#1 Atypical Femoral fractures @NEJM (Black DM et al.)
Risk reduces within months of @Bisphosphonate1 discontinuation. Benefit>risk in any group but less so in Asians and women <65yr nejm.org/doi/10.1056/NE…
#4 Delayed denosumab injections however surprisingly common in real-world evidence, and associated with less fracture protection, lower BMD gains (DH Solomon, Leder BZ et al.) pubmed.ncbi.nlm.nih.gov/31894244/
#9 Denosumab with or without cinacalcet for primary hyperparathyroidism (DENOCINA trial, Vestergaard @TheLancetEndo)
Dmab improved BMD but cinacalcet required to control calcemia; dmab further increased PTH...
(too bad no cinacalcet-only group) thelancet.com/journals/landi…
#11 @etiennecavalier within- and between-subject biological variation estimates of BTMs
Important for clinical interpretation especially for #FGF23
...also prize for the longest paper title of 2020 🤪 link.springer.com/article/10.100…
#3 ATRAID regulates the action of nitrogen-containing bisphosphonates on bone @LSurfactant@ScienceTM
Atraid-deficient mice had weaker bones and did not respond to N-BP treatment; patients with variants in ATRAID taking N-BPs presented with AFFs and ONJ stm.sciencemag.org/content/12/544…
#4 Regulation of #FGF23: glycerol-3-phosphate => FGF23 production through G-3-P acyltransferase–mediated lysophosphatidic acid synthesis and LPA receptor 1 @jclinicalinvest
#5 The mechanoresponse of bone is closely related to the #osteocyte lacunocanalicular network architecture @PNASNews@afvantol
...important evidence for osteocytes and the canalicular flow vs. strain hypothesis @LilianIPlotkin
Every doctor carries along her/his own little graveyard. Inevitably, we make mistakes. People die, or become disabled. You never forget those patients. 1/n
In my first year of training there was a 20yo woman with stage IV lymphoma (DLBCL). She was clinically fine but I overlooked her creatinin which showed severe CKD from diuretics. 1w later she came in with heart block from betablocker overdose and died. 2/n
An older woman during training was admitted after a fall. She complained of shoulder pain -> no fracture. Next day she was paraplegic from spinal fracture. She hadn't complained about her back and I missed that. 3/n