Key clinical point: Psoriatic arthritis (PsA) is associated with the risk for low bone mineral density (BMD), but this association is partially mediated by treatment with methotrexate or ciclosporin. Psoriasis excluding PsA in the absence of a secondary condition is not a risk factor for osteoporosis.

Major finding: PsA was associated with low BMD (β-coefficient = −0.014; P = .0006). However, the association became nonsignificant when patients were treated with methotrexate or ciclosporin (β-coefficient = −0.005; P = .28). Psoriasis without arthritis was not associated with low BMD or osteoporosis.

Study details: The data come from a cross-sectional study of 432,513 participants from the UK Biobank dataset.

Disclosures: The study was supported by the Zhejiang Provincial Natural Science Foundation for Distinguished Young Scholars of China and the National Natural Science Foundation of China. The authors declared no conflicts of interest.

Source: Xia J et al. Ann Rheum Dis. 2020 Jul 31. doi: 10.1136/annrheumdis-2020-217892.

Key clinical point: Psoriatic arthritis (PsA) is associated with the risk for low bone mineral density (BMD), but this association is partially mediated by treatment with methotrexate or ciclosporin. Psoriasis excluding PsA in the absence of a secondary condition is not a risk factor for osteoporosis.

Major finding: PsA was associated with low BMD (β-coefficient = −0.014; P = .0006). However, the association became nonsignificant when patients were treated with methotrexate or ciclosporin (β-coefficient = −0.005; P = .28). Psoriasis without arthritis was not associated with low BMD or osteoporosis.

Study details: The data come from a cross-sectional study of 432,513 participants from the UK Biobank dataset.

Disclosures: The study was supported by the Zhejiang Provincial Natural Science Foundation for Distinguished Young Scholars of China and the National Natural Science Foundation of China. The authors declared no conflicts of interest.

Source: Xia J et al. Ann Rheum Dis. 2020 Jul 31. doi: 10.1136/annrheumdis-2020-217892.

Key clinical point: Psoriatic arthritis (PsA) is associated with the risk for low bone mineral density (BMD), but this association is partially mediated by treatment with methotrexate or ciclosporin. Psoriasis excluding PsA in the absence of a secondary condition is not a risk factor for osteoporosis.

Major finding: PsA was associated with low BMD (β-coefficient = −0.014; P = .0006). However, the association became nonsignificant when patients were treated with methotrexate or ciclosporin (β-coefficient = −0.005; P = .28). Psoriasis without arthritis was not associated with low BMD or osteoporosis.

Study details: The data come from a cross-sectional study of 432,513 participants from the UK Biobank dataset.

Disclosures: The study was supported by the Zhejiang Provincial Natural Science Foundation for Distinguished Young Scholars of China and the National Natural Science Foundation of China. The authors declared no conflicts of interest.

Source: Xia J et al. Ann Rheum Dis. 2020 Jul 31. doi: 10.1136/annrheumdis-2020-217892.

Key clinical point: Treatment with abaloparatide is associated with a transient increase in heart rate (HR) and a small decrease in post-dose blood pressure (BP) in postmenopausal women with osteoporosis.

Major finding: Abaloparatide showed a significantly higher mean HR change from pretreatment to 1 hour posttreatment on day 1 vs. placebo (mean [standard deviation]: 7.9 [8.5] vs. 1.2 [7.1] beats per minute; P less than .0001). Abaloparatide showed a significantly higher change in systolic and diastolic blood pressure from pre-dose to 1 hour post-dose vs. placebo (−2.7/−3.6 vs. −1.5/−2.3 mmHg; P less than .05). These changes were not associated with an increased risk of serious cardiac adverse events, major adverse cardiovascular events, and heart failure.

Study details: The findings are based on a post-hoc analysis from the ACTIVE and ACTIVExtend trials including 2,460 postmenopausal women with osteoporosis.

Disclosures: Dr. Felicia Cosman, Dr. Steven R Cummings, Dr. Linda R Peterson, and Dr. Dwight A Towler consulted for/received research grants from pharmaceutical companies/research institutes including Amgen; Radius Health, Inc.; and the National Institutes of Health. Dr. Bruce Mitlak and Dr. Yamei Wang are employees of and hold equity in Radius Health, Inc.

Source: Cosman F et al. J Clin Endocrinol Metab. 2020 Jul 13. doi: 10.1210/clinem/dgaa450.

Key clinical point: Treatment with abaloparatide is associated with a transient increase in heart rate (HR) and a small decrease in post-dose blood pressure (BP) in postmenopausal women with osteoporosis.

Major finding: Abaloparatide showed a significantly higher mean HR change from pretreatment to 1 hour posttreatment on day 1 vs. placebo (mean [standard deviation]: 7.9 [8.5] vs. 1.2 [7.1] beats per minute; P less than .0001). Abaloparatide showed a significantly higher change in systolic and diastolic blood pressure from pre-dose to 1 hour post-dose vs. placebo (−2.7/−3.6 vs. −1.5/−2.3 mmHg; P less than .05). These changes were not associated with an increased risk of serious cardiac adverse events, major adverse cardiovascular events, and heart failure.

Study details: The findings are based on a post-hoc analysis from the ACTIVE and ACTIVExtend trials including 2,460 postmenopausal women with osteoporosis.

Disclosures: Dr. Felicia Cosman, Dr. Steven R Cummings, Dr. Linda R Peterson, and Dr. Dwight A Towler consulted for/received research grants from pharmaceutical companies/research institutes including Amgen; Radius Health, Inc.; and the National Institutes of Health. Dr. Bruce Mitlak and Dr. Yamei Wang are employees of and hold equity in Radius Health, Inc.

Source: Cosman F et al. J Clin Endocrinol Metab. 2020 Jul 13. doi: 10.1210/clinem/dgaa450.

Key clinical point: Treatment with abaloparatide is associated with a transient increase in heart rate (HR) and a small decrease in post-dose blood pressure (BP) in postmenopausal women with osteoporosis.

