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<title xml:lang="en">Microarchitectural Deterioration of Cortical and Trabecular Bone: Differing Effects of Denosumab and Alendronate</title>
<author>
<name sortKey="Seeman, Ego" sort="Seeman, Ego" uniqKey="Seeman E" first="Ego" last="Seeman">Ego Seeman</name>
<affiliation>
<nlm:aff id="A1">Austin Health, University of Melbourne, Melbourne, Australia</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Delmas, Pierre D" sort="Delmas, Pierre D" uniqKey="Delmas P" first="Pierre D" last="Delmas">Pierre D. Delmas</name>
<affiliation>
<nlm:aff id="A2">INSERM U831 and University of Lyon, Lyon, France</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Hanley, David A" sort="Hanley, David A" uniqKey="Hanley D" first="David A" last="Hanley">David A. Hanley</name>
<affiliation>
<nlm:aff id="A3">University of Calgary, Calgary, Alberta, Canada</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Sellmeyer, Deborah" sort="Sellmeyer, Deborah" uniqKey="Sellmeyer D" first="Deborah" last="Sellmeyer">Deborah Sellmeyer</name>
<affiliation>
<nlm:aff id="A4">Johns Hopkins University, Baltimore, MD, USA</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Cheung, Angela M" sort="Cheung, Angela M" uniqKey="Cheung A" first="Angela M" last="Cheung">Angela M. Cheung</name>
<affiliation>
<nlm:aff id="A5">University Health Network and University of Toronto, Toronto, Ontario, Canada</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Shane, Elizabeth" sort="Shane, Elizabeth" uniqKey="Shane E" first="Elizabeth" last="Shane">Elizabeth Shane</name>
<affiliation>
<nlm:aff id="A6">Columbia Presbyterian Medical Center, New York, NY, USA</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Kearns, Ann" sort="Kearns, Ann" uniqKey="Kearns A" first="Ann" last="Kearns">Ann Kearns</name>
<affiliation>
<nlm:aff id="A7">Mayo Clinic, Rochester, MN, USA</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Thomas, Thierry" sort="Thomas, Thierry" uniqKey="Thomas T" first="Thierry" last="Thomas">Thierry Thomas</name>
<affiliation>
<nlm:aff id="A8">INSERM U890 and University Hospital, Saint-Etienne, France</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Boyd, Steven K" sort="Boyd, Steven K" uniqKey="Boyd S" first="Steven K" last="Boyd">Steven K. Boyd</name>
<affiliation>
<nlm:aff id="A3">University of Calgary, Calgary, Alberta, Canada</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Boutroy, Stephanie" sort="Boutroy, Stephanie" uniqKey="Boutroy S" first="Stephanie" last="Boutroy">Stephanie Boutroy</name>
<affiliation>
<nlm:aff id="A2">INSERM U831 and University of Lyon, Lyon, France</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Bogado, Cesar" sort="Bogado, Cesar" uniqKey="Bogado C" first="Cesar" last="Bogado">Cesar Bogado</name>
<affiliation>
<nlm:aff id="A9">Instituto de Investigaciones Metabólicas, Buenos Aires, Argentina</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Majumdar, Sharmila" sort="Majumdar, Sharmila" uniqKey="Majumdar S" first="Sharmila" last="Majumdar">Sharmila Majumdar</name>
<affiliation>
<nlm:aff id="A10">University of California, San Francisco, San Francisco, CA, USA</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Fan, Michelle" sort="Fan, Michelle" uniqKey="Fan M" first="Michelle" last="Fan">Michelle Fan</name>
<affiliation>
<nlm:aff id="A11">Amgen, Inc., Thousand Oaks, CA, USA</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Libanati, Cesar" sort="Libanati, Cesar" uniqKey="Libanati C" first="Cesar" last="Libanati">Cesar Libanati</name>
<affiliation>
<nlm:aff id="A11">Amgen, Inc., Thousand Oaks, CA, USA</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Zanchetta, Jose" sort="Zanchetta, Jose" uniqKey="Zanchetta J" first="Jose" last="Zanchetta">Jose Zanchetta</name>
<affiliation>
<nlm:aff id="A9">Instituto de Investigaciones Metabólicas, Buenos Aires, Argentina</nlm:aff>
</affiliation>
</author>
</titleStmt>
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<idno type="wicri:source">PMC</idno>
<idno type="pmid">20222106</idno>
<idno type="pmc">4445722</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4445722</idno>
<idno type="RBID">PMC:4445722</idno>
<idno type="doi">10.1002/jbmr.81</idno>
<date when="2010">2010</date>
