The administration of denosumab (Prolix) improved QoL in patients with painful bone metastatic disease, particularly the improvement of EODS. Denosumab (Prolix) may also reduce the overall pain intensity.
Most chronic wounds can be cured with a variety of effective treatments in the right circumstances. In some cases, a cure occurs by its self, when a wound is managed in a good manner, without the use of surgery.
Wounds heal, at least partially, through scarring and the formation of collagen. The collagen scar is highly vascularized, in part through vasopressins. Increased blood flow is necessary to overcome the formation of scar tissue. The scar is composed of the extracellular matrix and collagen. The extracellular matrix is the precursor of the extracellular matrix. Collagen is the main element of the extracellular matrix. Collagen has many functions. Collagen serves as a scaffold to help cells attach, and a cell-signaling molecule. Most cells, after they bind to collagen, express specific proteins to assist in cell adhesion. The collagen fibers are organized in bundles.
About one million people get a wound a year in the United States. Overall, about one billion wounds are treated each year in the United States. While most wounds from accidents and falls will be manageable, more serious injuries are more difficult to treat. However, in the United States, treatment in the emergency department remains low and a significant proportion of patients are discharged without having been examined by a physician.
Many wound treatments exist that differ widely in their efficacy and are reliant on the particular wound type. Treatments are often chosen based on treatment success/failure and individual patient need. Although the efficacy of all treatments available for burn and scald injuries has not been adequately evaluated, evidence suggests that they should be preferred over wait-and-see management, because of the higher risk of infections in the latter approach.
Some of the most common signs of wounds include redness, tenderness or discharge. These signs are due to infection in 20-60% of the cases depending on the age group. The commonest sign (30-45% in all age groups) is bleeding. A history of chronic pain, and inability to fully extend the elbow, fingers, knee and toes may be related to arthritis. Patients under 16 years who complain of persistent soreness can have an underlying gastrointestinal problem. Other signs and symptoms depend on the underlying diagnosis of the wound.
Although wounds are mostly the result of disease, they can also be caused by wounds that are too small or too small relative to the size of the patient. Wounds that result in healing without scarring and wounds that are too large cause problems. Wounds can be caused by a variety of factors, some of which include trauma and infection. Wounds that have not adequately healed can be the result of an allergic reaction or an adverse reaction to drugs or surgical equipment. Wound healing always requires careful observation, however, in many cases the healing takes a relatively long time.
These data suggest that a bisphosphonate may provide some benefit. The benefit, if any, could be related more to improved fracture-healing than to disease stabilization or fracture prevention. Further research is warranted to investigate longer-lasting effects.
Both denosumab 75 mg and 100 mg are effective in the short-term treatment of osteoporotic vertebral compression fractures. However, the benefit of denosumab is significantly less than that of the standard-of-care treatment with bisphosphonates.
Denosumab, like many other therapeutic agents (e.g., antibiotics, NSAID, or diuretics), can affect normal physiological processes that depend on the normal functioning of bones and teeth (anatomic dynamics, bone and tooth mineralization, turnover, and bone remodeling). The risk should be considered with denosumab in patients with renal impairment or on dialysis. Because denosumab may affect these normal physiological processes in bone, it may trigger an unexpected adverse reaction such as a fracture. Patients with diabetes mellitus and renal dysfunction who take denosumab should be closely monitored.
At least two other clinical trials involving denosumab in patients with osteosarcoma are being performed. There remains potential interest in investigating the use of denosumab in patients with NSCLC.
Average age was 60.8 years. In a 5-year period (2010-2015), 15% of male patients and 39% female patients received wounds. In this small sample size, there was no statistically significant difference between male and female patients. It is suggested that wound healing time could influence the age of onset.