Major finding: Abaloparatide showed a significantly higher mean HR change from pretreatment to 1 hour posttreatment on day 1 vs. placebo (mean [standard deviation]: 7.9 [8.5] vs. 1.2 [7.1] beats per minute; P less than .0001). Abaloparatide showed a significantly higher change in systolic and diastolic blood pressure from pre-dose to 1 hour post-dose vs. placebo (−2.7/−3.6 vs. −1.5/−2.3 mmHg; P less than .05). These changes were not associated with an increased risk of serious cardiac adverse events, major adverse cardiovascular events, and heart failure.

Study details: The findings are based on a post-hoc analysis from the ACTIVE and ACTIVExtend trials including 2,460 postmenopausal women with osteoporosis.

Disclosures: Dr. Felicia Cosman, Dr. Steven R Cummings, Dr. Linda R Peterson, and Dr. Dwight A Towler consulted for/received research grants from pharmaceutical companies/research institutes including Amgen; Radius Health, Inc.; and the National Institutes of Health. Dr. Bruce Mitlak and Dr. Yamei Wang are employees of and hold equity in Radius Health, Inc.

Source: Cosman F et al. J Clin Endocrinol Metab. 2020 Jul 13. doi: 10.1210/clinem/dgaa450.

Key clinical point: Women with a previous fracture or who had an inflammatory rheumatic disease were more likely to start antiosteoporotic drugs (AODs) within 1 year from glucocorticoid (GC) initiation. However, the proportions starting an AOD were much lower than clinically indicated.

Major finding: Women with vs. without previous fracture were twice as likely to start an AOD within 1 year after initiating GC treatment, but the cumulative incidences were low: 9.1% vs. 4.6%, respectively. Women with a diagnosis of rheumatoid arthritis or another inflammatory rheumatic disease were more likely to start an AOD compared with women with other diagnoses.

Study details: This Norwegian population-based study evaluated the initiation of osteoporosis prophylaxis with AOD in women starting treatment with oral GC (n=105,477; age, 55 years or older).

Disclosures: Open Access funding was provided by the University of Bergen. Astrid Lunde is involved in the Denosumab Global Safety Study. Department of Clinical Epidemiology, Aarhus University receives an institutional research funding from several pharmaceutical companies, some of which manufacture AOD. None of these companies was involved in the current study. Vera Ehrenstein is a salaried employee of the Aarhus University. Ellen M Apalset, Mari Hoff, and Grethe S Tell declared no conflicts of interest.

Source: Apalset EM et al. Arch Osteoporos. 2020 Aug 5. doi: 10.1007/s11657-020-00783-8.

Key clinical point: Women with a previous fracture or who had an inflammatory rheumatic disease were more likely to start antiosteoporotic drugs (AODs) within 1 year from glucocorticoid (GC) initiation. However, the proportions starting an AOD were much lower than clinically indicated.

Major finding: Women with vs. without previous fracture were twice as likely to start an AOD within 1 year after initiating GC treatment, but the cumulative incidences were low: 9.1% vs. 4.6%, respectively. Women with a diagnosis of rheumatoid arthritis or another inflammatory rheumatic disease were more likely to start an AOD compared with women with other diagnoses.

Study details: This Norwegian population-based study evaluated the initiation of osteoporosis prophylaxis with AOD in women starting treatment with oral GC (n=105,477; age, 55 years or older).

Disclosures: Open Access funding was provided by the University of Bergen. Astrid Lunde is involved in the Denosumab Global Safety Study. Department of Clinical Epidemiology, Aarhus University receives an institutional research funding from several pharmaceutical companies, some of which manufacture AOD. None of these companies was involved in the current study. Vera Ehrenstein is a salaried employee of the Aarhus University. Ellen M Apalset, Mari Hoff, and Grethe S Tell declared no conflicts of interest.

Source: Apalset EM et al. Arch Osteoporos. 2020 Aug 5. doi: 10.1007/s11657-020-00783-8.

Key clinical point: Women with a previous fracture or who had an inflammatory rheumatic disease were more likely to start antiosteoporotic drugs (AODs) within 1 year from glucocorticoid (GC) initiation. However, the proportions starting an AOD were much lower than clinically indicated.

Major finding: Women with vs. without previous fracture were twice as likely to start an AOD within 1 year after initiating GC treatment, but the cumulative incidences were low: 9.1% vs. 4.6%, respectively. Women with a diagnosis of rheumatoid arthritis or another inflammatory rheumatic disease were more likely to start an AOD compared with women with other diagnoses.

Study details: This Norwegian population-based study evaluated the initiation of osteoporosis prophylaxis with AOD in women starting treatment with oral GC (n=105,477; age, 55 years or older).

Disclosures: Open Access funding was provided by the University of Bergen. Astrid Lunde is involved in the Denosumab Global Safety Study. Department of Clinical Epidemiology, Aarhus University receives an institutional research funding from several pharmaceutical companies, some of which manufacture AOD. None of these companies was involved in the current study. Vera Ehrenstein is a salaried employee of the Aarhus University. Ellen M Apalset, Mari Hoff, and Grethe S Tell declared no conflicts of interest.

Source: Apalset EM et al. Arch Osteoporos. 2020 Aug 5. doi: 10.1007/s11657-020-00783-8.

Key clinical point: Delaying denosumab doses by more than 16 weeks is associated with an increased risk of vertebral fracture in patients with osteoporosis vs. on-time injections. However, evidence is insufficient to conclude that fracture risk is increased at other anatomical sites with a long delay.

Major finding: Compared with on-time injections (within 4 weeks after the recommended date), short delay (by 4-16 weeks) had a hazard ratio (HR) of 1.03 and long delay (by more than 16 weeks) an HR of 1.44 (P for trend = .093) for composite fracture. For vertebral fractures, short delay had an HR of 1.48 and long delay an HR of 3.91 (P for trend = .005).

Study details: This U.K. population-based cohort study included 2,594 patients (age, 45 years or older) who initiated denosumab therapy for osteoporosis.

Disclosures: The study was supported by a grant from the National Institutes of Health and by the internal resources from the National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation (Beijing) and Xiangya Hospital, Central South University. The authors declared no conflicts of interest in relation to the subject of the study. Three of the authors reported receiving grants from 1 or more pharma companies, outside the submitted work.

