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Author: World Health Organization Publisher: ISBN: 9789241545228 Category : Medical Languages : en Pages : 68
Book Description
This book provides comprehensive guidelines for the design, implementation, and interpretation of preclinical studies and clinical trials of agents undergoing investigation for the management of osteoporosis. Noting the magnitude of the public health problem caused by osteoporosis and related fractures, the book responds to the urgent need for a cohesive and rational approach to the search for new therapeutic or preventive agents. Recommended principles and methods reflect the consensus reached by a large number of international experts, representatives of the pharmaceutical industry, and drug regulatory authorities. The book opens with a brief discussion of the current and future public health problem caused by osteoporotic fractures, followed by conceptual and operational definitions of osteoporosis and a recommended classification of four intervention categories that facilitate the definition of treatment objectives and the design of targetted studies. Against this background, the next chapter offers a detailed guide to the aims, design, conduct and interpretation of preclinical studies. Specific recommendations are given for the selection of in vitro and animal models, the design of the study, including dose ranges and duration of treatment, and the most appropriate end-points for assessing efficacy. The most extensive chapter provides a comprehensive description of basic principles and methods to follow during clinical trials. Information ranges from a discussion of problems with the use of bone mineral density to predict fracture risk, through advice on the choice of tests and techniques for measuring the effects of interventions, to a discussion of general principles of trial design, including selection of study population, treatment regimen, duration of studies, sample size, and frequency of measurement. Drawing on these detailed principles and methods, subsequent chapters offer concise guidance specific to phase I and phase II studies, phase III studies in severe osteoporosis, phase III studies in osteoporosis without fragility fractures, and phase III studies in osteopenia. The book concludes with chapters outlining principles and methods for phase III clinical trials in subjects with normal bone mass, and for phase IV studies.
Author: World Health Organization Publisher: ISBN: 9789241545228 Category : Medical Languages : en Pages : 68
Book Description
This book provides comprehensive guidelines for the design, implementation, and interpretation of preclinical studies and clinical trials of agents undergoing investigation for the management of osteoporosis. Noting the magnitude of the public health problem caused by osteoporosis and related fractures, the book responds to the urgent need for a cohesive and rational approach to the search for new therapeutic or preventive agents. Recommended principles and methods reflect the consensus reached by a large number of international experts, representatives of the pharmaceutical industry, and drug regulatory authorities. The book opens with a brief discussion of the current and future public health problem caused by osteoporotic fractures, followed by conceptual and operational definitions of osteoporosis and a recommended classification of four intervention categories that facilitate the definition of treatment objectives and the design of targetted studies. Against this background, the next chapter offers a detailed guide to the aims, design, conduct and interpretation of preclinical studies. Specific recommendations are given for the selection of in vitro and animal models, the design of the study, including dose ranges and duration of treatment, and the most appropriate end-points for assessing efficacy. The most extensive chapter provides a comprehensive description of basic principles and methods to follow during clinical trials. Information ranges from a discussion of problems with the use of bone mineral density to predict fracture risk, through advice on the choice of tests and techniques for measuring the effects of interventions, to a discussion of general principles of trial design, including selection of study population, treatment regimen, duration of studies, sample size, and frequency of measurement. Drawing on these detailed principles and methods, subsequent chapters offer concise guidance specific to phase I and phase II studies, phase III studies in severe osteoporosis, phase III studies in osteoporosis without fragility fractures, and phase III studies in osteopenia. The book concludes with chapters outlining principles and methods for phase III clinical trials in subjects with normal bone mass, and for phase IV studies.
Author: Derek Pearson Publisher: Springer Science & Business Media ISBN: 1447137108 Category : Medical Languages : en Pages : 280
Book Description
Clinical Trials in Osteoporosis is a practical handbook on clinical trials in the growing field of osteoporosis. Topics covered include study design, technical issues, data collection, quality assurance, data analysis and presentation. It aims to take the user through the process step-by-step from start to finish, also providing a background on regulatory guidelines, ethical implications, endpoints, current therapies and the ideal drug to use. There are no other books at present that specifically address the issue of clinical trials in osteoporosis. A number of issues dealt with in this book have been brought together in one publication for the first time. Clinical Trials in Osteoporosis is intended to serve as a practical manual for clinicians and scientists coming to the subject new and to provide a standard for existing centers to measure themselves against.
