Bone Quality and Fractures in Women With Osteoporosis Treated With Bisphosphonates for 1 to 14 Years

ABSTRACT Oral bisphosphonates are the primary medication for osteoporosis, but concerns exist regarding potential bone‐quality changes or low‐energy fractures. This cross‐sectional study used artificial intelligence methods to analyze relationships among bisphosphonate treatment duration, a wide var...

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Autores principales:	Hartmut H Malluche, Jin Chen, Florence Lima, Lucas J Liu, Marie‐Claude Monier‐Faugere, David Pienkowski
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	BONE QUALITY OSTEOPOROSIS BISPHOSPHONATES DXA FRACTURE RISK ASSESSMENT Orthopedic surgery RD701-811 Diseases of the musculoskeletal system RC925-935
Acceso en línea:	https://doaj.org/article/2ff53bce97bc4583bf673f5e0fb21c29
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spelling	oai:doaj.org-article:2ff53bce97bc4583bf673f5e0fb21c292021-11-04T12:00:57ZBone Quality and Fractures in Women With Osteoporosis Treated With Bisphosphonates for 1 to 14 Years2473-403910.1002/jbm4.10549https://doaj.org/article/2ff53bce97bc4583bf673f5e0fb21c292021-11-01T00:00:00Zhttps://doi.org/10.1002/jbm4.10549https://doaj.org/toc/2473-4039ABSTRACT Oral bisphosphonates are the primary medication for osteoporosis, but concerns exist regarding potential bone‐quality changes or low‐energy fractures. This cross‐sectional study used artificial intelligence methods to analyze relationships among bisphosphonate treatment duration, a wide variety of bone‐quality parameters, and low‐energy fractures. Fourier transform infrared spectroscopy and histomorphometry quantified bone‐quality parameters in 67 osteoporotic women treated with oral bisphosphonates for 1 to 14 years. Artificial intelligence methods established two models relating bisphosphonate treatment duration to bone‐quality changes and to low‐energy clinical fractures. The model relating bisphosphonate treatment duration to bone quality demonstrated optimal performance when treatment durations of 1 to 8 years were separated from treatment durations of 9 to 14 years. This may be due to a change in relationship of bone‐quality parameters with treatment duration. This model also showed that the effects of bisphosphonate treatment duration were most highly correlated with changes in means and standard deviations of infrared spectroscopically derived mineral and matrix parameters and histomorphometric bone turnover parameters. A second model related treatment duration to bone fracture in all 22 patients who fractured while on treatment with bisphosphonates for more than 8 years. This second model showed that bisphosphonate treatment duration, not hip bone mineral density (BMD), was the most strongly correlated parameter to these low‐energy bone fractures. Application of artificial intelligence enabled analysis of large quantities of structural, cellular, mineral, and matrix bone‐quality parameters to determine relationships with long‐term oral bisphosphonate treatment and fracture. Infrared spectroscopy provides clinically relevant bone‐quality information of which bone mineral purity is among the most relevant. Nine or more years of bisphosphonate treatment was associated with abnormal bone mineral purity, matrix abnormalities, and low‐energy fractures. These data justify limiting bisphosphonate treatment duration to 8 years. © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.Hartmut H MallucheJin ChenFlorence LimaLucas J LiuMarie‐Claude Monier‐FaugereDavid PienkowskiWileyarticleBONE QUALITYOSTEOPOROSISBISPHOSPHONATESDXAFRACTURE RISK ASSESSMENTOrthopedic surgeryRD701-811Diseases of the musculoskeletal systemRC925-935ENJBMR Plus, Vol 5, Iss 11, Pp n/a-n/a (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	BONE QUALITY OSTEOPOROSIS BISPHOSPHONATES DXA FRACTURE RISK ASSESSMENT Orthopedic surgery RD701-811 Diseases of the musculoskeletal system RC925-935
spellingShingle	BONE QUALITY OSTEOPOROSIS BISPHOSPHONATES DXA FRACTURE RISK ASSESSMENT Orthopedic surgery RD701-811 Diseases of the musculoskeletal system RC925-935 Hartmut H Malluche Jin Chen Florence Lima Lucas J Liu Marie‐Claude Monier‐Faugere David Pienkowski Bone Quality and Fractures in Women With Osteoporosis Treated With Bisphosphonates for 1 to 14 Years