Source: Lyu H et al. Ann Intern Med. 2020 Jul 28. doi: 10.7326/M20-0882.

Key clinical point: Delaying denosumab doses by more than 16 weeks is associated with an increased risk of vertebral fracture in patients with osteoporosis vs. on-time injections. However, evidence is insufficient to conclude that fracture risk is increased at other anatomical sites with a long delay.

Major finding: Compared with on-time injections (within 4 weeks after the recommended date), short delay (by 4-16 weeks) had a hazard ratio (HR) of 1.03 and long delay (by more than 16 weeks) an HR of 1.44 (P for trend = .093) for composite fracture. For vertebral fractures, short delay had an HR of 1.48 and long delay an HR of 3.91 (P for trend = .005).

Study details: This U.K. population-based cohort study included 2,594 patients (age, 45 years or older) who initiated denosumab therapy for osteoporosis.

Disclosures: The study was supported by a grant from the National Institutes of Health and by the internal resources from the National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation (Beijing) and Xiangya Hospital, Central South University. The authors declared no conflicts of interest in relation to the subject of the study. Three of the authors reported receiving grants from 1 or more pharma companies, outside the submitted work.

Source: Lyu H et al. Ann Intern Med. 2020 Jul 28. doi: 10.7326/M20-0882.

Key clinical point: Delaying denosumab doses by more than 16 weeks is associated with an increased risk of vertebral fracture in patients with osteoporosis vs. on-time injections. However, evidence is insufficient to conclude that fracture risk is increased at other anatomical sites with a long delay.

Major finding: Compared with on-time injections (within 4 weeks after the recommended date), short delay (by 4-16 weeks) had a hazard ratio (HR) of 1.03 and long delay (by more than 16 weeks) an HR of 1.44 (P for trend = .093) for composite fracture. For vertebral fractures, short delay had an HR of 1.48 and long delay an HR of 3.91 (P for trend = .005).

Study details: This U.K. population-based cohort study included 2,594 patients (age, 45 years or older) who initiated denosumab therapy for osteoporosis.

Disclosures: The study was supported by a grant from the National Institutes of Health and by the internal resources from the National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation (Beijing) and Xiangya Hospital, Central South University. The authors declared no conflicts of interest in relation to the subject of the study. Three of the authors reported receiving grants from 1 or more pharma companies, outside the submitted work.

Source: Lyu H et al. Ann Intern Med. 2020 Jul 28. doi: 10.7326/M20-0882.

Key clinical point: Postmenopausal women with osteoporosis have a lower concentration of serum magnesium (Mg). However, the association between serum Mg concentration and osteopenia is not significant.

Major finding: Serum Mg concentration was lower in postmenopausal women with osteoporosis vs. healthy controls (standardized mean difference [SMD], −0.56; 95% confidence interval [CI], −1.02 to −0.09). However, the concentration of serum Mg did not differ between those with osteopenia and healthy controls (SMD, −0.30; 95% CI, −0.69 to 0.09).

Study details: A meta-analysis of 11 studies including 2,776 postmenopausal women.

Disclosures: The study was financially supported through grants from the Natural Science Foundation of Shandong Province, the Medical and Health Science and Technology Development Project of Shandong Province, the Clinical Medical Science and Technology Innovation Program of the Jinan Science and Technology Bureau, and the Traditional Chinese Medicine Technology Development Plan of Shandong Province. The authors declared no conflicts of interest.

Source: Chang J et al. Front Med. 2020 Aug 4. doi: 10.3389/fmed.2020.00381.

Key clinical point: Postmenopausal women with osteoporosis have a lower concentration of serum magnesium (Mg). However, the association between serum Mg concentration and osteopenia is not significant.

Major finding: Serum Mg concentration was lower in postmenopausal women with osteoporosis vs. healthy controls (standardized mean difference [SMD], −0.56; 95% confidence interval [CI], −1.02 to −0.09). However, the concentration of serum Mg did not differ between those with osteopenia and healthy controls (SMD, −0.30; 95% CI, −0.69 to 0.09).

Study details: A meta-analysis of 11 studies including 2,776 postmenopausal women.

Disclosures: The study was financially supported through grants from the Natural Science Foundation of Shandong Province, the Medical and Health Science and Technology Development Project of Shandong Province, the Clinical Medical Science and Technology Innovation Program of the Jinan Science and Technology Bureau, and the Traditional Chinese Medicine Technology Development Plan of Shandong Province. The authors declared no conflicts of interest.

Source: Chang J et al. Front Med. 2020 Aug 4. doi: 10.3389/fmed.2020.00381.

Key clinical point: Postmenopausal women with osteoporosis have a lower concentration of serum magnesium (Mg). However, the association between serum Mg concentration and osteopenia is not significant.

Major finding: Serum Mg concentration was lower in postmenopausal women with osteoporosis vs. healthy controls (standardized mean difference [SMD], −0.56; 95% confidence interval [CI], −1.02 to −0.09). However, the concentration of serum Mg did not differ between those with osteopenia and healthy controls (SMD, −0.30; 95% CI, −0.69 to 0.09).

Study details: A meta-analysis of 11 studies including 2,776 postmenopausal women.

Disclosures: The study was financially supported through grants from the Natural Science Foundation of Shandong Province, the Medical and Health Science and Technology Development Project of Shandong Province, the Clinical Medical Science and Technology Innovation Program of the Jinan Science and Technology Bureau, and the Traditional Chinese Medicine Technology Development Plan of Shandong Province. The authors declared no conflicts of interest.

Source: Chang J et al. Front Med. 2020 Aug 4. doi: 10.3389/fmed.2020.00381.

Key clinical point: Early treatment with romosozumab significantly improves bone mineral density (BMD) of the lumbar spine (LS) in postmenopausal osteoporosis. The response is attenuated by previous treatment and predicted by early changes in bone turnover markers.

Major finding: At 6 months of romosozumab induction, the naïve group had the highest increase in LS BMD (13.6%; P less than .001), followed by teriparatide (8.7%; P less than .001), bisphosphonates (7.5%; P less than .001), and denosumab (3.6%; P less than .001) groups. Serum N-terminal type I procollagen propeptide value at baseline and 1 month and isoform 5b of tartrate-resistant acid phosphatase value at baseline and its percentage change at 1 and 6 months were significant predictors (P less than .05) of LS BMD change at 6 months.