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<title xml:lang="en" level="a" type="main">Microarchitectural Deterioration of Cortical and Trabecular Bone: Differing Effects of Denosumab and Alendronate</title>
<author>
<name sortKey="Seeman, Ego" sort="Seeman, Ego" uniqKey="Seeman E" first="Ego" last="Seeman">Ego Seeman</name>
<affiliation>
<nlm:aff id="A1">Austin Health, University of Melbourne, Melbourne, Australia</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Delmas, Pierre D" sort="Delmas, Pierre D" uniqKey="Delmas P" first="Pierre D" last="Delmas">Pierre D. Delmas</name>
<affiliation>
<nlm:aff id="A2">INSERM U831 and University of Lyon, Lyon, France</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Hanley, David A" sort="Hanley, David A" uniqKey="Hanley D" first="David A" last="Hanley">David A. Hanley</name>
<affiliation>
<nlm:aff id="A3">University of Calgary, Calgary, Alberta, Canada</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Sellmeyer, Deborah" sort="Sellmeyer, Deborah" uniqKey="Sellmeyer D" first="Deborah" last="Sellmeyer">Deborah Sellmeyer</name>
<affiliation>
<nlm:aff id="A4">Johns Hopkins University, Baltimore, MD, USA</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Cheung, Angela M" sort="Cheung, Angela M" uniqKey="Cheung A" first="Angela M" last="Cheung">Angela M. Cheung</name>
<affiliation>
<nlm:aff id="A5">University Health Network and University of Toronto, Toronto, Ontario, Canada</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Shane, Elizabeth" sort="Shane, Elizabeth" uniqKey="Shane E" first="Elizabeth" last="Shane">Elizabeth Shane</name>
<affiliation>
<nlm:aff id="A6">Columbia Presbyterian Medical Center, New York, NY, USA</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Kearns, Ann" sort="Kearns, Ann" uniqKey="Kearns A" first="Ann" last="Kearns">Ann Kearns</name>
<affiliation>
<nlm:aff id="A7">Mayo Clinic, Rochester, MN, USA</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Thomas, Thierry" sort="Thomas, Thierry" uniqKey="Thomas T" first="Thierry" last="Thomas">Thierry Thomas</name>
<affiliation>
<nlm:aff id="A8">INSERM U890 and University Hospital, Saint-Etienne, France</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Boyd, Steven K" sort="Boyd, Steven K" uniqKey="Boyd S" first="Steven K" last="Boyd">Steven K. Boyd</name>
<affiliation>
<nlm:aff id="A3">University of Calgary, Calgary, Alberta, Canada</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Boutroy, Stephanie" sort="Boutroy, Stephanie" uniqKey="Boutroy S" first="Stephanie" last="Boutroy">Stephanie Boutroy</name>
<affiliation>
<nlm:aff id="A2">INSERM U831 and University of Lyon, Lyon, France</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Bogado, Cesar" sort="Bogado, Cesar" uniqKey="Bogado C" first="Cesar" last="Bogado">Cesar Bogado</name>
<affiliation>
<nlm:aff id="A9">Instituto de Investigaciones Metabólicas, Buenos Aires, Argentina</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Majumdar, Sharmila" sort="Majumdar, Sharmila" uniqKey="Majumdar S" first="Sharmila" last="Majumdar">Sharmila Majumdar</name>
<affiliation>
<nlm:aff id="A10">University of California, San Francisco, San Francisco, CA, USA</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Fan, Michelle" sort="Fan, Michelle" uniqKey="Fan M" first="Michelle" last="Fan">Michelle Fan</name>
<affiliation>
<nlm:aff id="A11">Amgen, Inc., Thousand Oaks, CA, USA</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Libanati, Cesar" sort="Libanati, Cesar" uniqKey="Libanati C" first="Cesar" last="Libanati">Cesar Libanati</name>
<affiliation>
<nlm:aff id="A11">Amgen, Inc., Thousand Oaks, CA, USA</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Zanchetta, Jose" sort="Zanchetta, Jose" uniqKey="Zanchetta J" first="Jose" last="Zanchetta">Jose Zanchetta</name>
<affiliation>
<nlm:aff id="A9">Instituto de Investigaciones Metabólicas, Buenos Aires, Argentina</nlm:aff>
</affiliation>
</author>
</analytic>
<series>
<title level="j">Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research</title>
<idno type="ISSN">0884-0431</idno>
<idno type="eISSN">1523-4681</idno>
<imprint>
<date when="2010">2010</date>
</imprint>
</series>
</biblStruct>
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<textClass></textClass>
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<front>
