Oral bisphosphonate treatment in patients with Duchenne muscular dystrophy on long term glucocorticoid therapy.

Neuromuscular Disorders : NMD
Cuixia TianMeilan M Rutter

Abstract

Osteoporosis is a major problem in patients with Duchenne muscular dystrophy (DMD), due to glucocorticoid therapy and muscle weakness. Evidence on which to base optimal prevention and treatment strategies, including bisphosphonate use, in DMD are limited. Our objective was to describe bone health outcomes of oral alendronate treatment in patients with DMD and glucocorticoid-induced osteoporosis. We retrospectively studied 54 patients treated between 2005 and 2017, and assessed changes in dual-energy x-ray absorptiometry (DXA) whole body and lumbar spine bone mineral density and content, and lateral distal femur bone mineral density. We also examined vertebral fracture development in a subset with serial spine radiographs. Pre-alendronate DXA Z-score trajectories decreased progressively. Over three years post-alendronate initiation, Z-score trajectories improved (p<0.01) at most sites compared with pre-alendronate trajectories. Height-adjusted Z-score trajectories for lumbar spine bone mineral density (p = 0.01) and whole body bone mineral content (p = 0.0004) also improved. The positive trajectories did not seem to be sustained long term in those treated up to 6 years. Radiographic vertebral findings in 43 patients appeared sta...Continue Reading

Citations

Apr 11, 2021·Journal of Pediatric Endocrinology & Metabolism : JPEM·Renu SutharNaveen Sankhyan
Jul 8, 2021·Journal of Pediatric Orthopedics·Jennifer J BeckBarbara Minkowitz

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