Study details: The data come from a prospective, observational, multicenter study of postmenopausal patients with osteoporosis who were either treatment naïve and received romosozumab (n = 37) or were previously treated with bisphosphonates (n = 33), denosumab (n = 45), or teriparatide (n = 15) and switched to romosozumab.

Disclosures: The study received no commercial funding. Dr. Kosuke Ebina and Dr. Ken Nakata are affiliated with the Department of Musculoskeletal Regenerative Medicine, Osaka University, Graduate School of Medicine, which is supported by Taisho. Dr. Kosuke Ebina, Dr. Makoto Hirao, Dr. Hideki Tsuboi, Dr. Yoshio Nagayama, and Dr. Masafumi Kashii have received research grants from various pharmaceutical companies. The remaining authors reported no conflicts of interest.

Source: Ebina K et al. Bone. 2020 Aug 7. doi: 10.1016/j.bone.2020.115574.

Key clinical point: Early treatment with romosozumab significantly improves bone mineral density (BMD) of the lumbar spine (LS) in postmenopausal osteoporosis. The response is attenuated by previous treatment and predicted by early changes in bone turnover markers.

Major finding: At 6 months of romosozumab induction, the naïve group had the highest increase in LS BMD (13.6%; P less than .001), followed by teriparatide (8.7%; P less than .001), bisphosphonates (7.5%; P less than .001), and denosumab (3.6%; P less than .001) groups. Serum N-terminal type I procollagen propeptide value at baseline and 1 month and isoform 5b of tartrate-resistant acid phosphatase value at baseline and its percentage change at 1 and 6 months were significant predictors (P less than .05) of LS BMD change at 6 months.

Study details: The data come from a prospective, observational, multicenter study of postmenopausal patients with osteoporosis who were either treatment naïve and received romosozumab (n = 37) or were previously treated with bisphosphonates (n = 33), denosumab (n = 45), or teriparatide (n = 15) and switched to romosozumab.

Disclosures: The study received no commercial funding. Dr. Kosuke Ebina and Dr. Ken Nakata are affiliated with the Department of Musculoskeletal Regenerative Medicine, Osaka University, Graduate School of Medicine, which is supported by Taisho. Dr. Kosuke Ebina, Dr. Makoto Hirao, Dr. Hideki Tsuboi, Dr. Yoshio Nagayama, and Dr. Masafumi Kashii have received research grants from various pharmaceutical companies. The remaining authors reported no conflicts of interest.

Source: Ebina K et al. Bone. 2020 Aug 7. doi: 10.1016/j.bone.2020.115574.

Key clinical point: Early treatment with romosozumab significantly improves bone mineral density (BMD) of the lumbar spine (LS) in postmenopausal osteoporosis. The response is attenuated by previous treatment and predicted by early changes in bone turnover markers.

Major finding: At 6 months of romosozumab induction, the naïve group had the highest increase in LS BMD (13.6%; P less than .001), followed by teriparatide (8.7%; P less than .001), bisphosphonates (7.5%; P less than .001), and denosumab (3.6%; P less than .001) groups. Serum N-terminal type I procollagen propeptide value at baseline and 1 month and isoform 5b of tartrate-resistant acid phosphatase value at baseline and its percentage change at 1 and 6 months were significant predictors (P less than .05) of LS BMD change at 6 months.

Study details: The data come from a prospective, observational, multicenter study of postmenopausal patients with osteoporosis who were either treatment naïve and received romosozumab (n = 37) or were previously treated with bisphosphonates (n = 33), denosumab (n = 45), or teriparatide (n = 15) and switched to romosozumab.

Disclosures: The study received no commercial funding. Dr. Kosuke Ebina and Dr. Ken Nakata are affiliated with the Department of Musculoskeletal Regenerative Medicine, Osaka University, Graduate School of Medicine, which is supported by Taisho. Dr. Kosuke Ebina, Dr. Makoto Hirao, Dr. Hideki Tsuboi, Dr. Yoshio Nagayama, and Dr. Masafumi Kashii have received research grants from various pharmaceutical companies. The remaining authors reported no conflicts of interest.

Source: Ebina K et al. Bone. 2020 Aug 7. doi: 10.1016/j.bone.2020.115574.

Key clinical point: Diets rich in pro-inflammatory components may increase the risk of osteoporosis, fractures, and lower bone mineral density (BMD) of lumbar spine and total hip.

Major finding: Dietary Inflammatory Index (DII) was negatively linked with BMD of lumbar spine (odds ratios [OR], 0.990; P = .144) and total hip (OR, 0.995; P = .392). The highest category of DII was associated with an elevated risk of osteoporosis (pooled effect size [ES], 1.31; 95% confidence interval [CI], 1.16-1.48) and fractures (pooled ES, 1.26; 95% CI, 1.03-1.59) compared with the lowest category of DII.

Study details: A meta-analysis of 11 studies (4 cohort, 1 case-control, and 6 cross-sectional) involving 127,769 participants.

Disclosures: The study was supported by the National Natural Science Foundation of China. The authors declared no conflicts of interest.

Source: Fang Y et al. Osteoporos Int. 2020 Aug 1. doi: 10.1007/s00198-020-05578-8.

Key clinical point: Diets rich in pro-inflammatory components may increase the risk of osteoporosis, fractures, and lower bone mineral density (BMD) of lumbar spine and total hip.

Major finding: Dietary Inflammatory Index (DII) was negatively linked with BMD of lumbar spine (odds ratios [OR], 0.990; P = .144) and total hip (OR, 0.995; P = .392). The highest category of DII was associated with an elevated risk of osteoporosis (pooled effect size [ES], 1.31; 95% confidence interval [CI], 1.16-1.48) and fractures (pooled ES, 1.26; 95% CI, 1.03-1.59) compared with the lowest category of DII.

Study details: A meta-analysis of 11 studies (4 cohort, 1 case-control, and 6 cross-sectional) involving 127,769 participants.

