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See detailPolish Validation of the SarQoL®, a Quality of Life Questionnaire Specific to Sarcopenia
Konstantynowicz, J.; Abramowicz, P.; Glinkowski, W. et al

in Journal of Clinical Medicine (in press)

Recently, SarQoL® (Sarcopenia and Quality of Life), a quality of life (QoL) questionnaire specific to sarcopenia, was successfully developed. For practical reasons, there is a great interest in validating ... [more ▼]

Recently, SarQoL® (Sarcopenia and Quality of Life), a quality of life (QoL) questionnaire specific to sarcopenia, was successfully developed. For practical reasons, there is a great interest in validating this questionnaire in other populations. The aim of this cross-sectional study was to translate and adjust the SarQoL® into Polish and to standardize the validity of this method for the assessment of sarcopenic individuals in Poland with regard to psychometric properties. The English version was used for the translation process. A total of 106 community-dwelling Caucasian subjects aged 73.3 5.94 years (65.1% females) were studied, with 60 participants being diagnosed sarcopenic. The translation and cross-cultural adaptation was carried out in five phases according to specific standard guidelines. There were no major linguistic issues in the translation process. The data confirmed a good discriminant validity, i.e., significantly lower scores for all domains (reduced global QoL in sarcopenic subjects compared to non-sarcopenic ones; 54.9 16.5 vs. 63.3 17.1, p = 0.013), and high internal consistency (Cronbach’s alpha coefficient was 0.92). The significant correlation of the SarQoL® scores with those of other questionnaires (SF-36v2® Health Survey and EuroQoL-5-Dimension) that are supposed to have similar dimensions indicated the consistent construct validity of the SarQoL®-PL questionnaire. No floor/ceiling effects were found. An excellent agreement was found between the test and the re-test (intraclass coefficient correlation (ICC): 0.99). The first Polish version of the SarQoL® questionnaire is valid and consistent and therefore may be used with reliability for clinical and research purposes regarding QoL assessment of sarcopenic individuals. However, further research, in particular prospective studies, is needed to determine potential limitations and the suitability of the new tool for the Polish scenario and specificity. [less ▲]

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See detailEuropean guidance for the diagnosis and management of osteoporosis
Kanis, J.A.; Cooper, C.; Rizzoli, R et al

in Osteoporosis International (in press)

Summary: Guidance is provided in a European setting on the assessment and treatment of postmenopausal women at risk from fractures due to osteoporosis. Introduction: The International Osteoporosis ... [more ▼]

Summary: Guidance is provided in a European setting on the assessment and treatment of postmenopausal women at risk from fractures due to osteoporosis. Introduction: The International Osteoporosis Foundation and European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis published guidance for the diagnosis and management of osteoporosis in 2013. This manuscript updates these in a European setting. Methods Systematic reviews were updated. Results: The following areas are reviewed: the role of bone mineral density measurement for the diagnosis of osteoporosis and assessment of fracture risk; general and pharmacological management of osteoporosis; monitoring of treatment; assessment of fracture risk; case-finding strategies; investigation of patients; health economics of treatment. The update includes new information on the evaluation of bone microstructure evaluation in facture risk assessment, the role of FRAX® and Fracture Liaison Services in secondary fracture prevention, long-term effects on fracture risk of dietary intakes, and increased fracture risk on stopping drug treatment. Conclusions: A platform is provided on which specific guidelines can be developed for national use. [less ▲]

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See detailThree-Year Adverse Health Consequences of Sarcopenia in Community-Dwelling Older Adults According to 5 Diagnosis Definitions
Locquet, Médéa ULiege; Beaudart, Charlotte ULiege; Hajaoui, Manon ULiege et al

in Journal of the American Medical Directors Association (in press)

Objectives: To assess the occurrence of 3 major adverse outcomes of sarcopenia (ie, physical disabilities, institutionalizations and deaths) observed over a 3-year follow-up in older adults and compare ... [more ▼]

