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Translational research into osteoporosis wins NSW health award

Translational research into osteoporosis wins NSW health award

January 2, 2013

Translational research into osteoporosis wins NSW health award.

Professor Markus Seibel, Dr Kirtan Ganda and Dr Anna Lih have won the prestigious 2012 NSW Health Award for their ongoing translational research into cost effective ways of treating steoporosis patients.

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Markus Seibel, Kirtan Ganda and Susan Maree receive the award from Health Minister Jillian Skinner

Significantly, their research has led the Sydney Local Health District to establish an innovative integrated Fracture Liaison Service at Concord Hospital’s Department of Endocrinology and Metabolism.

The Hon. Jillian Skinner, Minister for Health, presented the award to the members of the ANZAC Bone Research Program and the hospital’s Department of Endocrinology at a ceremony in October.

The project had its origins in 2003 when Markus Seibel and an Honours student initiated an audit of patients admitted to Concord Hospital with osteoporotic fractures and discovered that although the fractures were repaired by surgery, there was no investigation of how the fracture occurred and no treatment to minimise the risk of another similar injury.

“Everyone had an X-ray but only 3% of patients got a bone mineral density scan which is an excellent test to define future fracture risk,” Prof Seibel recalled.

“Osteoporosis was basically ignored. So in May 2005 we established a Fracture Liaison Service with the purpose to identify, investigate and properly manage patients who presented to Concord Hospital with a recent minimal trauma fracture.”

In 2010 Drs Lih and Ganda and Prof Seibel analysed data from about 250 patients and compared the results to those from some 160 patients who had not taken up the opportunity, but were otherwise similar.

“While this was a non-randomised study and certain biases would naturally exist, our results were clear enough – re-fracture rates were 20% in the unmanaged group and only 4% in the managed group,” says Prof Seibel.

“Effectively, proper management of osteoporosis reduced the risk of re-fracture by up to 80%. Not only that, but we found the service and its interventions were highly cost efficient.

“A well-managed Fracture Liaison Service costs money. Our service is run by a doctor with some input from nursing staff, and we do blood tests, X-rays and a bone mineral density scan to identify those patients who require treatment, which usually consists of calcium, vitamin D and an anti-resorptive agent such as a bisphosphonate. All of that costs money but when you balance that against the cost of further fractures, in particular hip fractures, the service we deliver is peanuts compared with the follow on cost of further fractures. Just one example, a re-fracture has an average stay in hospital of 22 days. The direct costs are so large we don’t even have to take into account the indirect costs.”

The team put together a business case and the Sydney Local Health District agreed to establish and support a part-time position for a doctor to run the Fracture Liaison Service at Concord Hospital.

“If I’m not mistaken we’re the first hospital in NSW if not in Australia to have an institutionalised, integrated Fracture Liaison Service funded by the Local Health District,” says Prof Seibel.

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Atherosclerosis laboratory moves to ANZAC Research Institute

December 28, 2012

Photo: Courtesy Julie Taranto

The ANZAC Research Institute has achieved a significant expansion with the establishment at Concord of the Atherosclerosis Research Laboratory, previously at the Centre for Vascular Research at the University of NSW.

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The Atherosclerosis group, together with the existing Vascular Biology group.

“Having the laboratory here will greatly enhance the opportunities to collaborate with our colleagues at the ANZAC Research Institute,” said Professor Len Kritharides, who is the Director of Cardiology at Concord Hospital, and heads the Atherosclerosis and Vascular Biology Groups at the ANZAC.

“I am delighted that my colleague of many years, Professor Wendy Jessup, will be joining us to continue our laboratory research, funded by an NHMRC program grant which has just been renewed.”

The Vascular Biology team has been working closely with Concord Hospital’s Cardiology Department for several years, researching disorders of the heart and blood vessels, including platelet abnormalities and thrombosis. The addition of the atherosclerosis laboratory will provide fresh impetus and valuable resources to this research.

Atherosclerosis is a disease of the artery wall caused by a combination of cholesterol accumulation, inflammation, degeneration, and thrombosis. It is a major cause of illness and premature death worldwide, underlying almost all heart attacks, most strokes and the narrowing of arteries causing gangrene of the legs. It is promoted by conditions such as high levels of low-density lipoprotein cholesterol (LDL), low levels of protective high-density lipoprotein (HDL), diabetes, and smoking.

Cardiovascular disease causes 30% of deaths worldwide according to the World Health Organisation, and 34% of deaths here in Australia.

“Our laboratory has a long standing interest in understanding the cellular biology of atherosclerosis, particularly the investigation of cholesterol metabolism and protein secretion by macrophages,” says Prof Kritharides.

“Our laboratory research so far has been cell-based. Now that we are established at the ANZAC Research Institute we can work even more closely with colleagues within the ANZAC and Concord Hospital to develop translational research to unravel the complexities of atherosclerosis and heart disease in people.”

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