Disclosures: The study was supported by the National Natural Science Foundation of China. The authors declared no conflicts of interest.

Source: Fang Y et al. Osteoporos Int. 2020 Aug 1. doi: 10.1007/s00198-020-05578-8.

Key clinical point: Diets rich in pro-inflammatory components may increase the risk of osteoporosis, fractures, and lower bone mineral density (BMD) of lumbar spine and total hip.

Major finding: Dietary Inflammatory Index (DII) was negatively linked with BMD of lumbar spine (odds ratios [OR], 0.990; P = .144) and total hip (OR, 0.995; P = .392). The highest category of DII was associated with an elevated risk of osteoporosis (pooled effect size [ES], 1.31; 95% confidence interval [CI], 1.16-1.48) and fractures (pooled ES, 1.26; 95% CI, 1.03-1.59) compared with the lowest category of DII.

Study details: A meta-analysis of 11 studies (4 cohort, 1 case-control, and 6 cross-sectional) involving 127,769 participants.

Disclosures: The study was supported by the National Natural Science Foundation of China. The authors declared no conflicts of interest.

Source: Fang Y et al. Osteoporos Int. 2020 Aug 1. doi: 10.1007/s00198-020-05578-8.

Key clinical point: Postmenopausal osteoporotic women with low body mass index (BMI) have a higher risk of developing osteosarcopenia. Moreover, appropriate assessments, including the presence of comorbidities, will help in identifying patients at a greater risk of developing osteosarcopenia, especially for patients aged 65-74 years.

Major finding: Patients with osteosarcopenia had a higher risk of frailty vs. those with osteoporosis alone (odds ratio [OR], 2.33; P = .028). BMI (per 1 kg/m² decrease) seemed to be the strongest factor associated with osteosarcopenia risk (adjusted OR [aOR], 1.71; P less than .01). In patients aged 65-74 years, estimated glomerular filtration rate (per 10 mL/min/1.73m² decrease) and glycated hemoglobin (per 1% decrease) were identified as independent predictors of osteosarcopenia (aOR, 1.75; P = .01 and aOR, 5.01; P = .01, respectively).

Study details: The data come from a retrospective study of 276 patients with postmenopausal osteoporosis (osteoporosis alone: n=222 and osteosarcopenia: n=54).

Disclosures: The study was supported by grants awarded to Dr. Koji Ishikawa by KAKENHI and Grant of Japan Orthopaedics and Traumatology Research Foundation. The authors declared no conflicts of interest.

Source: Okamura H et al. PLoS One. 2020 Aug 7. doi: 10.1371/journal.pone.0237454.

Key clinical point: Postmenopausal osteoporotic women with low body mass index (BMI) have a higher risk of developing osteosarcopenia. Moreover, appropriate assessments, including the presence of comorbidities, will help in identifying patients at a greater risk of developing osteosarcopenia, especially for patients aged 65-74 years.

Major finding: Patients with osteosarcopenia had a higher risk of frailty vs. those with osteoporosis alone (odds ratio [OR], 2.33; P = .028). BMI (per 1 kg/m² decrease) seemed to be the strongest factor associated with osteosarcopenia risk (adjusted OR [aOR], 1.71; P less than .01). In patients aged 65-74 years, estimated glomerular filtration rate (per 10 mL/min/1.73m² decrease) and glycated hemoglobin (per 1% decrease) were identified as independent predictors of osteosarcopenia (aOR, 1.75; P = .01 and aOR, 5.01; P = .01, respectively).

Study details: The data come from a retrospective study of 276 patients with postmenopausal osteoporosis (osteoporosis alone: n=222 and osteosarcopenia: n=54).

Disclosures: The study was supported by grants awarded to Dr. Koji Ishikawa by KAKENHI and Grant of Japan Orthopaedics and Traumatology Research Foundation. The authors declared no conflicts of interest.

Source: Okamura H et al. PLoS One. 2020 Aug 7. doi: 10.1371/journal.pone.0237454.

Key clinical point: Postmenopausal osteoporotic women with low body mass index (BMI) have a higher risk of developing osteosarcopenia. Moreover, appropriate assessments, including the presence of comorbidities, will help in identifying patients at a greater risk of developing osteosarcopenia, especially for patients aged 65-74 years.

Major finding: Patients with osteosarcopenia had a higher risk of frailty vs. those with osteoporosis alone (odds ratio [OR], 2.33; P = .028). BMI (per 1 kg/m² decrease) seemed to be the strongest factor associated with osteosarcopenia risk (adjusted OR [aOR], 1.71; P less than .01). In patients aged 65-74 years, estimated glomerular filtration rate (per 10 mL/min/1.73m² decrease) and glycated hemoglobin (per 1% decrease) were identified as independent predictors of osteosarcopenia (aOR, 1.75; P = .01 and aOR, 5.01; P = .01, respectively).

Study details: The data come from a retrospective study of 276 patients with postmenopausal osteoporosis (osteoporosis alone: n=222 and osteosarcopenia: n=54).

Disclosures: The study was supported by grants awarded to Dr. Koji Ishikawa by KAKENHI and Grant of Japan Orthopaedics and Traumatology Research Foundation. The authors declared no conflicts of interest.

Source: Okamura H et al. PLoS One. 2020 Aug 7. doi: 10.1371/journal.pone.0237454.

Key clinical point: Asthma is associated with an increased risk of osteoporosis and fragility fractures (FF), particularly vertebral and humerus fractures.

Major finding: The risk of osteoporosis and FF was higher in asthma vs. non-asthma group (adjusted hazard ratio [aHR]: 1.18 and 1.12, respectively). The effect was stronger in younger age groups (P_interaction less than .0001). Forearm-wrist (aHR, 1.21) and vertebra (aHR, 1.19) were the sites associated with a higher risk. Among patients with asthma, a single oral corticosteroid course increased the risk of osteoporosis, and greater use of inhaled corticosteroids increased the risk of both bone diseases.

Study details: This population-based matched cohort study included 138,123 patients with asthma and 520,626 age-, sex-, and practice-matched people without asthma using data from the U.K. Clinical Practice Research Datalink.

