Papers by Luca Pietrogrande
Annals of the Rheumatic Diseases, 2012
ABSTRACT Background The ISSO was an Italian, 24-month, observational, prospective study that eval... more ABSTRACT Background The ISSO was an Italian, 24-month, observational, prospective study that evaluated the effectiveness of anti-osteoporotic treatments available in normal clinical practice for severe multi-fractured osteoporotic patients defined according to reimbursement criteria set out by the Italian Health National Service (Note 79, second part). Objectives The primary objective of the study was to estimate the proportion of patients experiencing one or more new clinical vertebral and non-vertebral fragility fractures in the first 24 months from the initiation of anti-osteoporosis medication. The evaluation of back pain and Health-Related Quality of Life (HRQOL) at 18 and 24 months were important secondary endpoints of the study and results are herein presented. Methods Back pain was evaluated by using a 0-10 visual analogue scale ([VAS]; 0 = no pain, 10 = worst possible pain), whereas the HRQOL was evaluated by using the European Quality of Life 5-Dimensions questionnaire (EQ-5D), which includes 5 dimensions of health (mobility, self-care, usual activities, pain/discomfort, anxiety/depression), and with a 0-100 mm VAS (0 = worst imaginable health state, 100 = best imaginable health state). Results Of the 769 patients (mean age ± SD 72.8±8.8 years; 689 [90.7%] women) enrolled between April 2008 and February 2009, 663 (87.2%) started a therapy and 438 (57.6%) completed the 24 months of observation. Teriparatide (572/663 patients, 86.3%) was the drug most commonly used during the study: 420/663 (63.3%) patients received only teriparatide (OT), 38/663 (5.7%) only bisphosphonates, 19/663 (2.9%) only parathyroid hormone, and 18/663 (2.7%) only strontium ranelate, while 168/663 patients (25.3%) took more than one drug. The rate of patients with back pain decreased from baseline to 18 and 24 months both in the total population (TP) (94.1%, 79.5% and 76.2%, respectively) and in those treated with OT (95.0%, 77.1% and 75.9%). The mean decreases in pain VAS from baseline to 18 and 24 months were -1.93 (95% CI: -2.21 to -1.65) and -2.05 (95% CI: -2.37 to -1.73) in TP, and were -2.31 (95% CI: -2.65 to -1.97) and -2.64 (95% CI: -3.04 to -2.23) in OT, respectively. The mean changes in EQ-5D score from baseline to 18 and 24 months were 0.125 (95% CI: 0.103 to 0.148) and 0.116 (95% CI: 0.093 to 0.138) in TP, and were 0.138 (95% CI: 0.108 to 0.167) and 0.121 (95% CI: 0.093 to 0.149) in OT, respectively. Changes in EQ-5D VAS were consistent with those of score. Conclusions The results at 18 and 24 months of the ISSO study show that the prescribed treatment was associated with improvements in back pain and HRQOL, which were sustained up to the end of the 24-month observational period. Patients treated with teriparatide as monotherapy improved at least as markedly as did the TP. Disclosure of Interest F. Bertoldo: None Declared, O. Di Munno: None Declared, L. Pietrogrande: None Declared, R. Del Fiacco Employee of: Eli Lilly Italy, H. Petto Employee of: Eli Lilly austria, P. Marchi Employee of: Eli Lilly Italy, S. Silvestri Shareholder of: Eli Lilly italy (minority shareholder), Employee of: Eli Lilly Italy
La Chirurgia Degli Organi Di Movimento, 2008
A rare case of a 28-year-old Asiatic male with the isolated absence of a posterior cruciate ligam... more A rare case of a 28-year-old Asiatic male with the isolated absence of a posterior cruciate ligament is reported. Clinical features, diagnostic steps, therapeutic strategies and follow-up are described. A review of the literature is also presented.
International Journal of Women's Health, 2009
Full length (1-84) parathyroid hormone (PTH) was introduced in Europe as a treatment for postmeno... more Full length (1-84) parathyroid hormone (PTH) was introduced in Europe as a treatment for postmenopausal osteoporosis in 2006. The efficacy of PTH (1-84) in the prevention of vertebral fractures is very high, and is similar to that of teriparatide. Its action in the prevention of femoral fractures has yet to be fully demonstrated, but the incidence of such fractures in trials was very low, and a decrease in nonvertebral fractures was seen in high-risk patients. The effect on bone mineral density (BMD) was clearly demonstrated in the spine and also in the hip. The effects on BMD were evident and increased progressively with treatment until 36 months. After its discontinuation there was a clear decrease in BMD if no antiresorptive treatment was initiated. Increases in bone volumetric density and bone volume in trabecular sites were also reported. Moreover, a bone volume increase was detected in cortical sites. Hypercalcemia and hypercalciuria are frequent consequences of PTH treatment, but rarely have clinical effects and are usually well controlled by reducing calcium and vitamin D supplementation.
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Papers by Luca Pietrogrande