<div type="abstract" xml:lang="en">
<p id="P1">The intensity of bone remodeling is a critical determinant of the decay of cortical and trabecular microstructure after menopause. Denosumab suppresses remodeling more than alendronate, leading to greater gains in areal bone mineral density (aBMD). These greater gains may reflect differing effects of each drug on bone microarchitecture and strength. In a phase 2 double-blind pilot study, 247 postmenopausal women were randomized to denosumab (60mg subcutaneous 6 monthly), alendronate (70mg oral weekly), or placebo for 12 months. All received daily calcium and vitamin D. Morphologic changes were assessed using high-resolution peripheral quantitative computed tomography (HR-pQCT) at the distal radius and distal tibia and QCT at the distal radius. Denosumab decreased serum C-telopeptide more rapidly and markedly than alendronate. In the placebo arm, total, cortical, and trabecular BMD and cortical thickness decreased (−2.1% to −0.8%) at the distal radius after 12 months. Alendronate prevented the decline (−0.6% to 2.4%,
<italic>p</italic>
= .051 to < .001 versus placebo), whereas denosumab prevented the decline or improved these variables (0.3% to 3.4%,
<italic>p</italic>
< .001 versus placebo). Changes in total and cortical BMD were greater with denosumab than with alendronate (
<italic>p</italic>
≤ .024). Similar changes in these parameters were observed at the tibia. The polar moment of inertia also increased more in the denosumab than alendronate or placebo groups (
<italic>p</italic>
< .001). Adverse events did not differ by group. These data suggest that structural decay owing to bone remodeling and progression of bone fragility may be prevented more effectively with denosumab.</p>
</div>
</front>
</TEI>
<pmc article-type="research-article">
<pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front>
<journal-meta>
<journal-id journal-id-type="nlm-journal-id">8610640</journal-id>
<journal-id journal-id-type="pubmed-jr-id">104</journal-id>
<journal-id journal-id-type="nlm-ta">J Bone Miner Res</journal-id>
<journal-id journal-id-type="iso-abbrev">J. Bone Miner. Res.</journal-id>
<journal-title-group>
<journal-title>Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research</journal-title>
</journal-title-group>
<issn pub-type="ppub">0884-0431</issn>
<issn pub-type="epub">1523-4681</issn>
</journal-meta>
<article-meta>
<article-id pub-id-type="pmid">20222106</article-id>
<article-id pub-id-type="pmc">4445722</article-id>
<article-id pub-id-type="doi">10.1002/jbmr.81</article-id>
<article-id pub-id-type="manuscript">NIHMS686608</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Article</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Microarchitectural Deterioration of Cortical and Trabecular Bone: Differing Effects of Denosumab and Alendronate</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Seeman</surname>
<given-names>Ego</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Delmas</surname>
<given-names>Pierre D</given-names>
</name>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Hanley</surname>
<given-names>David A</given-names>
</name>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Sellmeyer</surname>
<given-names>Deborah</given-names>
</name>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Cheung</surname>
<given-names>Angela M</given-names>
</name>
<xref ref-type="aff" rid="A5">5</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Shane</surname>
<given-names>Elizabeth</given-names>
</name>
<xref ref-type="aff" rid="A6">6</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Kearns</surname>
<given-names>Ann</given-names>
</name>
<xref ref-type="aff" rid="A7">7</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Thomas</surname>
<given-names>Thierry</given-names>
</name>
<xref ref-type="aff" rid="A8">8</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Boyd</surname>
<given-names>Steven K</given-names>
</name>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Boutroy</surname>
<given-names>Stephanie</given-names>
</name>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Bogado</surname>
<given-names>Cesar</given-names>
</name>
<xref ref-type="aff" rid="A9">9</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Majumdar</surname>
<given-names>Sharmila</given-names>
