Bisphosphonates for osteoporosis in primary biliary cirrhosis

Rudić, Jelena S; Giljača, Vanja; Krstić, Miodrag; Bjelaković, Goran; Gluud, Christian

doi:10.1002/14651858.cd009144

Cited by 5 publications

(3 citation statements)

References 61 publications

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“…Terapija osteopenije i osteoporoze kod pacijenata sa alkoholnom cirozom jetre Pored mera koje su usmerene na korekciju životnih navika (kao što su smanjenje konzumacije alkohola, prestanak pušenja i umerena fizička aktivnost) (4), za lečenje promena na kostima kod pacijenata sa alkoholnom cirozom jetre koriste se različite grupe lekova (4,7,60). Bisfosfonati su najčešće korišćena farmakološka sredstva za lečenje osteoporoze kod osoba sa hroničnim oboljenjima jetre, bez obzira na to što postoji ograničen broj studija o njihovoj efekasnosti kod ovih pacijenata (4,60). Pokazano je i da primena selektivnih modulatora estrogenskih receptora i paratireoidnog hormona može da ima pozitivne efekte na koštanu masu i smanjenje rizika od preloma kičmenih pršljenova kod osoba sa hroničnim oboljenjima jetre (4).…”

Section: Mineralna Gustina Kostiju U Alkoholnoj Cirozi Jetreunclassified

Compromised bone strength in patients with alcoholic liver cirrhosis

Jadžić¹,

Đonić²

2020

Medicinski podmladak

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Osteoporoza i/ili osteopenija su česte komplikacije alkoholne bolesti jetre, sa posebnim značajem u njenom ireverzibilnom stadijumu (engl. alcoholic liver cirrhosis – ALC). U ovoj publikaciji je predstavljen pregled savremene literature o učestalosti osteoporoze, povećanom riziku od preloma kosti, promenama mineralne gustine i mikrostrukture kostiju, kao i o etio-patogenetskim mehanizmima koji dovode do smanjenja kvaliteta kosti kod pacijenata sa ALC-om. Zabeleženo je da osteoporoza može biti prisutna kod značajnog broja ALC bolesnika, naročito u slabinskom delu kičmenog stuba. Identifikovano je više faktora rizika, kao i etio-patogenetskih mehanizama povezanih sa gubitkom mineralne gustine kosti kod bolesnika sa alkoholnom i cirozama druge etiologije. Određeni autori tvrde da je dominantan mehanizam gubitka koštane mase usporeno osteoblastno stvaranje kosti, dok drugi rezultati sugerišu pojačanu razgradnju koštanog matriksa kao dominantniji mehanizam u nastanku skeletnih oštećenja kod ALC bolesnika. Povećana koštana fragilnost i sklonost ka patološkim prelomima značajno utiču na životni vek i kvalitet života pacijenata sa ALC-om. Stoga se preporučuje da osteološki skrining i procena rizika od frakture budu obavezni deo individualnog pristupa lečenju bolesnika sa alkoholnom cirozom jetre.

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Section: Mineralna Gustina Kostiju U Alkoholnoj Cirozi Jetreunclassified

Compromised bone strength in patients with alcoholic liver cirrhosis

Jadžić¹,

Đonić²

2020

Medicinski podmladak

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“…Malnutrition and vitamin deficiencies, especially vitamins D and K could contribute to development of osteoporosis (26). To date, there is not still medical evidence to support or refute the use of bisphosphonates for patients with PBC (27).…”

Section: Primary Biliary Cirrhosismentioning

confidence: 99%

Rare causes of osteoporosis

Marcucci

Brandi

2015

ccmbm

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SummaryOsteoporosis is a metabolic bone disease characterized by loss of bone mass and strength, resulting in increased risk of fractures. It is classically divided into primary (postmenopausal or senile), secondary and idiopathic forms. There are many rare diseases, that cause directly or indirectly osteoporosis. The identification and classification of most of these rare causes of osteoporosis is crucial for the specialists in endocrinology and not, in order to prevent this bone complication and to provide for an early therapy. Several pathogenic mechanisms are involved, including various aspects of bone metabolism such as: decreased bone formation, increased bone resorption, altered calcium, phosphorus and/or vitamin D homeostasis, and abnormal collagen synthesis. In this review, less common forms of primary and secondary osteoporosis are described, specifying, if applicable: genetic causes, epidemiology, clinical features, and pathogenic mechanisms causing osteoporosis. A greater awareness of all rare causes of osteoporosis could reduce the number of cases classified as idiopathic osteoporosis and allow the introduction of appropriate and timely treatments.

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“…14 These trials assessed one bisphosphonate versus another bisphosphonate or versus placebo, and in one case versus sodium fluoride. 15 Etidronate was licensed for use in many countries for patients with established vertebral osteoporosis, 16 but at present it is barely used in the treatment of primary and secondary osteoporosis. By contrast, alendronate is a worldwide-approved drug and it is well established for the treatment of osteoporosis.…”

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confidence: 99%

Randomized trial comparing monthly ibandronate and weekly alendronate for osteoporosis in patients with primary biliary cirrhosis

et al. 2013

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Osteoporosis resulting in bone fractures is a complication in patients with primary biliary cirrhosis (PBC). Once‐weekly alendronate improves bone mass and is well tolerated in these patients, but there is a concern because of poor compliance. Therefore, the efficacy, adherence, and safety of monthly ibandronate (150 mg) with weekly alendronate (70 mg) were compared in a randomized, 2‐year study in 42 postmenopausal women with PBC and osteoporosis. Bone mineral density (BMD) of the lumbar spine and proximal femur (by DXA), liver function, and bone markers were measured at entry and every 6 months over 2 years. Adherence to therapy was assessed by the Morisky‐Green score. At enrollment, the two groups were similar with respect to age, BMD, severity of cholestasis, previous fractures, and bone markers. Thirty‐three patients, 14 in the ibandronate group and 19 in the alendronate group, completed the trial. At 2 years both treatments resulted in a significant increase in BMD at the lumbar spine (from 0.875 ± 0.025 to 0.913 ± 0.026 g/cm2, P < 0.001 with alendronate, and from 0.898 ± 0.024 to 0.949 ± 0.027 g/cm2, P < 0.001 with ibandronate). The mean percentage change was 4.5% and 5.7%, respectively (P = not significant). BMD increased at the total hip by 2.0% and 1.2%, respectively. Changes in bone markers were similar in both groups and one patient with alendronate developed a new vertebral fracture. Adherence to therapy was higher with ibandronate (P = 0.009). Neither treatment impaired liver function or cholestasis. Conclusion: Both regimens, weekly alendronate and monthly ibandronate, improve bone mass and are comparable in safety for osteoporosis therapy in patients with PBC, although adherence is higher with the monthly regimen. Further larger studies are needed to assess fracture prevention. (Hepatology 2013; 58:2070–2078)

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Bisphosphonates for osteoporosis in primary biliary cirrhosis

Cited by 5 publications

References 61 publications

Compromised bone strength in patients with alcoholic liver cirrhosis

Compromised bone strength in patients with alcoholic liver cirrhosis

Rare causes of osteoporosis

Randomized trial comparing monthly ibandronate and weekly alendronate for osteoporosis in patients with primary biliary cirrhosis

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