged 55 to 85 who had osteopenia, which is low bone mass that is not low enough to be classified as osteoporosis. They were randomly assigned to receive one of four treatments for a year: romosozumab; a placebo; or one of two current osteoporosis medications.

Continued

Results showed that romosozumab increased bone mineral density in the spine by 11.3 percent during the study period, compared with a 7.1 percent increase with teriparatide ( Forteo), a current osteoporosis treatment. The new drug also performed much better than alendronate ( Fosamax), a bisphosphonate medication that increased spinal bone density by 4.1 percent.

"In terms of rebuilding bone mass, this is clearly better than Forteo or the bisphosphonates," said Recker, who was not involved with the study.

The new drug also appears to be safe, with no major side effects reported, McClung said.

Recker expects that the antibody medication will prove safe because the bone-building signals that are left uninhibited by the drug will taper off naturally as the skeleton becomes better able to withstand weight loads and stresses. "I think it's going to be self-regulating," he said.

The drug is still several years from coming to market, McClung noted. Researchers have to prove to the U.S. Food and Drug Administration that it actually protects against bone fractures, which will require more research.

But onlookers are enthusiastic regarding the potential of romosozumab.

"This possibly represents the most important change in treatment of osteoporosis that we've seen," Recker pointed out. "We've not been able to have a strongly bone-building product available to us. There's no reason not to believe it will prevent fractures, but that has to be proven."

According to the National Osteoporosis Foundation, half of all Americans over age 50 are expected to have low bone density or osteoporosis by 2020.

WebMD News from HealthDay

Sources

SOURCES: Michael McClung, M.D., founding director, Oregon Osteoporosis Center, Portland, Ore.; Robert Recker, M.D., president, National Osteoporosis Foundation and director, Osteoporosis Research Center, Creighton University, Omaha, Neb.; Jan. 1, 2014, New England Journal of Medicine, online

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Novel Osteoporosis Drug Could Change Treatment: Study

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Early results indicate romosozumab can rebuild bone From the WebMD Archives By Dennis Thompson HealthDay Reporter THURSDAY, Jan. 2, 2014 (HealthDay News) -- A new medication for osteoporosis prompts the body to rebuild bone and could potentially strengthen the skeleton against fractures, researchers report.

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New osteoarthritis medication

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Vivlodex New FDA Drug Approval | CenterWatch

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Vivlodex (meloxicam) : For the management of osteoarthritis pain. New approved drug details including side effects, uses and general information.

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How Osteoarthritis Develops Animation - Causes & Symptoms of Osteoarthritis - Knee Pain Video

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Osteoarthritis is the most common form of arthritis and is associated with the aging process. Osteoarthritis is a chronic disease causing the deterioration of the cartilage within a joint. For most people, the cause of osteoarthritis is unknown, but metabolic, genetic, chemical, and mechanical factors play a role in its development.

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This is an 3D medical animation video to show what is osteoporosis and how it cause weakness to bone and the effect of osteoblast and osteoclast cells in it.also it shows the later stage and diagnosis of osteoporosis Please note that this video is not my copyrighted material.I am just sharing my collection from internet.So the credit goes to the real copyright owners.