Disclosures: The study was funded by a research grant from the British Medical Association. The authors declared no conflicts of interest.

Source: Chalitsios CV et al. Eur Respir J. 2020 Aug 6. doi: 10.1183/13993003.01251-2020.

Key clinical point: Asthma is associated with an increased risk of osteoporosis and fragility fractures (FF), particularly vertebral and humerus fractures.

Major finding: The risk of osteoporosis and FF was higher in asthma vs. non-asthma group (adjusted hazard ratio [aHR]: 1.18 and 1.12, respectively). The effect was stronger in younger age groups (P_interaction less than .0001). Forearm-wrist (aHR, 1.21) and vertebra (aHR, 1.19) were the sites associated with a higher risk. Among patients with asthma, a single oral corticosteroid course increased the risk of osteoporosis, and greater use of inhaled corticosteroids increased the risk of both bone diseases.

Study details: This population-based matched cohort study included 138,123 patients with asthma and 520,626 age-, sex-, and practice-matched people without asthma using data from the U.K. Clinical Practice Research Datalink.

Disclosures: The study was funded by a research grant from the British Medical Association. The authors declared no conflicts of interest.

Source: Chalitsios CV et al. Eur Respir J. 2020 Aug 6. doi: 10.1183/13993003.01251-2020.

Key clinical point: Asthma is associated with an increased risk of osteoporosis and fragility fractures (FF), particularly vertebral and humerus fractures.

Major finding: The risk of osteoporosis and FF was higher in asthma vs. non-asthma group (adjusted hazard ratio [aHR]: 1.18 and 1.12, respectively). The effect was stronger in younger age groups (P_interaction less than .0001). Forearm-wrist (aHR, 1.21) and vertebra (aHR, 1.19) were the sites associated with a higher risk. Among patients with asthma, a single oral corticosteroid course increased the risk of osteoporosis, and greater use of inhaled corticosteroids increased the risk of both bone diseases.

Study details: This population-based matched cohort study included 138,123 patients with asthma and 520,626 age-, sex-, and practice-matched people without asthma using data from the U.K. Clinical Practice Research Datalink.

Disclosures: The study was funded by a research grant from the British Medical Association. The authors declared no conflicts of interest.

Source: Chalitsios CV et al. Eur Respir J. 2020 Aug 6. doi: 10.1183/13993003.01251-2020.

Application of oil to the hair and scalp – purported to promote increased shine, health, and growth, and decrease graying of the hair – is used in many different cultures worldwide, including in India and among people of the African diaspora. Hair oiling typically entails combing the hair, followed by applying oil from the roots to the ends about once a week prior to shampooing. Hair oiling daily or every other day, often with a hair braid, is also practiced, using coconut oil or other oils. Oil is found in various hair products and has been popular in the United States, particularly as hot oil treatments in the 1980s.

Oils are used as part of Abhyanga massage, either by an Ayurvedic practitioner or as self-massage, as part of ancient Indian Ayurvedic medicine practice. The type of oil used is determined by the practitioner depending on the individual’s needs; cold-pressed sesame oil or coconut oil is often used as the base oil. Abhyanga is often performed with oil on the entire body as an act of self-care, which includes massage of the hair and scalp. The oil and herbs that are often added to the oil, as well as the scalp massage itself, are explained by practitioners as having therapeutic effects on the hair, including exfoliation of a dry scalp and on overall well-being. Outside of Ayurvedic medicine, hair oiling is also sometimes performed in India as part of routine hair care and can be a bonding experience among parents, grandparents, and children.

Amla oil, which is derived from Indian gooseberry (Phyllanthus emblica L.) and is often used in India on the hair, contains Vitamin C and has been shown to have activity against dermatophytes. In a study conducted in India, amla oil was found to have the most activity against Microsporum canis, M. gypseum, and Trichophyton rubrum, followed by cantharidine and coconut oil, while T. mentagrophytes was most susceptible to coconut oil, followed by amla and cantharidine oil.¹ A study conducted in mice in Thailand found that 5-alpha-reductase was reduced with the dried form of the herb Phyllanthus emblica L, as well as with some other traditional Thai herbs used as hair treatments.²

Castor oil has been utilized in many cultures to promote hair growth. Ricinoleic acid, an unsaturated omega-9 fatty acid and hydroxy acid, is the major component of seed oil obtained from mature castor plants. It has anti-inflammatory and antimicrobial effects, and in one study,³ was found to inhibit prostaglandin D2, which has been implicated in the pathogenesis of androgenetic alopecia.⁴ Jamaican black castor oil is darker in color and has a more alkaline pH compared with traditional castor oil (both contain ricinoleic acid). To produce Jamaican black castor oil, the seed is roasted, ground to a thick paste, boiled in a pot of hot water, then the oil is skimmed off of the top into individual bottles, whereas regular castor oil is cold pressed. The alkalinity of Jamaican black castor oil may play a role in opening up the hair cuticle, which may be beneficial, but application also needs to be followed by a routine that includes closing the cuticle to avoid increasing hair fragility; such a routine could include, for example, leave-in conditioner or rinsing conditioner with colder water.

Castor oil is sometimes used on its own or in combination with other oils, and it is also an ingredient in some hair care products. However, publicly available peer-reviewed research articles demonstrating the effects of castor oil when applied directly to the hair and scalp for hair growth are needed.

Different types of hair oils are used in African American hair care products and, worldwide, by people of the African diaspora as part of regular hair care and hair styling. Common oils include jojoba, coconut, castor, argan, olive, sunflower, and almond oils. Very curly hair often dries out more easily, especially in drier climates; and sebum build-up on the scalp does not occur as quickly, so hair typically does not need to be shampooed frequently. As such, over-shampooing also often dries the hair out faster, especially if hair has been chemically processed. Thus, oils help to coat and protect the hair, and smooth the cuticle. Oils themselves do not moisturize, but can seal moisture into the hair or act as humectants and draw moisture in. Rather than applying on dry hair, oils, when used as daily care as opposed to before shampooing, are often applied on clean hair after shampooing and after a leave-in conditioner has been applied to help seal in moisture for the most benefit. For treatment of scalp conditions, depending on the type of hair care practice performed at home, oils may be preferred over potentially drying solutions and foams if available, for optimum hair care.

