January 2017

Dear Colleagues,

I am honored to present my first report as ASBMR President. January is an important month in the US as we anticipate a Trump Presidency and what that might mean to medical research. The US Congress recently passed the 21st Century CURES Act providing an influx of about 7 billion dollars into medical research. This bill is indeed great news, especially if you are studying cancer or Alzheimer’s disease because the funding is specifically earmarked for certain initiatives including the Cancer Moonshot and the Brain and Precision Medicine Initiatives. However, to fund this they took away funding from Public Health Initiatives designed to keep people healthy and help prevent major chronic diseases like diabetes and osteoporosis. We will have to be strident in our advocacy for Bone, Mineral and Musculoskeletal research. This defense will be increasingly important in the uncertain future. Let us move forward with renewed vigor, together.

With this year being ASBMR’s 40th anniversary, we are looking both to our past to recognize the progress we have made and to our future with optimism as we celebrate and reflect on forty years of scientific excellence and achievements that have been promoted by ASBMR. There are many initiatives that we are implementing to commemorate our anniversary all year, culminating in our Annual Meeting celebrations in Denver. The January 2017 cover of JBMR features our founders and will be a keep-sake for many. Stay Tuned for the top 40 reasons ASBMR helps you in your career.

There has been a great deal of activity since we last met in September and I would like to thank all of you and many committee members for all of your work and continued dedication to advancing the mission and strategic objectives of the Society. I am honored to work with you to achieve these goals.

So as we continue to drive our overall mission of advancing bone, mineral and musculoskeletal science worldwide and promoting the translation of basic and clinical research to improve human health together, let me reflect on how we have accomplished these objectives since September 2016.

ASBMR Strategic Plan
ASBMR continues to drive forward the four strategic priorities of our 2015-2018 strategic plan through numerous activities. Our four strategic priorities are:

• Closing the Treatment Gap, including Identification of an Improved Clinical Trial Endpoint
• Drive, Expand and Translate the Research Agenda in Musculoskeletal Science
• Increase International Outreach and Strengthen International Engagement to Create ‘One Global ASBMR Family’ 
• Develop New Strategies and Revenue Streams to Enable ASBMR to Invest in the Future of the Field

With the strategic plan as our roadmap, the following activities highlight our progress as it fits within the key strategic priorities. 

Closing the Treatment Gap, including Identification of an Improved Clinical Trial Endpoint

Expand Communications to Members and the Public about Evidence on the Effectiveness and Safety of Treatments

ASBMR took the lead in September to launch the “Call to Action to Address the Crisis in the Treatment of Osteoporosis.” Thirty seven organizations from around the globe have pledged to intensify their organization’s current efforts and collaborate on new opportunities to increase the screening, diagnosis and treatment of high-risk individuals to prevent fractures and to partner with patients to make informed choices about osteoporosis treatment options. At the ASBMR 2016 Annual Meeting in Atlanta we hosted a number of events including a press conference, the Clinical Evening on “Can We Close the Treatment Gap for Osteoporosis” and a special panel discussion entitled “A Crisis in Osteoporosis Treatment.” In conjunction with these sessions, Sundeep Khosla, M.D. and Elizabeth Shane, M.D., published a perspective piece in JBMR in June entitled “Addressing the Crisis in the Treatment of Osteoporosis.”

The next step forward we have taken with the Call to Action is to develop a multi-stakeholder initiative working with the Center for Medical Technology Policy (CMPT). This initiative will identify the key barriers to osteoporosis screening, diagnosis and treatment to prevent fractures and develop a strategic plan to tackle the problem by directly engaging patients and primary care providers to help build more trust in the science and an understanding of the benefits versus the risks of osteoporosis drugs. Sundeep Khosla, M.D. and Douglas P. Kiel, M.D., M.P.H. are the co-chairs of the Expert Group of the initiative, which will have its first meeting in late February 2017 to begin work on the planning of a large workshop of a diverse group of stakeholders in June to develop a strategic roadmap that will ultimately be widely disseminated.

At the urging of Sundeep Khosla, M.D. and Elizabeth Shane, M.D., who both sit on the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Council, NIAMS is partnering with multiple other federal stakeholders (NIA, NIDDK, NCATS, NCCIH, NIDCR, and the Office on Research on Women’s Health) to engage the NIH Office of Disease Prevention (ODP). ODP, through its program, Pathway to Prevention (P2P), will provide an objective, external review of current state-of-the-science related to fracture prevention and important gaps in knowledge. Research gaps and methodological and scientific weaknesses will be identified. A research agenda will be suggested to move our field further in addressing the crisis. This will involve working with the Agency for Healthcare Research and Quality (AHRQ) to solicit proposals from Evidence-Based Practice Centers to prepare an evidence report addressing the key questions being posed, followed by a conference (similar to previous NIH Consensus Conferences). The proceedings of this effort will be published and disseminated, with a key target being primary care physicians, so they can better provide the appropriate evidence to patients.