Objectives: To assess the occurrence of 3 major adverse outcomes of sarcopenia (ie, physical disabilities, institutionalizations and deaths) observed over a 3-year follow-up in older adults and compare the risk of these outcomes using 5 definitions of sarcopenia. Design: The study is a part of the ongoing SarcoPhAge (for Sarcopenia and Physical Impairment with advancing Age) longitudinal project. Setting and Participants: The SarcoPhAge study follows 534 community-dwelling older adults. Measures: Sarcopenia was defined as low muscle mass plus a decreased muscle function. Data on adverse outcomes were collected yearly during the annual follow-up or with a phone call. The association between baseline sarcopenia and the occurrence of undesirable outcomes was tested using the Cox proportional hazards model or a logistic regression model. Results: A total of 534 subjects were recruited into this prospective cohort (73.5 6.2 years, 60.5% female). After 3 years, 33 participants were lost to follow-up. If no association between baseline sarcopenia and physical disabilities or institutionalizations was highlighted, a higher number of deaths occurred in individuals diagnosed with sarcopenia than in those who were not diagnosed (16.2% vs 4.6%, P value <.001). The probability of death within 3 years when presenting with sarcopenia showed an approximately 3-fold increase compared to subjects without sarcopenia. Conclusion: Over a 3-year period, sarcopenia at baseline was associated with an increased risk of mortality. There were some variations in the ability of different definitions of sarcopenia to predict outcomes. [less ▲]

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See detailPhosphate wasting disorders in adults
Marcucci, G; Masi, L; Ferrari, S et al

in Osteoporosis International (in press)

A cause of hypophosphatemia is phosphate wasting disorders. Knowledge concerning mechanisms involved in phosphate wasting disorders has greatly increased in the last decade by the identification of ... [more ▼]

A cause of hypophosphatemia is phosphate wasting disorders. Knowledge concerning mechanisms involved in phosphate wasting disorders has greatly increased in the last decade by the identification of phosphatonins, among them FGF-23. FGF-23 is a primarily bone derived factor decreasing renal tubular reabsorption of phosphate and the synthesis of calcitriol. Currently, pharmacological treatment of these disorders offers limited efficacy and is potentially associated to gastrointestinal, renal, and parathyroid complications; therefore, efforts have been directed toward newer pharmacological strategies that target the FGF-23 pathway. This review focuses on phosphate metabolism, its main regulators, and phosphate wasting disorders in adults, highlighting the main issues related to diagnosis and current and new potential treatments. [less ▲]

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See detailAbaloparatide is an effective treatment option for postmenopausal osteoporosis: review of the number needed to treat compared with teriparatide.
Reginster, Jean-Yves ULiege; Hattersley, G.; Williams, G et al

in Calcified Tissue International (in press)

Abaloparatide (ABL) is a 34-amino acid peptide designed to be a selective activator of the parathyroid hormone receptor type 1 signaling pathway. In the Abaloparatide Comparator Trial In Vertebral ... [more ▼]

Abaloparatide (ABL) is a 34-amino acid peptide designed to be a selective activator of the parathyroid hormone receptor type 1 signaling pathway. In the Abaloparatide Comparator Trial In Vertebral Endpoints (ACTIVE), subcutaneous ABL reduced the risk of new vertebral, nonvertebral, clinical, and major osteoporotic fracture compared with placebo and of major osteoporotic fracture compared with teriparatide. To further evaluate the effectiveness of ABL, we calculated the number needed to treat (NNT) to prevent one fracture using ACTIVE data. To estimate the potential effectiveness of ABL in populations at higher fracture risk than in ACTIVE, we calculated NNT for vertebral fracture using reference populations from historical placebo-controlled trials, assuming an 86% relative risk reduction in vertebral fracture with ABL treatment as observed in ACTIVE. NNT was calculated as the reciprocal of the absolute risk reduction in ACTIVE. The projected NNT for ABL in other populations was calculated based on incidence rate (IR) for vertebral fractures in the placebo arms of the FREEDOM (placebo IR 7.2%), FIT-1 (placebo IR 15.0%), and FIT-2 (placebo IR 3.8%) trials. NNT for ABL in ACTIVE was 28 for vertebral, 55 for nonvertebral, 37 for clinical, and 34 for major osteoporotic fracture. NNT for these fracture types for teriparatide in ACTIVE were 30, 92, 59, and 75, respectively. Using placebo IRs from FREEDOM, FIT-1, and FIT-2, projected NNTs for vertebral fracture with ABL were 17, 8, and 31. These data are useful for further evaluating ABL for the treatment of osteoporosis in postmenopausal women. [less ▲]

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See detailReview of the guideline of the American College of Physicians on the treatment of osteoporosis.
Kanis, J.A.; Cooper, C.; Rizzoli, R et al

in Osteoporosis International (in press)

Summary: This review, endorsed by the International Osteoporosis Foundation and the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases ... [more ▼]

Summary: This review, endorsed by the International Osteoporosis Foundation and the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases, summarizes several failings of the recent guidelines of the American College of Physicians (ACP) on the treatment of low bone density or osteoporosis to prevent fractures. Introduction: The ACP recently issued guidelines for the treatment of low bone density or osteoporosis to prevent fractures. Methods : Literature review and critical review of the ACP guidelines. Results :The guideline is lacking in scope due to the endorsement of treatment based on T-scores rather than fracture risk assessment and in failure to adequately consider anabolic therapies. Conclusions :The ACP guideline appears outdated. [less ▲]

