James Deardorff

speaker

224 appearances 2 recordings 1 series first heard Feb 2022 last heard Oct 2022

James Deardorff’s voice in public audio — every appearance, attributed to the second.

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GeriPal - A Geriatrics and Palliative Medicine Podcast · Bisphosphonates for Osteoporosis: Podcast with James Deardorff and Sei Lee · 17 Feb 2022 podcast

So what we were really trying to figure out is to help with decision-making around the initiation of bisphosphonates for osteoporosis, we wanted to...

identify what the time to benefit for the prevention of different fracture types among postmenopausal women with osteoporosis.

And to do that involves a lot of looking at previous randomized clinical trials and looking at the survival curves and trying to see when those curves really separate, when you start to see a benefit.

Yeah, exactly.

So what we did is we looked at trials from five previously published systematic reviews.

So just reviews that gathered evidence from a whole bunch of different trials and

And so we picked the ones that met our eligibility criteria.

So these were clinical trials involving postmenopausal women with a diagnosis of osteoporosis based on either an existing vertebral fracture or a bone mineral density T score of less than negative 2.5, which is kind of the typical definition of osteoporosis at that time.

And so this is a relatively high risk population.

And most of the clinical trials that were initially used to get these medications approved by the FDA uses this eligibility criteria.

Yeah, so I think most commonly the clinical trials assess nonvertebral fractures.

And so it's definitely the most common outcome.

So nonvertebral fractures include fractures like hip, clavicle, humerus, wrist, pelvis, and leg fractures.

And it varied a little bit study to study, but that was generally the case.

And so these fractures are common.

Relevant to patients, I mean, hip fractures can certainly cause the most morbidity, mortality.

I think the cited mortality rate after one year mortality rate after a hip fracture is somewhere in the range of like 20 to 30%.

And even fractures of the humerus or the leg can cause some decreases in function that can have long lasting impacts.

So these are really relevant outcome events.

We also looked at other outcomes like specifically hip fractures, which are a little bit more rare, but certainly very important.

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