Author: Andrea Giustina Publisher: Karger Medical and Scientific Publishers ISBN: 3805572964 Category : Medical Languages : en Pages : 213
Book Description
Osteoporosis is one of the most clinically relevant disabling chronic disease encountered in clinical practice. A common cause of osteoporosis is glucocorticoid excess, as glucocorticoids may increase bone resorption, inhibit bone formation, have indirect actions on bone by decreasing intestinal calcium absorption and induce hypercalciuria. This book presents a comprehensive overview of the effects of glucocorticoids on bone metabolism and structure and on the diagnosis and treatment of glucocorticoid-induced osteoporosis. It aims at providing updated information on the pathogenesis, diagnosis and treatment of this often dramatic complication of glucocorticoid excess. Being one of the few publications completely devoted to glucocorticoid-induced osteoporosis it will heighten the awareness of specialists who prescribe glucocorticoids of the clinical relevance of this treatment complication. 'Glucocorticoid-Induced Osteoporosis' is addressed to clinical experts as well as to general practitioners who will both benefit from the comprehensive and integrative view of the management of patients exposed to glucocorticoids.
Author: Gerald N. Grob Publisher: JHU Press ISBN: 1421413191 Category : Medical Languages : en Pages : 305
Book Description
How osteoporosis went from a normal aging process to a disease. In the middle of the twentieth century, few physicians could have predicted that the modern diagnostic category of osteoporosis would emerge to include millions of Americans, predominantly older women. Before World War II, popular attitudes held that the declining physical and mental health of older persons was neither preventable nor reversible and that older people had little to contribute. Moreover, the physiological processes that influenced the health of bones remained mysterious. In Aging Bones, Gerald N. Grob makes a historical inquiry into how this one aspect of aging came to be considered a disease. During the 1950s and 1960s, as more and more people lived to the age of 65, older people emerged as a self-conscious group with distinct interests, and they rejected the pejorative concept of senescence. But they had pressing health needs, and preventing age-related decline became a focus for researchers and clinicians alike. In analyzing how the normal aging of bones was transformed into a medical diagnosis requiring treatment, historian of medicine Grob explores developments in medical science as well as the social, intellectual, economic, demographic, and political changes that transformed American society in the post–World War II decades. Though seemingly straightforward, osteoporosis and its treatment are shaped by illusions about the conquest of disease and aging. These illusions, in turn, are instrumental in shaping our health care system. While bone density tests and osteoporosis treatments are now routinely prescribed, aggressive pharmaceutical intervention has produced results that are inconclusive at best. The fascinating history in Aging Bones will appeal to students and scholars in the history of medicine, health policy, gerontology, endocrinology, and orthopedics, as well as anyone who has been diagnosed with osteoporosis.
Author: World Health Organization Publisher: World Health Organization ISBN: 9241209216 Category : Medical Languages : en Pages : 206
Book Description
Bone is hard tissue that is in a constant state of flux being built up by bone-forming cells called osteoblasts while also being broken down or resorbed by cells known as osteoclasts. During childhood and adolescence bone formation is dominant; bone length and girth increase with age ending at early adulthood when peak bone mass is attained. Males generally exhibit a longer growth period resulting in bones of greater size and overall strength. In males after the age of 20 bone resorbtion becomes predominant and bone mineral content declines about 4% per decade. Females tend to maintain peak mineral content until menopause at which time it declines about 15% per decade. Osteoporosis is a disease characterized by low bone mass and structural deterioration of bone tissue leading to bone fragility and an increased susceptibility to fractures especially of the hip spine and wrist. Osteoporosis occurs primarily as a result of normal ageing but can arise as a result of impaired development of peak bone mass (e.g. due to delayed puberty or undernutrition) or excessive bone loss during adulthood (e.g. due to estrogen deficiency in women undernutrition or corticosteriod use). Osteoporosis-induced fractures cause a great burden to society. Hip fractures are the most serious as they nearly always result in hospitalization are fatal about 20% of the time and produce permanent disability about half the time. Fracture rates increase rapidly with age and the lifetime risk of fracture in 50 year-old women is about 40% similar to that for coronary heart disease. In 1990 there were 1.7 million hip fractures alone worldwide; with changes in population demographics this figure is expected to rise to 6 million by 2050. To help describe the nature and consequences of osteoporosis as well as strategies for its prevention and management a WHO Scientific Group meeting of international experts was held in Geneva which resulted in this technical report. This monograph describes in detail normal bone development and the causes and risk factors for developing osteoporosis. The burden of osteoporosis is characterized in terms of mortality morbidity and economic costs. Methods for its prevention and treatment are discussed in detail for both pharmacological and non-pharmacological approaches. For each approach the strength of the scientific evidence is listed. The report also provides cost-analysis information for potential interventions and discusses important aspects of developing national policies to deal with osteoporosis. Recommendations are made to the general population care providers health administrators and researchers. Lastly national organizations and support groups are listed by country.