In November 2016 ASBMR hosted a free webinar on the Call to Action which reprised our press conference presentations at the Annual Meeting, with over 300 registrants, and in January 2017 we co-hosted a webinar with JBMR entitled, “Atypical Femur Fractures: A Patient-Centered Perspective,” with over 600 registrants, which candidly brought to light the fears that patients are expressing in regards to receiving treatment for osteoporosis and discussed potential ways forward to gain patient trust. Further, Sundeep Khosla, MD and others published a perspective piece in JBMR in January 2017 entitled “Addressing the Crisis in the Treatment of Osteoporosis: A Path Forward.”

Additionally, ASBMR’s three clinical task forces have progressed in their work. The task force on goal-directed treatment published a progress report in JBMR in January, “Goal-Directed Treatment for Osteoporosis: A Progress Report From the ASBMR-NOF Working Group on Goal-Directed Treatment for Osteoporosis.” The task forces on Cell Based Therapies and on Long Term Safety and Efficacy of Vertebral Augmentation are nearing completion of their work and will be submitting their reports to JBMR for publication. I want to thank The Chairs and members of these task forces for their contributions towards these important initiatives.

Finally, significant progress is being made toward the goal of identifying an improved clinical trial endpoint by the Foundation for NIH (FNIH) Bone Quality Project, led by Dennis Black, Ph.D. A letter of intent was submitted to the FDA last summer to begin the process of biomarker qualification and there has been an encouraging response from FDA. Further discussions are planned in the coming months, with the process likely to take about 2 years. The plan is to examine 2 year change in hip bone mineral density (BMD) as a predictor of hip fracture efficacy. Other time periods will also be looked at, as well as spine BMD which for anabolic drugs may be more useful over the shorter term.

Create a Research Agenda to Close the Treatment Gap
The research agenda around closing the treatment gap on the number of patients needing treatment continues to evolve and move forward. Accomplishments and areas to highlight include:

• ASBMR submitted comments to the Centers for Medicare and Medicaid Services (CMS) in response to its recent proposed rule to implement changes for the 2017 Hospital Outpatient Prospective Payment System (HOPPS). This rule would severely cut the reimbursement rate for axial dual-energy X-ray absorptiometry (DXA) tests in the hospital outpatient setting by 37% compared to 2016 rates, heightening the risk of preventable fractures and increasing costs to the Medicare program due to fracture-related expenses. In its comments, ASBMR urged CMS to withdraw the proposed rule to protect patients with osteoporosis and low bone density. After much lobbying of CMS by ASBMR and the partner organizations on the DXA Coalition, we successfully avoided the cut to Axial DXA and will see a $12 payment increase in 2017.
• The NBHA Medicare Data Working Group and DXA Coalition submitted an abstract to the ASBMR 2016 Annual Meeting that used the 5% Medicare dataset to determine the number of osteoporosis diagnoses, percent of hip fractures without an osteoporosis diagnosis, and the number of age adjusted hip fractures. Results showed that the decline in hip fractures may be over: incidence rates declined from 2002 to 2012 but from 2012-2014, hip fracture rates were greater than predicted trends.
• United States Bone and Joint Initiative released the Burden of Musculoskeletal diseases in the United States: Prevalence, Societal and Economic Cost, which ASBMR highlighted in E-news and other communication.

Drive, Translate and Expand the Research Agenda in Musculoskeletal Science

Creation of Standards and Definitions Around Significant Research Tools
To address standards for high resolution peripheral quantitative computed tomography (HR-pQCT), ASBMR representatives Mary Leonard, M.D., and Eric Orwoll, M.D. were added to the International Osteoporosis Foundation project on HR-pQCT co-chaired by Mary Bouxsein, Ph.D. The group met in September in Atlanta and will meet in March 2017 at WCO-IOF-ESCEO to continue work on draft manuscript.

Advance Knowledge on Functional Genomics
Providing support to advance knowledge on functional genomics of skeletal disease is also a priority. At the 2016 Annual Meeting, the Pre-Meeting Symposium on “Bone–Omics: Translating Genomic Discoveries into Clinical Applications,” was followed by the Gerald D. Aurbach Lecture on“Personalized Medicine: Using Omics Profiling and Big Data to Understand and Manage Health and Disease” by Michael Snyder, Ph.D. Additionally, three hands-on-workshops, developed in conjunction with the IFMRS Big Data Work Group, ASBMR Program Committee and Strategic Plan Team, were debuted. Plans are underway to again offer hands-on workshops at our 2017 Annual Meeting. Finally, the IFRMS Big Data Work Group continues to compile and expand its inventory of existing databases for musculoskeletal research.

