Osteoporosis: Gangji V

Bergmann P, Body JJ, Boonen S, Boutsen Y, Devogelaer JP, Goemaere S, Kaufman JM, Reginster JY, Gangji V, Anonymous00023. · Laboratory of Clinical Chemistry, CHU Brugmann, Université Libre de Bruxelles, Bruxelles, Belgium. · Int J Clin Pract. · Pubmed #19125989 links to  free full text

Abstract: OBJECTIVES: To review the clinical value of bone turnover markers (BTM), to initiate and/or monitor anti-resorptive treatment for osteoporosis compared with bone mineral density (BMD) and to evaluate suitable BTM and changes in BTM levels for significance of treatment efficiency. METHODOLOGY: Consensus meeting generating guidelines for clinical practice after review and discussion of the randomised controlled trials or meta-analyses on the management of osteoporosis in postmenopausal women. RESULTS: Although the correlation between BMD and BTM is statistically significant, BTM cannot be used as predictive markers of BMD in an individual patient. Both are independent predictors of fracture risk, but BTM can only be used as an additional risk factor in the decision to treat. Current data do not support the use of BTM to select the optimal treatment. However, they can be used to monitor treatment efficiency before BMD changes can be evaluated. Early changes in BTM can be used to measure the clinical efficacy of an anti-resorptive treatment and to reinforce patient compliance. DISCUSSION: Determining a threshold of BTM reflecting an optimal long-term effect is not obvious. The objective should be the return to the premenopausal range and/or a decrease at least equal to the least significant change (30%). Preanalytical and analytical variability of BTM is an important limitation to their use. Serum C-terminal cross-linked telopeptide of type I collagen (CTX), procollagen 1 N terminal extension peptide and bone specific alkaline phosphatase (BSALP) appear to be the most suitable. Conclusion: Consensus regarding the use of BTM resulted in guidelines for clinical practice. BMD determines the indication to treat osteoporosis. BTM reflect treatment efficiency and can be used to motivate patients to persist with their medication.

Appelboom T, Gangji V, Margaux J, Steinfeld S. · No affiliation provided · Rev Med Brux. · Pubmed #12584936 No free full text.

Abstract: Actually, 18 rheumatologists and specialists in physical therapy are collaborating in the Department, allowing to develop possibilities for the diagnosis and therapeutic challenge of patients suffering from disorders of the locomotor system. Accordingly, the knowledge, the know-how, the experience plus the willingness to make a good job are used for helping the patient, for contributing to medical progress and also for the education of future medical doctors. Our department has significantly contributed to a better understanding and therapeutic approach of rheumatoid arthritis, Sjogren's syndrome, aseptic necrosis, osteoporosis, osteoarthritis, and inflammation; it has been among the first in the world to offer new therapeutic modalities, otherwise not accessible and, to help a series of hopeless patients. In addition, a new sector for a performing rehabilitation has been recently developed. Accordingly, during these mast twenty years, a performing department with a motivated team has been developed offering a maximum of medical services for the community and ready for the challenges of tomorrow.

Gangji V, Appelboom T. · Rheumatology Department, H pital Erasme, Université Libre de Bruxelles, Brussels, Belgium. · Clin Rheumatol. · Pubmed #11206358 No free full text.

Abstract: Pamidronate, a bisphosphonate analogue has been evaluated in a retrospective study for its analgesic effect on chronic back pain due to vertebral fractures in 26 patients suffering from senile osteoporosis or glucocorticoid-induced osteoporosis. Sixty milligrams of pamidronate was administered intravenously every 3 months for one year. After three months of treatment, the pain score fell from 3.2 +/- 0.1 to 1.2 +/- 0.2 in both groups. In conclusion, intravenous pamidronate seems to be a valuable treatment for chronic back pain due to osteoporotic vertebral fractures.