Author: Robert Marcus Publisher: Academic Press ISBN: 0080538266 Category : Medical Languages : en Pages : 861
Book Description
Osteoporosis is the most comprehensive, authoritative reference on this disease. Some of the topics covered include basic biology, anatomy, physiology, pathophysiology, preclinical issues, experimental medicine, management, and therapeutics. Written by renowned experts in this field, this book is a must-have for the researcher, the academic clinician, or anyone in the field of bone biology.Key Features* The source on osteoporosis* Written by expert investigators in their respective fields* Each chapter provides timely, comprehensive, and scholarly discussion* Fully illustrated in color and black & white* Covers everything from basic anatomy and physiology to diagnosis, management and treatment
Author: Hong-wen Deng Publisher: World Scientific ISBN: 9814480983 Category : Medical Languages : en Pages : 562
Book Description
This book reviews important topics in osteoporosis, with the emphasis on both clinical management and basic research of the disease. From the clinical perspective, topics covering pathogenesis, diagnosis, and treatment of osteoporosis are extensively elaborated. Several more chapters complement clinical overview of osteoporosis, that discuss the effects of nutrition and exercise to bone health, the application of biochemical markers in osteoporosis diagnosis, novel potential drug targets for osteoporosis treatment, and osteoporosis in males and in children. As the prevalence of osteoporosis now reaches epidemiological levels, epidemiology and social impacts of osteoporosis is also reviewed in the book. Basic research on osteoporosis is also highlighted in the book, with a number of chapters dedicated to the review of genetics of osteoporosis, animal models for osteoporosis, and statistical methods in osteoporosis study.
Author: Institute of Medicine Publisher: National Academies Press ISBN: 0309225493 Category : Medical Languages : en Pages : 432
Book Description
The Best Pharmaceuticals for Children Act (BPCA) and the Pediatric Research Equity Act (PREA) were designed to encourage more pediatric studies of drugs used for children. The FDA asked the IOM to review aspects of pediatric studies and changes in product labeling that resulted from BPCA and PREA and their predecessor policies, as well as assess the incentives for pediatric studies of biologics and the extent to which biologics have been studied in children. The IOM committee concludes that these policies have helped provide clinicians who care for children with better information about the efficacy, safety, and appropriate prescribing of drugs. The IOM suggests that more can be done to increase knowledge about drugs used by children and thereby improve the clinical care, health, and well-being of the nation's children.
Author: Institute of Medicine Publisher: National Academies Press ISBN: 0309158060 Category : Medical Languages : en Pages : 442
Book Description
Rare diseases collectively affect millions of Americans of all ages, but developing drugs and medical devices to prevent, diagnose, and treat these conditions is challenging. The Institute of Medicine (IOM) recommends implementing an integrated national strategy to promote rare diseases research and product development.
Author: World Health Organization
Author: World Health Organization
Author: Derek Pearson
Author: Andrea Giustina
Author: Gerald N. Grob
Author: World Health Organization
Author: Robert Marcus
Author: Hong-wen Deng
Author: Institute of Medicine
Author: Institute of Medicine
Author: Royal College of Physicians of London