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See detailUnderstanding osteoporotic pain and its pharmacological treatment: supplementary presentation
Vellucci, R; Terenzi, R; Kanis, J.A. et al

in Osteoporosis International (in press)

Osteoporosis, a disorder that affects millions of people worldwide, is characterized by decreased bone mass and microstructural alterations giving rise to an increased risk of fractures. Osteoporotic ... [more ▼]

Osteoporosis, a disorder that affects millions of people worldwide, is characterized by decreased bone mass and microstructural alterations giving rise to an increased risk of fractures. Osteoporotic fractures can cause acute and chronic nociceptive and neuropathic pain that mainly affects elderly patients with multiple comorbidities and commonly on different drug regimens. Central sensitization seems to play a pivotal role in developing and maintaining chronicity of post-fracture pain in osteoporosis. Antiosteoporosis drugs are able to partially control pain, but additional analgesics are always necessary for pain due to bone fractures. Nonsteroidal anti-inflammatory drugs (NSAIDs) and selective COX-2 inhibitors reduce acute pain but with a poor effect on the chronic neuropathic component of pain and with relevant side effects. Opioid drugs can control the whole spectrum of acute and chronic bone pain, but they differ with respect to their efficacy on neuropathic components, their tolerability and safety. Chronic pain after osteoporotic fractures requires a multifaceted approach, which includes a large spectrum of drugs (antiosteoporosis treatment, acetaminophen, NSAIDs, selective COX-2 inhibitors, weak and strong opioids) and non-pharmacological treatment. Based on a better understanding of the pathogenesis of osteoporotic and post-fracture pain, a guided stepwise approach to post-fracture osteoporotic pain will also better meet the needs of these patients. [less ▲]

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See detailFrench translation and validation of the “Anterior Knee Pain Scale” (AKPS)
Buckinx, Fanny ULiege; Bornheim, Stephen ULiege; Remy, G. et al

in Disability and Rehabilitation (in press)

Purpose: To linguistically and cross-culturally translate the Anterior Knee Pain Scale into French and to evaluate the reliability and validity of this translated version of the questionnaire. Methods ... [more ▼]

Purpose: To linguistically and cross-culturally translate the Anterior Knee Pain Scale into French and to evaluate the reliability and validity of this translated version of the questionnaire. Methods: The translation part was performed in six stages, according to international guidelines: (i) two initial translations from English to French; (ii) synthesis of the two translations; (iii) backward translations into the original language; (iv) expert committee to compare the backward translations with the original questionnaire; (v) pre-final version testing and (VI) expert committee appraisal. To validate the French version of the Anterior Knee Pain Scale, we assessed its validity, reliability and floor/ceiling effects. To do this, volunteer patients from the French part of Belgium and from France, with patellofemoral pain were asked to answer the French version of the Anterior Knee Pain Scale at baseline and after 7 days, as well as the generic SF-36 questionnaire. Results: The Anterior Knee Pain Scale was translated without any major difficulties. A total of 101 subjects aged 34.5 ± 11.4 years (58.4% of women) were included in this study. Results indicated an excellent test-retest reliability (Intra-class correlation coefficient (ICC) = 0.97, 95%CI: 0.96–0.98), a high internal consistency (Cronbach’s alpha = 0.87), a consistent construct validity (high correlations with the SF-36 questionnaire were found with domains related to physical function (r = 0.80), physical role (r = 0.70) and pain (r = 0.64)) and low or moderate correlations with domains related to mental health (r = 0.26), vitality (r = 0.32) and social function (r = 0.41). Moreover, no floor/ceiling effects have been found. Conclusions: A valid French version of the Anterior Knee Pain Scale is now available and can be used with confidence to better assess the disease burden associated with patellofemoral pain. It was successfully cross-culturally adapted into French.Implications for rehabilitationThe results on psychometric properties of the French Anterior Knee Pain Scale are comparable with six validated versions obtained for the Finnish, the Turkish, the Chinese, the Dutch, the Thai and the Persian populations.The French translated version of the Anterior Knee Pain Scale is a reliable and valid instrument for assessing the functional limitations associated with patellofemoral pain.The test–retest reliability of the French Anterior Knee Pain Scale was excellent, the internal consistency was high and the construct validity was consistent. There were no floor/ceiling effects. © 2017 Informa UK Limited, trading as Taylor & Francis Group [less ▲]