Hair oiling is a long-standing practice which, when used correctly, can be beneficial for hair management and health. There are, however, caveats to hair oiling, which include being careful not to excessively brush or comb hair that has a lot of oil in it because the hair is slick, which can cause hair to fall out during combing. Some oils have elevated levels of lauric acid (coconut oil has 50%), which has a high affinity for hair proteins.⁵ While this can support hair strength, care should be taken not to overuse some oils or other products known as “protein packs,” which should be used as directed. Since hair is protein, excess protein build-up coating the hair can block needed moisture, making the hair more knotted and brittle, potentially resulting in more breakage with brushing or other hair care practices.

Some oil-containing hair products also contain artificial fragrances and/or dyes, which in some individuals, may promote an immunogenic effect, such as contact dermatitis. Certain oils, particularly olive oil, can promote an environment favorable to yeast growth, especially Malassezia species, implicated in seborrheic dermatitis. Practices that involve excessive application of oil to the scalp can also result in build up if not shampooed regularly. Sulfonated castor oil (also known as Turkey Red oil) has been reported to cause contact dermatitis.⁶
 

Dr. Wesley and Dr. Talakoub are cocontributors to this column. Dr. Wesley practices dermatology in Beverly Hills, Calif. Dr. Talakoub is in private practice in McLean, Va. This month’s column is by Dr. Wesley. Write to them at dermnews@mdedge.com. They had no relevant disclosures.

Application of oil to the hair and scalp – purported to promote increased shine, health, and growth, and decrease graying of the hair – is used in many different cultures worldwide, including in India and among people of the African diaspora. Hair oiling typically entails combing the hair, followed by applying oil from the roots to the ends about once a week prior to shampooing. Hair oiling daily or every other day, often with a hair braid, is also practiced, using coconut oil or other oils. Oil is found in various hair products and has been popular in the United States, particularly as hot oil treatments in the 1980s.

Oils are used as part of Abhyanga massage, either by an Ayurvedic practitioner or as self-massage, as part of ancient Indian Ayurvedic medicine practice. The type of oil used is determined by the practitioner depending on the individual’s needs; cold-pressed sesame oil or coconut oil is often used as the base oil. Abhyanga is often performed with oil on the entire body as an act of self-care, which includes massage of the hair and scalp. The oil and herbs that are often added to the oil, as well as the scalp massage itself, are explained by practitioners as having therapeutic effects on the hair, including exfoliation of a dry scalp and on overall well-being. Outside of Ayurvedic medicine, hair oiling is also sometimes performed in India as part of routine hair care and can be a bonding experience among parents, grandparents, and children.

Amla oil, which is derived from Indian gooseberry (Phyllanthus emblica L.) and is often used in India on the hair, contains Vitamin C and has been shown to have activity against dermatophytes. In a study conducted in India, amla oil was found to have the most activity against Microsporum canis, M. gypseum, and Trichophyton rubrum, followed by cantharidine and coconut oil, while T. mentagrophytes was most susceptible to coconut oil, followed by amla and cantharidine oil.¹ A study conducted in mice in Thailand found that 5-alpha-reductase was reduced with the dried form of the herb Phyllanthus emblica L, as well as with some other traditional Thai herbs used as hair treatments.²

Castor oil has been utilized in many cultures to promote hair growth. Ricinoleic acid, an unsaturated omega-9 fatty acid and hydroxy acid, is the major component of seed oil obtained from mature castor plants. It has anti-inflammatory and antimicrobial effects, and in one study,³ was found to inhibit prostaglandin D2, which has been implicated in the pathogenesis of androgenetic alopecia.⁴ Jamaican black castor oil is darker in color and has a more alkaline pH compared with traditional castor oil (both contain ricinoleic acid). To produce Jamaican black castor oil, the seed is roasted, ground to a thick paste, boiled in a pot of hot water, then the oil is skimmed off of the top into individual bottles, whereas regular castor oil is cold pressed. The alkalinity of Jamaican black castor oil may play a role in opening up the hair cuticle, which may be beneficial, but application also needs to be followed by a routine that includes closing the cuticle to avoid increasing hair fragility; such a routine could include, for example, leave-in conditioner or rinsing conditioner with colder water.

Castor oil is sometimes used on its own or in combination with other oils, and it is also an ingredient in some hair care products. However, publicly available peer-reviewed research articles demonstrating the effects of castor oil when applied directly to the hair and scalp for hair growth are needed.

Different types of hair oils are used in African American hair care products and, worldwide, by people of the African diaspora as part of regular hair care and hair styling. Common oils include jojoba, coconut, castor, argan, olive, sunflower, and almond oils. Very curly hair often dries out more easily, especially in drier climates; and sebum build-up on the scalp does not occur as quickly, so hair typically does not need to be shampooed frequently. As such, over-shampooing also often dries the hair out faster, especially if hair has been chemically processed. Thus, oils help to coat and protect the hair, and smooth the cuticle. Oils themselves do not moisturize, but can seal moisture into the hair or act as humectants and draw moisture in. Rather than applying on dry hair, oils, when used as daily care as opposed to before shampooing, are often applied on clean hair after shampooing and after a leave-in conditioner has been applied to help seal in moisture for the most benefit. For treatment of scalp conditions, depending on the type of hair care practice performed at home, oils may be preferred over potentially drying solutions and foams if available, for optimum hair care.

Hair oiling is a long-standing practice which, when used correctly, can be beneficial for hair management and health. There are, however, caveats to hair oiling, which include being careful not to excessively brush or comb hair that has a lot of oil in it because the hair is slick, which can cause hair to fall out during combing. Some oils have elevated levels of lauric acid (coconut oil has 50%), which has a high affinity for hair proteins.⁵ While this can support hair strength, care should be taken not to overuse some oils or other products known as “protein packs,” which should be used as directed. Since hair is protein, excess protein build-up coating the hair can block needed moisture, making the hair more knotted and brittle, potentially resulting in more breakage with brushing or other hair care practices.

