Trial reportJournal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research2013
Interruption or deferral of antiretroviral therapy reduces markers of bone turnover compared with continuous therapy: The SMART body composition substudy.
Trial report in Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed, 37 citations in OpenAlex.
- Vitamin D and Calcium Supplement Attenuate Bone Loss among HIVInfected Patients Receiving Tenofovir Disoproxil Fumarate/Emtricitabine/ Efavirenz: An Open-Label, Randomized Controlled Trial.Current HIV research · 2020Trial
- Immediate Initiation of Antiretroviral Therapy for HIV Infection Accelerates Bone Loss Relative to Deferring Therapy: Findings from the START Bone Mineral Density Substudy, a Randomized Trial.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2017Trial
- Greater change in bone turnover markers for efavirenz/emtricitabine/tenofovir disoproxil fumarate versus dolutegravir + abacavir/lamivudine in antiretroviral therapy-naive adults over 144 weeks.AIDS (London, England) · 2015Trial
- Bone loss in young adults with HIV following antiretroviral therapy containing tenofovir disoproxil fumarate regimen using machine learning.Frontiers in pharmacology · 2025Article
- The effect of anti-retroviral therapy on fracture healing : an in vivo animal model.Bone & joint research · 2022Article
- Pharmacotherapeutic options for kidney disease in HIV positive patients.Expert opinion on pharmacotherapy · 2021Review
- People living with HIV and fracture risk.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2020Review
- Influence of HIV Infection and Antiretroviral Therapy on Bone Homeostasis.Frontiers in endocrinology · 2020Review
- The Hidden Burden of Fractures in People Living With HIV.JBMR plus · 2018Review
- Serious Non-AIDS Conditions in HIV: Benefit of Early ART.Current HIV/AIDS reports · 2018Review
- Upregulation of Apoptosis Pathway Genes in Peripheral Blood Mononuclear Cells of HIV-Infected Individuals with Antiretroviral Therapy-Associated Mitochondrial Toxicity.Antimicrobial agents and chemotherapy · 2017Article
- Does systemic inflammation and immune activation contribute to fracture risk in HIV?Current opinion in HIV and AIDS · 2016Review
- Osteoprotegerin, but Not Receptor Activator for Nuclear Factor-κB Ligand, is Associated With Subclinical Coronary Atherosclerosis in HIV-Infected Men.Journal of acquired immune deficiency syndromes (1999) · 2015Article
- Bone loss in HIV: a contemporary review.Current opinion in endocrinology, diabetes, and obesity · 2015Review
- A Case of Hypercalcemia and Overexpression of CYP27B1 in Skeletal Muscle Lesions in a Patient with HIV Infection After Cosmetic Injections with Polymethylmethacrylate (PMMA) for Wasting.Calcified tissue international · 2015Article
- Clinically Indicated Corticosteroids Do Not Affect Bone Turnover During Immune Restoration of Severely Lymphopenic HIV-Infected Patients.AIDS research and human retroviruses · 2015Article
- Bone alterations associated with HIV.Current HIV/AIDS reports · 2014Article
- Relationships between inflammation, immune activation, and bone health among HIV-infected adults on stable antiretroviral therapy.Journal of acquired immune deficiency syndromes (1999) · 2014Article
- High prevalence of low bone mass and associated factors in Korean HIV-positive male patients undergoing antiretroviral therapy.Journal of the International AIDS Society · 2014Article
- Increased fracture risk with HIV infection--a growing concern.Nature reviews. Endocrinology · 2013Article
Corrections and comments
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Authors and funding
11 authors at 8 institutions in 5 countries.
Funding
Abstract
Bone mineral density (BMD) declines significantly in HIV patients on antiretroviral therapy (ART). We compared the effects of intermittent versus continuous ART on markers of bone turnover in the Body Composition substudy of the Strategies for Management of AntiRetroviral Therapy (SMART) trial and determined whether early changes in markers predicted subsequent change in BMD. For 202 participants (median age 44 years, 17% female, 74% on ART) randomized to continuous or intermittent ART, plasma markers of inflammation and bone turnover were evaluated at baseline and months 4 and 12; BMD at the spine (dual-energy X-ray absorptiometry [DXA] and computed tomography) and hip (DXA) was evaluated annually. Compared with the continuous ART group, mean bone-specific alkaline phosphatase (bALP), osteocalcin, procollagen type 1 N-terminal propeptide (P1NP), N-terminal cross-linking telopeptide of type 1 collagen (NTX), and C-terminal cross-linking telopeptide of type 1 collagen (βCTX) decreased significantly in the intermittent ART group, whereas RANKL and the RANKL:osteoprotegerin (OPG) ratio increased (all p ≤ 0.002 at month 4 and month 12). Increases in bALP, osteocalcin, P1NP, NTX, and βCTX at month 4 predicted decrease in hip BMD at month 12, whereas increases in RANKL and the RANKL:OPG ratio at month 4 predicted increase in hip and spine BMD at month 12. This study has shown that compared with continuous ART, interruption of ART results in a reduction in markers of bone turnover and increase in BMD at hip and spine, and that early changes in markers of bone turnover predict BMD changes at 12 months.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.