Influence of non-osteoporotic treatments in patients on active anti-osteoporotic therapy: evidence from the OSTEOMED registry.

PURPOSE: To evaluate the effect of different non-osteoporotic drugs on the increase or decrease in the risk of incident fragility fractures (vertebral, humerus or hip) in a cohort of patients diagnosed with osteoporosis on active anti-osteoporotic therapy. METHODS: For this retrospective longitudinal study, baseline and follow-up data on prescribed non-osteoporotic treatments and the occurrence of vertebral, humerus or hip fractures in 993 patients from the OSTEOMED registry were analyzed using logistic regression models. The drugs evaluated with a possible beneficial effect were thiazides and statins, while the drugs evaluated with a possible harmful effect were antiandrogens, aromatase inhibitors, proton pump inhibitors, selective serotonin reuptake inhibitors, benzodiazepines, GnRH agonists, thyroid hormones, and oral and inhaled corticosteroids. RESULTS: Logistic regression analyses indicated that no treatment significantly improved fracture risk, with the only treatments that significantly worsened fracture risk being letrozole (OR = 0.18, p-value = 0.03) and oral corticosteroids at doses ≤ 5 mg/day (OR = 0.16, p-value = 0.03) and > 5 mg/day (OR = 0.27, p-value = 0.04). CONCLUSION: The potential beneficial or detrimental effects of the different drugs evaluated on fracture risk are masked by treatment with anabolic or antiresorptive drugs that have a more potent action on bone metabolism, with two exceptions: letrozole and oral corticosteroids. These findings may have important clinical implications, as patients receiving these treatments are not fully protected by bisphosphonates, which may imply the need for more potent anti-osteoporotic drugs such as denosumab or teriparatide.

Efectos de la infección in vitro de células monocítico-macrofágicaspor Chlamydia y su relación con los valores de lípidos / Effects in vitro of Chlamydia infection on monocitic-macrophagic cells and its relationship with lipid levels

Introducción: La célula mononuclear-fagocítica es un elemento celular clave en el proceso aterogénico. El monocito forma parte trascendental del proceso inflamatorio característico del inicio y desarrollo de la placa de ateroma. Por otra parte, la infiltración celular es también un elemento que debe tenerse en cuenta en el proceso inflamatorio cuando se ha considerado la asociación entre arteriosclerosis e infección. En la teoría infecciosa los gérmenes más frecuentemente asociados a la patología vascular han sido Citomegalovirus, Helicobacter y Chlamydia. En el presente trabajo nos ha interesado evaluar las características del comportamiento celular en cultivos de células implicadas en el proceso aterogénico infectadas con Chlamydia. Material y métodos: Se han empleado células endoteliales humanas establecidas (células Hep-2), células mononucleares establecidas (células THP-1) y cultivos primarios de monocitos procedentes de sangre periférica de voluntarios. Resultados: Todos los cultivos celulares son fácilmente infectados por Chlamydia. No obstante, sus efectos son distintos dependiendo del tipo celular. Cuando se ha comparado el efecto de sueros normo e hiperlipidémicos en los cultivos de células mononucleares infectadas con Chlamydia, se ha podido comprobar que el efecto que provoca la infección es amortiguado porla existencia de valores elevados de lípidos plasmáticos (AU)

Introduction: The mononuclear-fagocitic cellular type is a key element during the atherogenicprocess. The monocyte takes a transcendental role in the inflammatory process that is relevant at the onset and subsequent development of atheroma plaque. Otherwise, the cellular infiltration is a key feature to consider during the inflammatory process that we can found related with the atherosclerosis/infection association. According with the infectious explanation of atherosclerosis, microorganism more frequent associated with vascular pathology has been: Citomegalovirus, Helicobacter and Chlamydia. In the present paper we are interested to evaluate the characteristics and cellular behaviour of cultures of cells related with atherogenic process that has been previously infected with Chlamydia. Material and methods: We have analized established human endothelial cells (Hep-2 cells),established mononuclear cells (THP-1 cells) and primary cultures of monocytes from blood health volunteers. Results: All of cells types has been easily infected by Chlamydia. Nevertheless, the effects are different according with the different cells types. When we have compared the effect of nor moor hyperlipidemic serum specimens over the cultures of infected mononuclear cells it is possible o show that the effect of infection is amortiguated by the presence of high serum levels oflipids (AU)