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Challenging Cases in Osteoporosis: Tips from an Expert

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Using three complicated patient cases, Kenneth G. Saag, MD, MSc, shared his expertise on osteoporosis and walked through his thought process and the literature, during a session of the 2022 ACR Education Exchange.

Denosumab vs. Zoledronate: An Analysis of Treatments for Low Bone Mineral Density in Patients with HIV

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In a small study of men with low bone mineral density (BDM) living with HIV and taking anti-retroviral therapy, both zoledronate or denosumab were well tolerated and effective for bone mineral density of the lumbar spine and femoral neck.

Case Report: Rheumatoid Arthritis Complicated by Large Granular Lymphocytic Leukemia

Nam D. Nguyen, DO (Maj., USAF, MC), Erica Hill, DO (Lt. Col., USAF, MC), & Jay Higgs, MD (Col. [ret], USAF, MC)  |  

Large granular lymphocytic (LGL) leukemia is a rare, chronic, lymphoproliferative disorder of cytotoxic T cell or natural killer cell lineage with an annual incidence of 0.72 cases per 1 million people in the U.S.1 The most common sub­type of LGL leukemia, T-LGL leukemia, follows an indolent disease course and accounts for approximately 85% of cases….

Osteoporosis Experts Discuss Bisphosphonate Holidays

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ACR CONVERGENCE 2020—Bisphosphonates are an important treatment for millions of older Americans with osteoporosis because the drugs inhibit osteoclastic bone resorption to reduce the risk of painful, debilitating fractures.1 More than 20 years ago, data emerged that bisphosphonates have a long terminal half-life.2 So after years of therapy, could some patients take a drug holiday?…

Zoledronate After Denosumab Does Not Fully Prevent Bone Loss

Marilynn Larkin  |  

NEW YORK (Reuters Health)—In postmenopausal women and men treated for at least two years with denosumab, a single infusion of zoledronate given after denosumab discontinuation does not completely prevent bone turnover and loss, researchers say. Given the findings, “bone mineral density (BMD) should probably be higher than the current target for discontinuation of bisphosphonate treatment…

Analysis of National & Local Coverage Determinations

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The Medicare statute states that items and services provided to beneficiaries must be “reasonable and necessary” to qualify for reimbursement. Although the Medicare program determines in specific cases whether an item or service is reasonable and necessary, it also issues policies, called coverage determinations, to instruct Medicare Administrative Contractors (MACs) what to reimburse providers for….

Denosumab Tied to Infection Risk

Marilynn Larkin  |  

NEW YORK (Reuters Health)—The osteoporosis drug denosumab is associated with a higher incidence of serious infections compared with placebo, but the risk is similar to comparator drugs, a systematic review and meta-analysis reveals. Talia Diker-Cohen, MD, PhD, of Tel Aviv University, and colleagues searched the literature through May 2019 for randomized controlled trials of denosumab…

High-Dose Teriparatide with Denosumab Gives Bigger BMD Boost

Anne Harding  |  

NEW YORK (Reuters Health)—Adding high-dose teriparatide to denosumab therapy leads to substantially greater increases in bone-mineral density (BMD) than combination therapy with low-dose teriparatide, a new phase 4 study shows. “The combination of denosumab and teriparatide, particularly with high-dose teriparatide of 40 ug daily, may be of benefit to patients at very high risk of…