Osteoporosis is a frequent problem in disorders characterized by iron overload such as thalassemia andhereditary hemochromatosis. Iron accelerates the production of reactive oxygen species (ROS), which are involved in the pathogenesis of bone loss. On the other hand, antioxidants capable of counteracting oxidative stress by quenching ROS have been reported to be important in decreasing the risk of osteoporosis.We investigated the effects of vitamin K2 and chlorogenic acid on bone metabolism in postmenopausal rats with iron overload using several indices, including bone metabolic markers, oxidative stress, and antioxidant markers. A 5% iron lactate diet for 30 days in postmenopausal rats led to significantly increased excretion of urinary deoxypyridinoline and 8-hydroxy-2′-deoxyguanosine (8-OHdG). On the other hand, supplementation with vitamin K2 (500 mg/kg, food intake) and chlorogenic acid (2 g/kg, food intake) led to decreased excretion of urinary deoxypyridinoline but not 8-OHdG.We also discuss the role of antioxidants in the relationship between bone metabolism and oxidative stress. This article is part of a Special Issue entitled ECTS 2011. Disclosure of interest: None declared. doi:10.1016/j.bone.2011.03.717 PP331-S A Markov model of the cost effectiveness of risedronate treatment for prevention of proximal hip, clavicle and forearm fractures W. Moehrke a, ⁎, K. Abendroth , H.-P. Kruse c a Medical Department, Warner Chilcott Deutschland GmbH, Darmstadt, Germany b REKO Deutschland e.V., Jena, Germany c Osteoporosezentrum Hamburg -Neuer Wall, Hamburg, Germany Abstract: Background/Objectives: In Germany, osteoporosis affects approximately 7.8 million people or 26% of the population 50 years of age or older. The total direct costs attributable to osteoporosis in the year 2003 were estimated at € 5.4 billion, accounting for Background/Objectives: In Germany, osteoporosis affects approximately 7.8 million people or 26% of the population 50 years of age or older. The total direct costs attributable to osteoporosis in the year 2003 were estimated at € 5.4 billion, accounting for 3.5% of all healthcare expenditures by the social health insurance fund. The objective of this analysis was to estimate the costs of proximal femur, clavicle and forearm fractures and to calculate the changes of fractures and costs by treatment with risedronate. Methods: A validated Markov model of osteoporosis was populated with German epidemiological and cost data and risedronate efficacy data. The prevalence of low bone mineral density (T-score≤−2.5) was derived by data from the CaMos trial and the prevalence of vertebral fractures was estimated by data of the EPOS trial in the German female population (2008) 50 to 90 years of age. The HIP trial has shown a risk reduction of hip fractures with risedronate of 60% in patients with prevalent fractures and of 40% in patients without prevalent fractures. The costs of hip, clavicle and forearm fractures in the first year after the fracture were taken from the cost of illness tables of the German Federal Health Monitoring System. The annual cost of drug treatment was 356.03€ at co-payment of 35.61€. The time horizon of modelled costs and fractures was 10 years with a treatment period of 3 years. Costs and outcomes were discounted at 5%. Results: It is estimated that 2,954,293 German women 50 to 90 years of age have low BMD or have sustained a vertebral fracture. It is estimated that in this population 541,158 women will suffer from a hip fracture, 279,423 from a clavicle fracture and 321,709 from a forearm fracture at costs of 25.2 billion €. Treatment with risedronate will decrease the number of hip fractures to 444,468, of clavicle fractures to 226,807 and of forearm fractures to 260,758 at costs of 21.8 billion €. Conclusions: Treatment with risedronate can decrease the number of hip, clavicle and forearm fractures and costs in the German population with postmenopausal osteoporosis. This article is part of a Special Issue entitled ECTS 2011. Disclosure of interest: W. Moehrke Employee of Warner Chilcott, K. Abendroth Consulting fees from Warner Chillcott, H.-P. Kruse Advisory Board Membership of Warner Chilcott. doi:10.1016/j.bone.2011.03.718 Abstracts / Bone 48 (2011) S187–S203 S203
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Dec 1, 2011
Muhammad Sughis + 4
Open Access