Enhancing Clinical-Basic Interactions
A “champions group” of the ASBMR Membership Engagement and Education Committee and Young Investigator Subcommittee members generated many great ideas that were implemented at the 2016 Annual Meeting. Five “Meet-the-Professor” sessions featuring two instructors (one clinician and one basic science investigator) were included in the 2016 Annual Meeting with one entirely dedicated to bridging the gap between clinicians and scientists for meaningful collaboration. Poster tour sessions, “Clinical Posters for the Basic Scientist” and “Basic Posters for the Practicing Clinician,” also took place at the 2016 Annual Meeting. At the 2017 meeting we are planning several Meet the Professor Sessions focused on various basic science pathways, e.g. the WNT pathway for clinicians.

Publishing the Best Science – JBMR® and the Launch of JBMR Plus
In the fall of 2016, the JBMR® rolled out several new important features that will support authors, reviewers, and readers in publicizing and managing their contributions to the journal. JBMR® is also expecting an uptick in color pages now that the new flat fee structure has been implemented. New page design enhancements will complement the increase in color. At the Annual Meeting in Atlanta, the Council approved Roberto Civitelli, M.D. to succeed Juliet Compston, M.D., FRCP as the Editor-in-Chief of JBMR at the conclusion of 2017.

In Atlanta, the Council also approved Peter Ebeling, A.O. to be the founding editor of JBMR Plus, the new open access sister journal to JBMR®. Joining him are Teresita Bellido, Ph.D. and Bo Abrahamsen, M.D., Ph.D. as Deputy Editors for the inaugural year. JBMR Plus successfully opened for submissions on January 9 and is accepting original contributions as well as referred content from JBMR®. The submission and peer review site was set up to make it easy for the Editors to transfer papers together with their reviews, which will enable a rapid submission-to-acceptance speed. JBMR Plus expects to see over 100 papers submitted in 2017, with the majority referred from JBMR®.

The 9th Edition of the Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism is scheduled to be published in 2017 with a copyright date in 2018. I want to thank John Bilezikian for serving as the editor of the Primer. He has worked tirelessly with his associate editors in maximizing the important state of the art information in the Primer and meeting the publication timelines. We will know by the June Council meeting when we can expect to have printed copies mailed out to ASBMR members and whether advances will be available at this year’s Annual Meeting.

Increase International Outreach and Strengthen International Engagement to Create ‘One Global ASBMR Family’

ASBMR International Outreach
At the September Council meeting, membership retention and engagement were identified as areas of particular concern, as there has been a significant decline seen in our membership numbers. The Membership Engagement and Education Committee, chaired by Nicola Napoli, M.D., have been working with staff to analyze the data and diagnose the areas where ASBMR is experiencing a decline. This analysis and recommendations for a path forward will be presented in-depth at the Winter Council meeting.

In April 2016 we surveyed all ASBMR members to gain insights into their impressions of our current membership benefits and what they find to be most valuable. Our international members identified that networking opportunities are where they find the most value and serve as the chief motivation for their involvement with volunteer work within the society. As a result, we are tailoring the messaging around our various initiatives, volunteer opportunities and Annual Meeting to appeal to the different motivating factors of our members based on geography.

In May and November 2016, John Bilezikian, M.D. and Roberto Civitelli, M.D. presented ASBMR Annual Meeting Highlights Sessions at two meetings in Brazil, the Brazilian Society of Orthopedics on Bone Metabolism (ABOOM) and the Brazilian Society for Bone Metabolism (ABRASSO) meeting. In March 2017, we are planning to reprise the joint ASBMR/IOF session from our Annual Meeting at the WCO-IOF-ESCEO meeting in Florence, Italy, with Bo Abrahamsen, M.D., Ph.D. serving as the ASBMR Co-Chair for the session. In May 2017, an ASBMR representative and I will be participating at the ECTS 2017 Clinical Debate as presenter and co-chair, respectively. Finally, we are coordinating efforts with the International Federation of Musculoskeletal Research Societies (IFMRS) to promote the ANZBMS-IFMRS-JSBMR meeting in June 2017 in Brisbane, Australia and sending two ASBMR representatives to make presentations: Drs. Kristine Ensrud M.D., M.P.H. and Charles Farber, Ph.D.

