AMGEN OA-ANZBMS Clinical Grant Program 2017
Professor Emma Duncan
Royal Brisbane and Women's Hospital
'Determining bone health without bone biopsy in patients with chronic kidney disease.'
Patients with chronic kidney disease have very poor bone health, with extremely high fracture rates and higher risk of death after fracture. Osteoporosis is a key component of these bone problems. Knowing how best to manage osteoporosis in a patient with kidney disease is very difficult without a bone biopsy.
Professor Duncan and her co-investigators will compare the information seen on a bone biopsy (an uncomfortable and expensive test not widely available) with the results from blood tests and state-of-the-art imaging. They hope to find a link between the main cause of osteoporosis seen on the biopsy and the results from blood tests and imaging, which could then help doctors to plan the most appropriate and targeted medical management for osteoporosis.
Knowing the main contribution to osteoporosis in patients with chronic kidney disease means treatment can be targeted more accurately to treat the main cause and prevent fracture, also avoiding the current need for painful bone biopsy.
Dr Catherine Connaughton
Australian Catholic University
'Understanding health and community services that improve recovery from fracture in older adults.'
Quality of life (QoL) is reduced for at least 12-18 months after an osteoporotic fracture. Dr Connaughton and her team aim to identify health and community services associated with rapid improvement of QoL.
The team will use data from over 6000 patients worldwide to find out which health and community services improves QoL, both 4 months and 12 months after fracture. Hip, wrist, vertebral, and arm fractures will all be studied. The influence of age, gender and socio-economic circumstances will also be analysed.
The findings of this project will benefit the 141,000 Australians who suffer fragility fractures each year. Improved recovery may reduce the cost to the economy of osteoporosis and the impacts on quality of life osteoporosis.
RACP/Osteoporosis Australia Research Entry Award 2017
Dr Angela Sheu
“The relationship between osteoporosis and diabetes: exploring the bone-metabolism interface”
Osteoporosis and diabetes are two common conditions that affect many Australians. Despite having relatively normal bone density, paradoxically diabetes patients experience more fractures. However, the underlying mechanisms that account for this increased fracture risk is unknown. Further, a commonly used osteoporosis medication may affect the development of diabetes, strengthening the link between these two hormonal pathways. Using data from the Dubbo Osteoporosis Epidemiology Study (DOES), the longest running cohort of osteoporosis in Australia, Dr Sheu will explore the factors that link bone and metabolic health. She will also conduct a trial investigating how osteoporosis medications may affect the risk of developing diabetes. This will be the first study to examine in detail the interaction between metabolic factors and bone health. The clinical goal is a greater understanding of how these processes interact, in order to identify high risk patients for both conditions, and to minimise the serious and costly complications of each of these diseases. Understanding mechanistic interactions between bone and glucose metabolism allows the potential for future therapeutic interventions to be utilised beyond their current clinical use.
Professor Philip Sambrook Young Investigator Travel Award 2017
Dr Jasna Aleksova, Hudson Institute of Medical Research: Reducing the bone health impacts of kidney dialysis
People with chronic kidney disease are at much higher risk of developing osteoporosis and fractures than the general population. PhD student Dr Jasna Aleksova is conducting research at Melbourne’s Hudson Institute of Medical Research to understand why this happens, and investigating ways to more easily detect poor bone health in these patients.
A large study conducted by Dr Aleksova and her colleagues has found that low levels of the sex hormone oestradiol, a common effect of dialysis in men, is strongly linked to low spinal bone strength. This important finding may lead to new treatments to help preserve bone strength in these patients.
Further research by Dr Aleksova’s group has found that highly detailed analysis of bone density x-ray images to reveal the microscopic ‘architecture’ inside bones is a highly sensitive and convenient way of predicting fracture risk in patients with advanced kidney disease. The usual way of assessing bone health in dialysis patients is to remove a tiny piece of bone for examination under the microscope. Dr Aleksova’s work may help to reduce the need for this invasive and difficult procedure.
Dr Aleksova is presenting her findings at the American Society of Bone and Mineral Research annual meeting in Denver, USA, in September 2017.