description	ABSTRACT Oral bisphosphonates are the primary medication for osteoporosis, but concerns exist regarding potential bone‐quality changes or low‐energy fractures. This cross‐sectional study used artificial intelligence methods to analyze relationships among bisphosphonate treatment duration, a wide variety of bone‐quality parameters, and low‐energy fractures. Fourier transform infrared spectroscopy and histomorphometry quantified bone‐quality parameters in 67 osteoporotic women treated with oral bisphosphonates for 1 to 14 years. Artificial intelligence methods established two models relating bisphosphonate treatment duration to bone‐quality changes and to low‐energy clinical fractures. The model relating bisphosphonate treatment duration to bone quality demonstrated optimal performance when treatment durations of 1 to 8 years were separated from treatment durations of 9 to 14 years. This may be due to a change in relationship of bone‐quality parameters with treatment duration. This model also showed that the effects of bisphosphonate treatment duration were most highly correlated with changes in means and standard deviations of infrared spectroscopically derived mineral and matrix parameters and histomorphometric bone turnover parameters. A second model related treatment duration to bone fracture in all 22 patients who fractured while on treatment with bisphosphonates for more than 8 years. This second model showed that bisphosphonate treatment duration, not hip bone mineral density (BMD), was the most strongly correlated parameter to these low‐energy bone fractures. Application of artificial intelligence enabled analysis of large quantities of structural, cellular, mineral, and matrix bone‐quality parameters to determine relationships with long‐term oral bisphosphonate treatment and fracture. Infrared spectroscopy provides clinically relevant bone‐quality information of which bone mineral purity is among the most relevant. Nine or more years of bisphosphonate treatment was associated with abnormal bone mineral purity, matrix abnormalities, and low‐energy fractures. These data justify limiting bisphosphonate treatment duration to 8 years. © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
format	article
author	Hartmut H Malluche Jin Chen Florence Lima Lucas J Liu Marie‐Claude Monier‐Faugere David Pienkowski
author_facet	Hartmut H Malluche Jin Chen Florence Lima Lucas J Liu Marie‐Claude Monier‐Faugere David Pienkowski
author_sort	Hartmut H Malluche
title	Bone Quality and Fractures in Women With Osteoporosis Treated With Bisphosphonates for 1 to 14 Years
title_short	Bone Quality and Fractures in Women With Osteoporosis Treated With Bisphosphonates for 1 to 14 Years
title_full	Bone Quality and Fractures in Women With Osteoporosis Treated With Bisphosphonates for 1 to 14 Years
title_fullStr	Bone Quality and Fractures in Women With Osteoporosis Treated With Bisphosphonates for 1 to 14 Years
title_full_unstemmed	Bone Quality and Fractures in Women With Osteoporosis Treated With Bisphosphonates for 1 to 14 Years
title_sort	bone quality and fractures in women with osteoporosis treated with bisphosphonates for 1 to 14 years
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/2ff53bce97bc4583bf673f5e0fb21c29
work_keys_str_mv	AT hartmuthmalluche bonequalityandfracturesinwomenwithosteoporosistreatedwithbisphosphonatesfor1to14years AT jinchen bonequalityandfracturesinwomenwithosteoporosistreatedwithbisphosphonatesfor1to14years AT florencelima bonequalityandfracturesinwomenwithosteoporosistreatedwithbisphosphonatesfor1to14years AT lucasjliu bonequalityandfracturesinwomenwithosteoporosistreatedwithbisphosphonatesfor1to14years AT marieclaudemonierfaugere bonequalityandfracturesinwomenwithosteoporosistreatedwithbisphosphonatesfor1to14years AT davidpienkowski bonequalityandfracturesinwomenwithosteoporosistreatedwithbisphosphonatesfor1to14years
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Bone Quality and Fractures in Women With Osteoporosis Treated With Bisphosphonates for 1 to 14 Years

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