The assessment of bone strength based on the results of ultrasound densitometry in infants born after in vitro fertilization (IVF) weighing less than 1500 g

D.R. Merzlyakova1,2, N.R. Hafizova1, G.A. Vakhitova1, Z.A. Shangareeva1, G.G. Gilyazova2, A.I. Nazarova1 1Bashkir State Medical University, Ufa, Russian Federation 2Republican Children's Clinical Hospital, Ufa, Russian Federation Aim: to assess the status of bone mineral density (BMD) using the ultrasound densitometry as a screening technique in premature in vitro fertilization (IVF) and non-IVF infants weighing less than 1500 g at birth. Patients and Methods: the study included 189 premature babies who stayed in the department for newborns and premature infants with health problems. The infants were divided into two groups, depending on the IVF use: born through the IVF or conceived naturally. Each of the groups was divided into two subgroups based on the infant weight at birth: subgroups A consisted of very low birth weight (VLBW) babies and subgroups B consisted of extremely low birth weight (ELBW) babies. The first group (n=101) consisted of IVF-infants, 52 and 49 of them were included in subgroups 1A and 1B, respectively. The second group (comparison, n=88) consisted of the naturally conceived infants, 46 and 42 of them were included in subgroups 2A and 2B, respectively. BMD was measured using the ultrasound densitometry method. The evaluated parameters comprised the speed of sound (SOS) and Z-score, representing the difference in BMD between the studied infants and the mean BMD of other children of the same age and gender (standard deviation (SD) for the tibia). Z-score &lt;-1 SD (SOS &lt;10‰ and &gt;3‰) was associated with a low bone density and Z-score &lt;-2 SD (SOS &lt;3‰) – with a clinically significant low bone density. Results: the normal values of bone density were found in 39 (38.6%) infants of group 1 and 58 (65.9%) infants of group 2 (p&gt;0.05). In the group 1 infants a decrease in bone density was found more frequently than in the group 2 infants: 49 (48.5%) and 21 (23.8%), respectively, p&lt;0.05, and the difference was statistically significant (&lt;-1SD). A clinically significant low bone density (SOS &lt;3‰) found in 13 (12.8%) IVF-babies. The extremely low birth weight (ELBW) in IVF-babies is a risk factor for osteopenia and osteoporosis. Conclusion: a significant decrease in the bone density values (SOS &lt;10‰ and &gt;3‰) was found in IVF-infants as compared to those in naturally conceived infants. A clinically significant decrease in bone density in premature IVF-infants with ELBW was reported in 12.8% of cases. The early diagnosis of osteopenia can be established by using a safe technique — the ultrasound densitometry. Keywords: bone mineral density, densitometry, in vitro fertilization, IVF, premature babies, osteopenia, bone tissue, screening, very low birth weight, extremely low birth weight. For citation: Merzlyakova D.R., Hafizova N.R., Vakhitova G.A. et al. The assessment of bone strength based on the results of ultrasound densitometry in infants born after in vitro fertilization (IVF) weighing less than 1500 g. Russian Journal of Woman and Child Health. 2023;6(1):34–38 (in Russ.). DOI: 10.32364/2618-8430-2023-6-1-34-38. </p

Multiple Myeloma Treatment in Real-world Clinical Practice: Results of a Prospective, Multinational, Noninterventional Study

Multiple myeloma (MM) remains an incurable disease, with little information available on its management in real-world clinical practice. The results of the present prospective, noninterventional observational study revealed great diversity in the treatment regimens used to treat MM. Our results also provide data to inform health economic, pharmacoepidemiologic, and outcomes research, providing a framework for the design of protocols to improve the outcomes of patients with MM. Background: The present prospective, multinational, noninterventional study aimed to document and describe real-world treatment regimens and disease progression in multiple myeloma (MM) patients. Patients and Methods: Adult patients initiating any new MM therapy from October 2010 to October 2012 were eligible. A multistage patient/site recruitment model was applied to minimize the selection bias; enrollment was stratified by country, region, and practice type. The patient medical and disease features, treatment history, and remission status were recorded at baseline, and prospective data on treatment, efficacy, and safety were collected electronically every 3 months. Results: A total of 2358 patients were enrolled. Of these patients, 775 and 1583 did and did not undergo stem cell transplantation (SCT) at any time during treatment, respectively. Of the patients in the SCT and non-SCT groups, 49%, 21%, 14%, and 15% and 57%, 20%, 12% and 10% were enrolled at treatment line 1, 2, 3, and ≥ 4, respectively. In the SCT and non-SCT groups, 45% and 54% of the patients had received bortezomib-based therapy without thalidomide/lenalidomide, 12% and 18% had received thalidomide/lenalidomide-based therapy without bortezomib, and 30% and 4% had received bortezomib plus thalidomide/lenalidomide-based therapy as frontline treatment, respectively. The corresponding proportions of SCT and non-SCT patients in lines 2, 3, and ≥ 4 were 45% and 37%, 30% and 37%, and 12% and 3%, 33% and 27%, 35% and 32%, and 8% and 2%, and 27% and 27%, 27% and 23%, and 6% and 4%, respectively. In the SCT and non-SCT patients, the overall response rate was 86% to 97% and 64% to 85% in line 1, 74% to 78% and 59% to 68% in line 2, 55% to 83% and 48% to 60% in line 3, and 49% to 65% and 36% and 45% in line 4, respectively, for regimens that included bortezomib and/or thalidomide/lenalidomide. Conclusion: The results of our prospective study have revealed great diversity in the treatment regimens used to manage MM in real-life practice. This diversity was linked to factors such as novel agent accessibility and evolving treatment recommendations. Our results provide insight into associated clinical benefits. © 2018 The Author