International Federation of Musculoskeletal Research Societies (IFMRS)
ASBMR has served, together with the European Calcified Tissue Society (ECTS), as a co-founder and co-chair for the International Federation of Musculoskeletal Research Societies (IFMRS) since its inception in 2013. In December 2016, the International Bone and Mineral Society (IBMS) was dissolved and the transfer of its assets to IFMRS is in process, as was approved by all seven member societies. The first meeting of the now fully incorporated IFMRS Board of Directors took place at the ASBMR 2016 Annual Meeting and reconvened in Boston earlier this month for strategic planning. As previously mentioned, IFMRS is partnering with ANZBMS this year on a joint meeting in Brisbane, Australia in June 2017. It will continue to expand the Big Data Initiative and a collaborate with other societies on educational programs of PhDs and postdocs.

Develop New Strategies and Revenue Streams to Enable ASBMR to Invest in the Future of the Field

ASBMR Fund for Research and Education
The ASBMR Development Committee, co-chaired by Bart Clarke, M.D. and Shonni Silverberg, M.D., has worked hard over the last year to develop an individual giving campaign for the ASBMR Fund for Research and Education. In 2016, our goal was to have at least 85 members donate and raise at least $25,000. By the end of 2016, 59 members had made contributions totaling $20,000. In acknowledgement of the 40th Anniversary of ASBMR, the Fund is launching a “$40 for 40” campaign in 2017, encouraging members to donate $40 in support of the Society.

We are also pleased to announce that as a result of donations to the Fund, we were able to create the Betsy Love McClung Travel Grant in honor of Betsy Love McClung, RN, MN for her role in supporting the development of nurses and allied health professionals caring for patients with osteoporosis. The goal of the grant is to allow the award recipient to continue their professional development in the field of osteoporosis by providing travel funds to attend the ASBMR Annual Meeting, beginning in 2016. Eleven applications were received and two applicants were chosen to receive the funding to attend the 2016 Annual Meeting. Additionally, two new young investigator awards were given for abstracts presented at the meeting, made possible by donations to the fund.

ASBMR Rising Star Award
The ASBMR Rising Star Award Committee awarded six applicants in 2016. The award provides funding to our most promising young scientists and physician-scientists in the bone field who have already been recognized by NIH “K awards” and other similar international career development programs. The award provides $60,000 USD in funding for each awardee – three US-based and three international – to help them successfully implement their programs, stay in the field and transition to independent investigators. The program will be reprised again in 2017 and led by Teresita Bellido, Ph.D. and Richard Eastell, M.D.

ASBMR 2017 Annual Meeting
The ASBMR Annual Meeting is the highlight of each year. I have truly enjoyed working with my colleagues Anna Teti, Ph.D., Teresita Bellido, Ph.D. and Kenneth Saag, M.D. and ASBMR staff to develop the scientific program for this year’s meeting in Denver. Some highlights of the program include:

• Gerald D. Aurbach Lecture on “Cellular Senescence: Yin and Yang”, Judith Campisi, Ph.D.
• Louis V. Avioli Lecture on “The Quest for Osteoporosis Mechanisms: How Far We’ve Come, How Much Further We Need to Go”, Stavros Manolagas, M.D., Ph.D., University of Arkansas for Medical Sciences (USA) 
• Clinical Evening on “Treating the Treatment Gap”
• Basic Evening: “The Bone Marrow Niche and Hematopoiesis”
• A 40th Anniversary Plenary Symposium
• A variety of symposia on CRISPR, Sleep, Energy Metabolism and Musculoskeletal disease, Testosterone Treatment, Bone Muscle Interactions and Rare Bone Diseases are planned, , In addition to the Annual Meeting, we will again host a pre-meeting symposium, ASBMR Symposium – Current Concepts in Bone Fragility: From Cells to Surrogates, organized by Mary Bouxsein, Ph.D., Claus Glueer, Ph.D. and Marjolein van der Meulen, Ph.D. Highlights of the program include: 
• Hierarchical Materials in Nature: How Bone is Tough
• Interaction of Skeletal Traits Determines Long Bone Fragility
• Tissue-to-Material Level Contributions to Bone Mechanical Behavior 
• Contribution of Bone Microstructure to Bone Mechanical Behavior
• Translation of Bone Strength Assessments to Clinical Utility
• Surrogate Endpoints for Clinical Outcomes in Osteoporosis

Thank you for your efforts to support the ASBMR mission to advance bone, mineral and musculoskeletal science worldwide and to promote the translation of basic and clinical research to improve human health. I look forward to a productive and successful new year. In this inauguration season, let us remember the words of John F Kennedy, “United, there is little we cannot do”.

Sincerely,

Jane A. Cauley, DrPH
ASBMR President