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Bone anabolics in osteoporosis: Actuality and perspectives

World Journal of Orthopedics 2014年第3期5卷 247-254页

作者： andrea montagnani Metabolic Bone Diseases Area Department of Internal MedicineMisericordia Hospital58100 GrossetoItaly

Vertebral and nonvertebral fractures prevention is the main goal for osteoporosis therapy by inhibiting bone resorption and/or stimulating bone *** drugs decrease the activation frequency,thereby determining a secondary decrease in bone formation rate and a low bone *** are today’s mainstay among antiresorptive treatment of ***,oral selective estrogen receptor modulators and recently denosumab have a negative effect on bone *** active on bone formation are considered a better perspective in the treatment of severe ***-human parathyroid hormone(PTH)has showed to increase bone formation and significantly decrease vertebral fractures in severe patients,but with a modest effect on nonvertebral *** study of Wnt signaling pathway,that induces prevalently an osteoblastic activity,opens large possibilities to antagonists of Wnt-inhibitors,such as sclerostin antibodies and dickkopf-1 antagonists,with potential effects not only on trabecular bone but also on cortical bone.

关键词： Anabolic therapy Bone mass Bone fracture Osteoporosis

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Severe immune thrombocytopenia after peg-interferonalpha2a, ribavirin and telaprevir treatment completion: a case report and systematic review of literature

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World Journal of Hepatology 2015年第12期7卷 1718-1722页

作者： Rosario Arena Paolo Cecinato andrea Lisotti Federica Buonfiglioli Claudio Calvanese Giuseppe Grande Marco montagnani Francesco Azzaroli Giuseppe Mazzella Department of Medical and Surgical Science-DIMEC University of Bologna S.Orsola-Malpighi Hospital

Mild to moderate autoimmune thrombocytopenia(AITP) is a common finding in patients receiving interferonbased antiviral treatment, due to bone marrow suppression. Here we report the case of a patient with chronic genotype 1b hepatitis C virus(HCV) infection treated with pegylated-interferon alpha-2a, ribavirin and telaprevir for 24 wk; the patient developed severe AITP three weeks after treatment withdrawal. We performed a systematic literature search in order to review all published cases of AITP related to HCV antiviral treatment. To our knowledge, this is the second case of AITP observed after antiviral treatment withdrawal. In most published cases AITP occurred during treatment; in fact, among 24 cases of AITP related to interferonbased antiviral treatment, only one occurred after discontinuation. Early diagnosis of AITP is a key factor in order to achieve an early interferon discontinuation; in the era of new direct antiviral agents those patients have to be considered for interferon-free treatment regimens. Prompt prescription of immuno-suppressant treatment(i.e., corticosteroids, immunoglobulin infusion and even rituximab for unresponsive cases) leads to favourable prognosis in most of cases. Physicians using interferonbased treatments should be aware that AITP can occur both during and after treatment, specially in the new era of interferon-free antiviral treatment. Finally, in the case of suspected AITP, presence of anti-platelet antibodies should be checked not only during treatment but alsoafter discontinuation.

关键词： Autoimmune thrombocytopenia Pegylatedinterferon Chronic hepatitis C Viral hepatitis Antiplateletantibody

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