Health Tip: Help Prevent Bone Fractures

Health Tip: Help Prevent Bone Fractures

More than 53 million people in the United States have osteoporosis or are at higher risk due to low bone mass, the U.S. National Institutes of Health says.

If you’re at greater risk of osteoporosis, how can you reduce your chances of developing a bone fracture? Here are the agency’s suggestions:

  • Help protect your bones by taking calcium and vitamin D supplements, or by getting enough of these essentials through your diet.
  • Limit salt.
  • Eat enough protein. Women should have 46 grams a day and men should have 56 grams a day.
  • Exercise to build and maintain bone density.
  • Reduce your risk of falling by practicing balance, flexibility and strength exercises.
  • Keep a tidy home, free of clutter that could become a tripping hazard.
Copyright ©2017 HealthDay. All rights reserved.
Bone Drug ‘Holiday’ May Raise Fracture Risk

Bone Drug ‘Holiday’ May Raise Fracture Risk

Osteoporosis patients who take “holidays” from bisphosphonate drugs are at increased risk for fractures, a new study finds.

A six-year follow-up of patients who took a break from the bone-building drugs found 15 percent of them suffered fractures, according to researchers at Loyola University in Maywood, Ill.

“Fracture risk needs to be regularly assessed during the drug holiday and treatment resumed accordingly,” said Dr. Pauline Camacho and her colleagues.

Bisphosphonates, such as alendronate (Fosamax) and risedronate (Actonel), are the most widely prescribed osteoporosis drugs. They are designed to slow or prevent bone loss.

But patients who take these drugs for long periods are typically told to take temporary breaks to prevent rare but serious side effects to the jaw and thighs.

However, there is little data on how long these breaks should last, the researchers explained.

To shed light on the issue, they examined the medical records of patients (371 women, 30 men) with osteoporosis or osteopenia (weak bones but not osteoporosis). Patients took bisphosphonates for an average of 6.3 years before beginning breaks from the drugs.

Over six years, 15.4 percent of the patients suffered fractures after going on their drug holiday. The most common fracture sites were the wrist, foot, ribs and spine. However, foot fractures are not currently considered osteoporosis-related fractures, the researchers noted.

The patients most likely to suffer fractures were older and had lower bone mineral density at the beginning of the study. Patients who suffered fractures were put back on bisphosphonates.

The yearly incidence of fractures ranged from about 4 percent to almost 10 percent, with most occurring during the fourth and fifth years.

“Patients who begin drug holidays at high risk for fracture based on bone mineral density, age or other clinical risk factors warrant close follow-up during the holiday, especially as its duration lengthens,” the researchers said in a university news release.

The study was published recently in Endocrine Practice.

More information

The U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases has more on osteoporosis.

SOURCE: Loyola University Health System, news release, May 4, 2018

Widely Used COPD Meds Tied to Increased Fracture Risk

Widely Used COPD Meds Tied to Increased Fracture Risk

TUESDAY, Feb. 13, 2018 (HealthDay News) — Many patients with chronic obstructive pulmonary disease (COPD) are placed on powerful inhaled corticosteroid therapy to ease symptoms.

But new research suggests the treatment might raise their odds for bone fractures.

Still, the Canadian study wasn’t able to prove cause-and-effect, and the overall risk remained small, said one expert not connected to the study.

“Looking at their data, there would be an estimated 1 [extra] fracture for every 241 patients using high-dose inhaled corticosteroids for over four years,” said Dr. Walter Chua. He’s the senior attending physician for pulmonary care at Northwell Health’s Long Island Jewish Forest Hills hospital in Forest Hills, N.Y.

Chua believes that although steroids may raise bone fracture risk, “patients should not panic as the risk of fracture is small and we have ways of monitoring that risk.”

COPD — often linked to smoking — is a combination of emphysema and chronic bronchitis. It is a progressive, debilitating illness that currently has no cure. COPD remains the number three killer of Americans.

Many COPD patients are given inhaled corticosteroid medications to help alleviate symptoms. But, according to the study team, prior research has suggested that the drugs may reduce bone mineral density, particularly in postmenopausal women.