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See detailEvaluation of the responsiveness of the SarQoL® questionnaire, a patient-reported outcome measure specific to sarcopenia.
Geerinck, Anton ULiege; Bruyère, Olivier ULiege; Locquet, Médéa ULiege et al

in Advances in Therapy (2018), 35

INTRODUCTION: The Sarcopenia Quality of Life (SarQoL®) questionnaire was developed to provide a patient-reported outcome measure specific to sarcopenia. Its psychometric properties indicate that it is a ... [more ▼]

INTRODUCTION: The Sarcopenia Quality of Life (SarQoL®) questionnaire was developed to provide a patient-reported outcome measure specific to sarcopenia. Its psychometric properties indicate that it is a valid and reliable instrument. However, until now, its ability to detect change over time has not been examined. Therefore, the objective of this study is to evaluate the responsiveness (also known as sensitivity to change) of the SarQoL® questionnaire in a prospective, longitudinal cohort of community-dwelling, older, sarcopenic subjects. METHODS: Sarcopenic subjects from the SarcoPhAge (Sarcopenia and Physical impairment with advancing Age) study were included. Responsiveness was evaluated with nine pre-specified hypotheses on the correlation between the evolution of the SarQoL® scores after a 2-year interval and the evolution of the scores on the Short Form-36 (SF-36) and the Euroqol 5-dimension (EQ-5D) questionnaires. This technique considers responsiveness to be a form of longitudinal validity. Additionally, standardized response means were also calculated to compare the quantity of change measured by the different questionnaires. RESULTS: A total of 42 sarcopenic subjects were included. The median age of the sample was 72.9 (68.9-78.8) years, 59.5% were female, and the mean body mass index was 23.3 (20.4-25.7) kg/m2. A good responsiveness was observed, as evidenced by the confirmation of eight out of nine hypotheses, well above the 75% confirmation threshold. The standardized response mean of the Overall SarQoL® score was significantly higher than those of the SF-36 Physical Component Summary (p = 0.005), the EQ-5D Utility Index (p < 0.001) and the Euroqol visual analogue scale (p = 0.003). CONCLUSION: The first data available on the ability of the SarQoL® questionnaire to detect change over time indicates that the questionnaire has good responsiveness. This, together with the previously established psychometric properties, confirms that the SarQoL® questionnaire is a relevant instrument for the assessment of quality of life in sarcopenic populations. [less ▲]

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See detailRecommendations for the conduct of economic evaluations in osteoporosis: outcomes of an experts' consensus meeting organized by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) and the US branch of the International Osteoporosis Foundation
Hiligsmann, Mickaël ULiege; Reginster, Jean-Yves ULiege; Tosteson, A.N.A. et al

in Osteoporosis International (2018), First online

Summary Economic evaluations are increasingly used to assess the value of health interventions, but variable quality and heterogeneity limit the use of these evaluations by decision-makers. These ... [more ▼]

Summary Economic evaluations are increasingly used to assess the value of health interventions, but variable quality and heterogeneity limit the use of these evaluations by decision-makers. These recommendations provide guidance for the design, conduct, and reporting of economic evaluations in osteoporosis to improve their transparency, comparability, and methodologic standards. Introduction This paper aims to provide recommendations for the conduct of economic evaluations in osteoporosis in order to improve their transparency, comparability, and methodologic standards. Methods A working group was convened by the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis to make recommendations for the design, conduct, and reporting of economic evaluations in osteoporosis, to define an osteoporosis-specific reference case to serve a minimum standard for all economic analyses in osteoporosis, to discuss methodologic challenges and initiate a call for research. A literature review, a face-to-face meeting in New York City (including 11 experts), and a review/approval by a larger group of experts worldwide (including 23 experts in total) were conducted. Results Recommendations on the type of economic evaluation, methods for economic evaluation, modeling aspects, base-case analysis and population, excess mortality, fracture costs and disutility, treatment characteristics, and model validation were provided. Recommendations for reporting economic evaluations in osteoporosis were also made and an osteoporosis-specific checklist was designed that includes items to report when performing an economic evaluation in osteoporosis. Further, 12 minimum criteria for economic evaluations in osteoporosis were identified and 12 methodologic challenges and need for further research were discussed. Conclusion While the working group acknowledges challenges and the need for further research, these recommendations are intended to supplement general and national guidelines for economic evaluations, improve transparency, quality, and comparability of economic evaluations in osteoporosis, and maintain methodologic standards to increase their use by decision-makers. [less ▲]

