The National Osteoporosis Foundation recommends a bone density test in all women over the age of 65. Postmenopausal women to age 65 with risk factors may also require testing. In 1999 only one-third of women in our clinics over age 65 had received a DXA (dual energy x-ray absorptiometry). In 2003 over two-thirds of women had a DXA. This improvement resulted from an organized effort to educate physicians and practitioners in the Cleveland Clinic system as well as the placement of DXA centers in the Cleveland Clinic satellite offices. In 2003 more than 11,000 DXA's were performed. A project to develop a DXA database that will combine bone density results with relevant clinical data is underway and will enable clinical research and drug trials to proceed at a faster pace. In addition to osteoporosis, the Center sees patients with many metabolic bone diseases, including renal osteodystrophy, transplant bone disease, steroid osteoporosis, hyperparathyroidism, osteogenesis imperfecta and others.
Bone Deficiency: Bone Summit 2004
The Center, along with the Orthopaedic Research Center, organized and hosted an international conference attended by 187 participants from 12 countries and 17 states. The Summit brought together investigators, clinicians and industry to meet around issues of osteoporosis, skeletal repair, cell-based therapies for bone growth and skeletal imaging.
Osteoporosis: Clinical Trials
Numerous clinical drugs are currently underway or completed at the Center for Osteoporosis and Metabolic Bone Disease. The include evaluation of the anabolic agent parathyroid hormone, rhPTH 1-84 and rhPTH 1-34, PTH in combination with raloxifene, and PTH as a treatment in patients with low bone mass who are on TPN. Use of novel dosing of an oral bisphosphonate, ibandronate, as well as evaluation of the intravenous bisphosphonate zolendronate in men and as an agent to prevent hip fractures are also ongoing.
Osteoporosis: Basic Research
The Center for Osteoporosis and Metabolic Bone Disease is multidisciplinary clinic with participation of rheumatologists. In addition, the Center has strong ties the Department of Biomedical Engineering, Department of Orthopaedic Surgery and the Orthopaedic Research Center where molecular mechanisms of bone formation, skeletal repair and bone growth using cell based therapies are active areas of basic and clinical research.
Current Research
- Forteo Observational Study
- Open Label Proof of Concept Study of IV Zoledronic Acid (ZA) 5 mg after Forteo in Postmenopausal Women
- A Randomized, Double-Blind Study to Compare the Efficacy of Treatment with Denosumab versus Alendronate Sodium in Postmenopausal Women with low Bone Mineral Density
- Registry: Hip Fracture Initiative Database
- A Dose Range Finding Study of SB-751689 in Post-Menopausal Women with Osteoporosis
Other Trials (As of September 3, 2004)
- Use of zometa in treatment of women with osteoporosis -- evaluate intravenous dose and dosing intervals
- Use of yearly zometa in treatment of Paget's disease of bone
- Statin use in treatment of osteoporosis
- Use of parathyroid hormone(1-34) in patients on total parenteral nutrition
- Use of intact parathyroid hormone in treatment of osteoporosis
- Diagnosis and treatment off osteoporosis in patients with myeloma
- Surgical versus medical treatment of spinal fractures ( to start)
- Comparison of ibandronate and alendronate
- A database registry of all bone density scans performed at the Cleveland Clinic