The new study was led by Dr. Samy Suissa of McGill University in Montreal. His team tracked outcomes for more than 240,000 COPD patients, aged 55 and older, in the Canadian province of Quebec.

During an average follow-up of just over five years, the overall fracture rate was just over 15 people per 1,000 patients per year.

However, the rate was higher among patients who had used inhaled corticosteroids for longer than four years, at daily doses of 1,000 micrograms or more.

Gender didn’t seem to play a role, since the risk rose equally for men and women, Suissa’s team said.

The study appears in the February issue of the journal Chest.

“Since fractures are more frequent in women than men, our study suggests that the excess number of fractures associated with [inhaled corticosteroids] will be greater in women — even though we did not find that the risk increase was particularly higher in women than in men,” Suissa said in a journal news release.

So what does this mean for the many COPD patients who are using corticosteroids?

Dr. Ann Tilley is a pulmonologist at Lenox Hill Hospital, in New York City. She wasn’t involved in the new research, but read over the findings and stressed that it couldn’t prove cause-and-effect.

Information on other patient factors that might raise bone fracture — things like smoking status, obesity and exercise levels — weren’t accounted for, Tilley noted.

Still, “the most important take-home message here is that long-term use of high-dose inhaled steroids may not be without risk,” Tilley said, “and we should try to minimize their use when possible.”

“I would encourage patients to talk to their doctors about their inhalers and ask specifically if they need to be using an inhaled corticosteroid, and if so, could a lower dose be tried,” she said.

Chua agreed, noting that other research has also shown “a slight uptick in the rates of pneumonia [for COPD patients] while on inhaled corticosteroids.”

He believes that for patients with confirmed COPD, “inhalers containing corticosteroids should generally be reserved as a last line of treatment after optimization of other inhaler alternatives.”

And if patients must use steroids, they “should be monitored for bone mineral density and fracture risk, for which we have medications/therapies to help reduce that risk,” Chua said.

More information

The U.S. National Heart, Lung, and Blood Institute has more on COPD.

SOURCES: Walter Chua, MD , senior pulmonary attending physician, Northwell Health’s Long Island Jewish Forest Hills, Forest Hills, NY; Ann Tilley, MD, pulmonologist, Lenox Hill Hospital, New York City; Chest, news release, Feb. 5, 2018

Fracture Risk Higher for Seniors With Diabetes

Fracture Risk Higher for Seniors With Diabetes

Seniors with type 2 diabetes may be at increased risk for fractures. And researchers think they know why.

“Fracture in older adults with type 2 diabetes is a highly important public health problem and will only increase with the aging of the population and growing epidemic of diabetes,” said study author Dr. Elizabeth Samelson.

Samelson and her colleagues used special medical scans to assess more than 1,000 people over a three-year study period. The investigators found that older adults with type 2 diabetes had bone weakness that cannot be measured by standard bone density testing.

“Our findings identify skeletal deficits that may contribute to excess fracture risk in older adults with diabetes and may ultimately lead to new approaches to improve prevention and treatment,” said Samelson, of Hebrew SeniorLife’s Institute for Aging Research in Boston.

Fractures among seniors with osteoporosis — the age-related bone-thinning disease — are a major concern. Such fractures can lead to decreased quality of life, disability and even death, as well as significant health care costs, she said in an institute news release.

Even those with normal or higher bone density than their peers appeared to have a higher fracture risk if they had type 2 diabetes, the researchers said.

Specifically, these people had a 40 percent to 50 percent increased risk of hip fracture, the findings showed. This is considered the most serious type of osteoporosis-related fracture.

The study authors said that better understanding of the various factors that influence bone strength and fractures will aid prevention efforts.

The report was published Sept. 20 in the Journal of Bone and Mineral Research.

More information

The U.S. National Institutes of Health has more on bone health.

SOURCE: Hebrew SeniorLife’s Institute for Aging Research, news release, Sept. 20, 2017

Copyright ©2017 HealthDay. All rights reserved.
Call Now Button