</name>
<xref ref-type="aff" rid="A10">10</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Fan</surname>
<given-names>Michelle</given-names>
</name>
<xref ref-type="aff" rid="A11">11</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Libanati</surname>
<given-names>Cesar</given-names>
</name>
<xref ref-type="aff" rid="A11">11</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Zanchetta</surname>
<given-names>Jose</given-names>
</name>
<xref ref-type="aff" rid="A9">9</xref>
</contrib>
</contrib-group>
<aff id="A1">
<label>1</label>
Austin Health, University of Melbourne, Melbourne, Australia</aff>
<aff id="A2">
<label>2</label>
INSERM U831 and University of Lyon, Lyon, France</aff>
<aff id="A3">
<label>3</label>
University of Calgary, Calgary, Alberta, Canada</aff>
<aff id="A4">
<label>4</label>
Johns Hopkins University, Baltimore, MD, USA</aff>
<aff id="A5">
<label>5</label>
University Health Network and University of Toronto, Toronto, Ontario, Canada</aff>
<aff id="A6">
<label>6</label>
Columbia Presbyterian Medical Center, New York, NY, USA</aff>
<aff id="A7">
<label>7</label>
Mayo Clinic, Rochester, MN, USA</aff>
<aff id="A8">
<label>8</label>
INSERM U890 and University Hospital, Saint-Etienne, France</aff>
<aff id="A9">
<label>9</label>
Instituto de Investigaciones Metabólicas, Buenos Aires, Argentina</aff>
<aff id="A10">
<label>10</label>
University of California, San Francisco, San Francisco, CA, USA</aff>
<aff id="A11">
<label>11</label>
Amgen, Inc., Thousand Oaks, CA, USA</aff>
<author-notes>
<corresp id="cor1">Address correspondence to: Ego Seeman, Department of Endocrinology, Austin Health, Heidelberg 3084, Melbourne, Australia
<email>egos@unimelb.edu.au</email>
</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted">
<day>20</day>
<month>5</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="ppub">
<month>8</month>
<year>2010</year>
</pub-date>
<pub-date pub-type="pmc-release">
<day>27</day>
<month>5</month>
<year>2015</year>
</pub-date>
<volume>25</volume>
<issue>8</issue>
<fpage>1886</fpage>
<lpage>1894</lpage>
<pmc-comment>elocation-id from pubmed: 10.1002/jbmr.81</pmc-comment>
<permissions>
<copyright-statement>© 2010 American Society for Bone and Mineral Research</copyright-statement>
<copyright-year>2010</copyright-year>
</permissions>
<abstract>
<p id="P1">The intensity of bone remodeling is a critical determinant of the decay of cortical and trabecular microstructure after menopause. Denosumab suppresses remodeling more than alendronate, leading to greater gains in areal bone mineral density (aBMD). These greater gains may reflect differing effects of each drug on bone microarchitecture and strength. In a phase 2 double-blind pilot study, 247 postmenopausal women were randomized to denosumab (60mg subcutaneous 6 monthly), alendronate (70mg oral weekly), or placebo for 12 months. All received daily calcium and vitamin D. Morphologic changes were assessed using high-resolution peripheral quantitative computed tomography (HR-pQCT) at the distal radius and distal tibia and QCT at the distal radius. Denosumab decreased serum C-telopeptide more rapidly and markedly than alendronate. In the placebo arm, total, cortical, and trabecular BMD and cortical thickness decreased (−2.1% to −0.8%) at the distal radius after 12 months. Alendronate prevented the decline (−0.6% to 2.4%,
<italic>p</italic>
= .051 to < .001 versus placebo), whereas denosumab prevented the decline or improved these variables (0.3% to 3.4%,
<italic>p</italic>
< .001 versus placebo). Changes in total and cortical BMD were greater with denosumab than with alendronate (
<italic>p</italic>
≤ .024). Similar changes in these parameters were observed at the tibia. The polar moment of inertia also increased more in the denosumab than alendronate or placebo groups (
<italic>p</italic>
< .001). Adverse events did not differ by group. These data suggest that structural decay owing to bone remodeling and progression of bone fragility may be prevented more effectively with denosumab.</p>
</abstract>
<kwd-group>
<kwd>DENOSUMAB</kwd>
<kwd>ALENDRONATE</kwd>
<kwd>HR-PQCT</kwd>
<kwd>VOLUMETRIC BONE MINERAL DENSITY</kwd>
<kwd>CORTICAL THICKNESS</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
</record>

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