Association between Glucocorticoid-Induced Osteoporosis and Myasthenia Gravis: A Cross-Sectional Study

Abstract

PurposeTo investigate the association between glucocorticoid-induced osteoporosis and myasthenia gravis (MG) using a cross-sectional survey in Japan.MethodsWe studied 363 patients with MG (female 68%; mean age, 57 ± 16 years) who were followed at six Japanese centers between April and July 2012. We evaluated the clinical information of MG and fractures, bone markers, and radiological assessment. Quality of life was measured using an MG-specific battery, MG-QOL15.ResultsGlucocorticoids were administered in 283 (78%) of 363 MG patients. Eighteen (6%) of 283 MG patients treated with prednisolone had a history of osteoporotic fractures. The duration of glucocorticoid therapy, but not the dose of prednisolone, was associated with the osteoporotic fractures in MG patients. Bone mineral density was significantly decreased in the MG patients with fractures. The multivariate analyses showed that the total quantitative MG score was the only independent factor associated with osteoporotic fractures (OR = 1.30, 95% CI 1.02–1.67, p = 0.03). MG patients who had experienced fractures reported more severe difficulties in activities of daily living.ConclusionGlucocorticoid-induced osteoporosis aggravates quality of life in patients with MG.

Effects of alendronate and alfacalcidol on bone in patients with myasthenia gravis initiating glucocorticoids treatment

“…In our previous study, we observed reduced muscle strength, vitamin D deficiency, secondary hyperparathyroidism and elevated bone resorption contribute to bone loss in patients with MG . Limb weakness and impaired vision caused by MG itself would increase the risk of falls and therefore elevate incidence of bone fracture . In addition, a large‐scale analysis from the UK General Practice Research Database indicated that fracture risk was increased in patients with MG using antidepressant, anxiolytic or anticonvulsant drugs .…”

“…Patients with MG are usually exposed to large cumulative doses of GCs, which have potential risks of bone loss and fracture. While prevention and treatment of osteoporosis induced by GCs in patients with MG is very important, it is often overlooked …”

Health maintenance for adults with neuromuscular diseases on immunosuppression

“…1 Treatment of these conditions often involves the use of immunosuppressing medications, and these medications can cause a wide variety of side effects. [2][3][4] While there are many immunosuppressants that can be used to treat neuromuscular diseases, this review will focus on the most commonly used ones. Those familiar with the management of neuromuscular diseases will note that several of these medications do not have formal indications for the treatment of neuromuscular conditions, but they are nevertheless used frequently in clinical practice.…”

“…There are many neuromuscular conditions that are either caused or exacerbated by immune‐mediated processes, including inflammatory myopathies, Duchenne muscular dystrophy, diseases of the neuromuscular junction, and immune‐mediated neuropathies . Treatment of these conditions often involves the use of immunosuppressing medications, and these medications can cause a wide variety of side effects . While there are many immunosuppressants that can be used to treat neuromuscular diseases, this review will focus on the most commonly used ones.…”

Glucocorticoid induced osteoporosis in neurological patients: prevention and treatment

“…Так, использование ГКС в течение 3-6 мес является серьезным фактором риска развития остеопороза. У больных миастенией, получающих ле-чение стероидами, длительность терапии ГКС связана с увеличением частоты переломов [21], что существен-но ухудшает качество жизни пациентов. Известно, что значительное снижение минеральной плотности кости (МПК) может возникать уже в первые 3-6 мес приема ГКС [22,22].…”