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See detailAbaloparatide for risk reduction of nonvertebral and vertebral fractures in postmenopausal women with osteoporosis: a network meta-analysis
Reginster, Jean-Yves ULiege; Bianic, F.; Campbell, R et al

in Arthritis and Rheumatology (2018, September), 70(S9), 2308

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See detailUnderstanding osteoporotic pain and its pharmacological treatment.
Vellucci, R.; Terenzi, R.; Kanis, J.A. et al

in Osteoporosis International (2018), 29(7), 1477-1491

Osteoporosis, a disorder that affects millions of people worldwide, is characterized by decreased bone mass and microstructural alterations giving rise to an increased risk of fractures. Osteoporotic ... [more ▼]

Osteoporosis, a disorder that affects millions of people worldwide, is characterized by decreased bone mass and microstructural alterations giving rise to an increased risk of fractures. Osteoporotic fractures can cause acute and chronic pain that mainly affects elderly patients with multiple comorbidities and commonly on different drug regimens. The aim of this paper is to summarize the pathogenesis and systemic treatment of osteoporotic pain. This narrative review summarizes the main pathogenetic aspects of osteoporotic pain and the cornerstones of its treatment. Osteoporotic fractures induce both acute and chronic nociceptive and neuropathic pain. Central sensitization seems to play a pivotal role in developing and maintaining chronicity of post-fracture pain in osteoporosis. Antiosteoporosis drugs are able to partially control pain, but additional analgesics are always necessary for pain due to bone fractures. Nonsteroidal anti-inflammatory drugs (NSAIDs) and selective COX-2 inhibitors reduce acute pain but with a poor effect on the chronic neuropathic component of pain and with relevant side effects. Opioid drugs can control the whole spectrum of acute and chronic bone pain, but they differ with respect to their efficacy on neuropathic components, their tolerability and safety. Chronic pain after osteoporotic fractures requires a multifaceted approach, which includes a large Spectrum of drugs (antiosteoporosis treatment, acetaminophen, NSAIDs, selective COX-2 inhibitors, weak and strong opioids) and nonpharmacological treatment. Based on a better understanding of the pathogenesis of osteoporotic and post-fracture pain, a guided stepwise approach to post-fracture osteoporotic pain will also better meet the needs of these patients. [less ▲]

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See detailDifferent glucosamine sulfate products generate different outcomes on osteoarthritis symptoms
Reginster, Jean-Yves ULiege; Bruyère, Olivier ULiege; Cooper, Cyrus

in Annals of the Rheumatic Diseases (2018), 77(7), 1-2

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See detailFrench cross-cultural adaptation and measurement properties of the “ANTERIOR KNEE PAIN SCALE”
Buckinx, Fanny ULiege; Bornheim, Stephen ULiege; Remy, Gaël et al

in Abstract Book - 21st European Congress of Physical and Rehabilitation Medicine (2018, May)

Purpose: to linguistically and cross-culturally translate the Anterior Knee Pain Scale into French and to evaluate the reliability and validity of this translated version of the questionnaire. Methods ... [more ▼]

Purpose: to linguistically and cross-culturally translate the Anterior Knee Pain Scale into French and to evaluate the reliability and validity of this translated version of the questionnaire. Methods: The translation part was performed in six stages, according to international guidelines: (i) two initial translations from English to French; (ii) synthesis of the two translations; (iii) backward translations into the original language; (iv) expert committee to compare the backward translations with the original questionnaire; (v) pre-final version testing and (VI) expert committee appraisal. To validate the French version of the Anterior Knee Pain Scale, we assessed its validity, reliability and floor/ceiling effects. To do this, volunteer patients from the French part of Belgium and from France, with patellofemoral pain were asked to answer the French version of the Anterior Knee Pain Scale at baseline and after 7 days, as well as the generic SF-36 questionnaire. Results: The Anterior Knee Pain Scale was translated without any major difficulties. A total of 101 subjects aged 34.5±11.4 years (58.4% of women) were included in this study. Results indicated an excellent test-retest reliability (ICC=0.97, 95%CI 0.96-0.98), a high internal consistency (Cronbach’s alpha=0.87), a consistent construct validity (high correlations with the SF-36 questionnaire were found with domains related to physical function (r=0.80), physical role (r=0.70), and pain (r=0.64)) and low or moderate correlations with domains related to mental health (r=0.26), vitality (r=0.32), and social function (r=0.41)). Moreover, no floor/ceiling effects have been found. Conclusion: A valid French version of the Anterior Knee Pain Scale is now available and can be used with confidence to better assess the disease burden associated with patellofemoral pain . It was successfully cross-culturally adapted into French. [less ▲]

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