Persistence with denosumab therapy in women affected by osteoporosis with fragility fractures: a multicenter observational real practice study in Italy.

BACKGROUND: Persistence is commonly considered a key factor for the successful management of osteoporosis and fragility fractures. Denosumab is the first biologic agent developed for the treatment of osteoporosis with satisfying data regarding the persistence with this therapy. AIM: The purpose of this multicenter observational real practice study was to evaluate the persistence with denosumab treatment in post-menopausal women affected by osteoporosis. MATERIAL/SUBJECTS AND METHODS: Women were recruited in four specialized centers for the management of osteoporosis in North, Center and South of Italy. We included women with a diagnosis of post-menopausal osteoporosis, aged >50 years, able to obtain a prescription according to the Italian reimbursement criteria in force during the study period for anti-osteoporotic pharmacological treatment. They initiated a treatment with subcutaneous denosumab (Prolia®) 60 mg/every 6 months between November 2011 and May 2016. Women who had received aromatase inhibitors were excluded. Patients were assessed at baseline and every 6 months for all treatment length. Persistence data were evaluated for a total of 36 months. RESULTS: Eight hundred seventy women were enrolled; mean aged 70 years, with a mean body mass index of 24.8 ± 4.1 kg/m2. At the Dual-energy X-ray absorptiometry assessment, the mean lumbar spine T-score was -2.76 ± 1.14 standard deviations (SD) and the mean femoral neck T-score was -2.49 ± 0.80 SD. During the study, the total persistence was 91.4%. Total dropouts were 75 (8.6%), higher within the initial 6-month period of treatment. CONCLUSIONS: Persistence to denosumab treatment in our observational real practice study was very high. These results suggest that factors such as frequency of visits, pharmacological schedule, and opportunity to call the doctor might play an important role in the persistence and adherence to treatment to obtain maximum therapeutic effect and avoid further fragility fractures.

Immunological properties of Andean starch films are independent of their nanometric roughness and stiffness.

Starch is a natural material extracted from roots, seeds, stems and tubers of different plants. It can be processed as a thermoplastic to produce a variety promising products for biomedical applications, including foams, sheets and films. In the present work, we investigated the immunological properties of microfilms prepared with starches extracted from six different types of Andean potatoes and their relationship with the different film-surface features. We confirmed the biocompatibility of all the films using THP-1 human monocytes, noticing only slight decrease in cell viability in two of the tested starches. We also analyzed pro-inflammatory cytokine release and immune cell surface receptor modulation on THP-1 plated onto the films. Our data show differences in the immunological profile of the same cells cultured onto the different starch films. Furthermore, we examined whether the dissimilar stiffness or the nanometric roughness of the films might influence the immune stimulation of the THP-1 monocytes. Our results demonstrate no correlation between cultured THP-1 immune activation and surface film characteristics. We conclude that different Andean native potato starch films have specific ability to interact with cell membranes of immune cells, conceivably due to the different spatial localization of amylose and amylopectin in the diverse starches.

Chondroma of the tongue.

Chondroma is a remarkably rare lesion of the oral soft tissues. Most previously reported chondromas of this area have been associated with varying percentages of fibrous, adipose or bone tissues, and the occurrence of such neoplasms exclusively composed of chondromatous tissue is exceedingly rare. We report the clinicopathological features of a pure chondroma of the dorsum of the tongue, occurring in a 51-year-old woman and discuss the possible origin of the tumour.