Some oil-containing hair products also contain artificial fragrances and/or dyes, which in some individuals, may promote an immunogenic effect, such as contact dermatitis. Certain oils, particularly olive oil, can promote an environment favorable to yeast growth, especially Malassezia species, implicated in seborrheic dermatitis. Practices that involve excessive application of oil to the scalp can also result in build up if not shampooed regularly. Sulfonated castor oil (also known as Turkey Red oil) has been reported to cause contact dermatitis.⁶
 

Dr. Wesley and Dr. Talakoub are cocontributors to this column. Dr. Wesley practices dermatology in Beverly Hills, Calif. Dr. Talakoub is in private practice in McLean, Va. This month’s column is by Dr. Wesley. Write to them at dermnews@mdedge.com. They had no relevant disclosures.

Application of oil to the hair and scalp – purported to promote increased shine, health, and growth, and decrease graying of the hair – is used in many different cultures worldwide, including in India and among people of the African diaspora. Hair oiling typically entails combing the hair, followed by applying oil from the roots to the ends about once a week prior to shampooing. Hair oiling daily or every other day, often with a hair braid, is also practiced, using coconut oil or other oils. Oil is found in various hair products and has been popular in the United States, particularly as hot oil treatments in the 1980s.

Oils are used as part of Abhyanga massage, either by an Ayurvedic practitioner or as self-massage, as part of ancient Indian Ayurvedic medicine practice. The type of oil used is determined by the practitioner depending on the individual’s needs; cold-pressed sesame oil or coconut oil is often used as the base oil. Abhyanga is often performed with oil on the entire body as an act of self-care, which includes massage of the hair and scalp. The oil and herbs that are often added to the oil, as well as the scalp massage itself, are explained by practitioners as having therapeutic effects on the hair, including exfoliation of a dry scalp and on overall well-being. Outside of Ayurvedic medicine, hair oiling is also sometimes performed in India as part of routine hair care and can be a bonding experience among parents, grandparents, and children.

Amla oil, which is derived from Indian gooseberry (Phyllanthus emblica L.) and is often used in India on the hair, contains Vitamin C and has been shown to have activity against dermatophytes. In a study conducted in India, amla oil was found to have the most activity against Microsporum canis, M. gypseum, and Trichophyton rubrum, followed by cantharidine and coconut oil, while T. mentagrophytes was most susceptible to coconut oil, followed by amla and cantharidine oil.¹ A study conducted in mice in Thailand found that 5-alpha-reductase was reduced with the dried form of the herb Phyllanthus emblica L, as well as with some other traditional Thai herbs used as hair treatments.²

Castor oil has been utilized in many cultures to promote hair growth. Ricinoleic acid, an unsaturated omega-9 fatty acid and hydroxy acid, is the major component of seed oil obtained from mature castor plants. It has anti-inflammatory and antimicrobial effects, and in one study,³ was found to inhibit prostaglandin D2, which has been implicated in the pathogenesis of androgenetic alopecia.⁴ Jamaican black castor oil is darker in color and has a more alkaline pH compared with traditional castor oil (both contain ricinoleic acid). To produce Jamaican black castor oil, the seed is roasted, ground to a thick paste, boiled in a pot of hot water, then the oil is skimmed off of the top into individual bottles, whereas regular castor oil is cold pressed. The alkalinity of Jamaican black castor oil may play a role in opening up the hair cuticle, which may be beneficial, but application also needs to be followed by a routine that includes closing the cuticle to avoid increasing hair fragility; such a routine could include, for example, leave-in conditioner or rinsing conditioner with colder water.

Castor oil is sometimes used on its own or in combination with other oils, and it is also an ingredient in some hair care products. However, publicly available peer-reviewed research articles demonstrating the effects of castor oil when applied directly to the hair and scalp for hair growth are needed.

Different types of hair oils are used in African American hair care products and, worldwide, by people of the African diaspora as part of regular hair care and hair styling. Common oils include jojoba, coconut, castor, argan, olive, sunflower, and almond oils. Very curly hair often dries out more easily, especially in drier climates; and sebum build-up on the scalp does not occur as quickly, so hair typically does not need to be shampooed frequently. As such, over-shampooing also often dries the hair out faster, especially if hair has been chemically processed. Thus, oils help to coat and protect the hair, and smooth the cuticle. Oils themselves do not moisturize, but can seal moisture into the hair or act as humectants and draw moisture in. Rather than applying on dry hair, oils, when used as daily care as opposed to before shampooing, are often applied on clean hair after shampooing and after a leave-in conditioner has been applied to help seal in moisture for the most benefit. For treatment of scalp conditions, depending on the type of hair care practice performed at home, oils may be preferred over potentially drying solutions and foams if available, for optimum hair care.

Hair oiling is a long-standing practice which, when used correctly, can be beneficial for hair management and health. There are, however, caveats to hair oiling, which include being careful not to excessively brush or comb hair that has a lot of oil in it because the hair is slick, which can cause hair to fall out during combing. Some oils have elevated levels of lauric acid (coconut oil has 50%), which has a high affinity for hair proteins.⁵ While this can support hair strength, care should be taken not to overuse some oils or other products known as “protein packs,” which should be used as directed. Since hair is protein, excess protein build-up coating the hair can block needed moisture, making the hair more knotted and brittle, potentially resulting in more breakage with brushing or other hair care practices.

Some oil-containing hair products also contain artificial fragrances and/or dyes, which in some individuals, may promote an immunogenic effect, such as contact dermatitis. Certain oils, particularly olive oil, can promote an environment favorable to yeast growth, especially Malassezia species, implicated in seborrheic dermatitis. Practices that involve excessive application of oil to the scalp can also result in build up if not shampooed regularly. Sulfonated castor oil (also known as Turkey Red oil) has been reported to cause contact dermatitis.⁶
 

Dr. Wesley and Dr. Talakoub are cocontributors to this column. Dr. Wesley practices dermatology in Beverly Hills, Calif. Dr. Talakoub is in private practice in McLean, Va. This month’s column is by Dr. Wesley. Write to them at dermnews@mdedge.com. They had no relevant disclosures.