Bone recovery after zoledronate therapy in thalassemia-induced osteoporosis: a meta-analysis and systematic review

Mamtani, Manju; Kulkarni, Hemant

doi:10.1007/s00198-009-0875-4

Cited by 23 publications

(16 citation statements)

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“…Bu nedenle transfüzyonlar, şelasyon ve seks hormonlarıyla optimal tedaviye rağmen jeneralize osteoporoz ve osteopeni sık görülmektedir (1). Talasemiye bağlı osteoporoz, uygun transfüzyon ve demir şelasyon tedavisine rağmen talasemi majörlü hastaların %30-50'sinde görülmektedir (6,8). Kırık prevalansı talasemi majörlü hastalarda %16,6, talasemi intermediali hastalarda %12,2'dir (9).…”

Section: Discussionunclassified

“…Tedavi ile kemik rezorbsiyon ve formasyon belirteçlerinin azalması ilacın kemik döngüsünü azaltarak etki gösterdiğini düşündürmektedir (6). Genel olarak zoledronat tedavisinin iyi tolere edildiği ve ağrıyı azalttığı da gösterilmiştir (6,9).…”

Section: Discussionunclassified

“…Fakat yaşam süresinin uzaması diğer komorbiditelerin ortaya çıkmasına neden olmuştur (6,7). Kemik iliği ekspansiyonuyla iskelet sistemi hastalıklarından en sık osteoporoz görülmektedir (6).…”

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“…Alendronat, klodronat, pamidronat ve zoledronatla yapılmış çalışmalarda zoledronatın en umut vaat eden bifosfonat adayı olduğu saptanmıştır (6).…”

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Talasemi Osteoporozunda Zoledronik Asit Kullanımı: İki Olgu Sunumu ve Literatürün Gözden Geçirilmesi

...

2012

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ÖzetTalasemi majör hastalarında, erken tanı ve uygulanan tedaviler ile yaşam süresinin uzamasıyla birlikte, osteoporozla ilişkili sorunlar belirgin şekilde artmıştır. Bu hastalarda optimal transfüzyonlarla bile kemik iliği hiperaktif kalmaktadır. Bu nedenle transfüzyonlar, demir şelasyonu ve seks hormonlarıyla optimal tedaviye rağmen jeneralize osteoporoz ve osteopeni talasemide sık görülmektedir. Talasemiye bağlı osteoporozda kemik rezorbsiyonunun artmış olması osteoklast fonksiyonunun potent inhibitörleri olan bifosfonatların kullanımını gündeme getirmiştir. Bu makalede talasemi major ve sekonder osteoporoz tanılarıyla takip edilen iki kızkardeş tartışılmakta ve 6 yıl süre ile uygulanan 4 mg aralıklı zoledronik asit tedavisinin sonuçları sunulmaktadır. Talasemide gelişen osteoporozun etyopatogenezi ve uygulanan tedavi yaklaşımları gözden geçirilmektedir. Türk Fiz T›p Re hab Derg 2012;58:154-8. Anah tar Ke li me ler: Talasemi, osteoporoz, zoledronik asit Sum maryThe life span of thalassemia major patients has been extended with early diagnosis and treatment modalities. This condition has resulted in an increase in osteoporosis-related problems. Even with optimal transfusions, the bone marrow of these patients remains hyperactive. For this reason, despite blood transfusion, iron chelation, and sex hormone replacement therapy, generalized osteoporosis and osteopenia are still frequent in thalassemia patients. In thalassemia-induced osteoporosis, bone resorption increases. This condition makes biphosphonates, which are potent inhibitors of osteoclast function, the drug of choice. In this article, two sisters with thalassemia major and secondary osteoporosis are discussed and the results of treatment with intermittent zoledronic acid (iv. 4 mg ) for 6 years are presented. We also performed a review of the literature on the etiopathogenesis of thalasemia-induced osteoporosis and the treatment modalities. Turk J Phys Med Re hab 2012;58:154-8.

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“…Alendronat, klodronat, pamidronat ve zoledronatla yapılmış çalışmalarda zoledronatın en umut vaat eden bifosfonat adayı olduğu saptanmıştır (6).…”

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Talasemi Osteoporozunda Zoledronik Asit Kullanımı: İki Olgu Sunumu ve Literatürün Gözden Geçirilmesi

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2012

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“…The term "low bone mineral density for age" was mentioned at the "2007 ISCD Pediatric Position Development Conference" as a criterion for low bone mass in children, and is described as a child with a Z-score below -2.0 (Daniels et al, 2003). In spite of adequate transfusion and iron chelation, Thalassemia-induced osteoporosis (TIO) is seen in 30-50% of TM patients, that can cause substantially compromised quality of life in thalassemic patients (Mamtani & Kulkarni, 2010).…”

Section: Osteoporosismentioning

confidence: 99%

What We Learn from Bone Complications in Congenital Diseases? Thalassemia, an Example

Hamidi¹

2012

Osteoporosis

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Osteoporosis in young adults: pathophysiology, diagnosis, and management

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Postmenopausal osteoporosis is mainly caused by increased bone remodeling resulting from estrogen deficiency. Indications for treatment are based on low areal bone mineral density (aBMD, T-score ≤ -2.5), typical fragility fractures (spine or hip), and more recently, an elevated 10-year fracture probability (by FRAX®). In contrast, there is no clear definition of osteoporosis nor intervention thresholds in younger individuals. Low aBMD in a young adult may reflect a physiologically low peak bone mass, such as in lean but otherwise healthy persons, whereas fractures commonly occur with high-impact trauma, i.e., without bone fragility. Furthermore, low aBMD associated with vitamin D deficiency may be highly prevalent in some regions of the world. Nevertheless, true osteoporosis in the young can occur, which we define as a T-score below -2.5 at spine or hip in association with a chronic disease known to affect bone metabolism. In the absence of secondary causes, the presence of fragility fractures, such as in vertebrae, may point towards genetic or idiopathic osteoporosis. In turn, treatment of the underlying condition may improve bone mass as well. In rare cases, a bone-specific treatment may be indicated, although evidence is scarce for a true benefit on fracture risk. The International Osteoporosis Foundation (IOF) convened a working group to review pathophysiology, diagnosis, and management of osteoporosis in the young, excluding children and adolescents, and provide a screening strategy including laboratory exams for a systematic approach of this condition.

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Bone recovery after zoledronate therapy in thalassemia-induced osteoporosis: a meta-analysis and systematic review

Abstract: Sufficient evidence exists to demonstrate that 4 mg zoledronate given every 3 months markedly improves the BMD; however, more qualitative and quantitative evidence is required to understand the mechanisms of its action and the potential side effects.

Cited by 23 publications

References 29 publications

Talasemi Osteoporozunda Zoledronik Asit Kullanımı: İki Olgu Sunumu ve Literatürün Gözden Geçirilmesi

Talasemi Osteoporozunda Zoledronik Asit Kullanımı: İki Olgu Sunumu ve Literatürün Gözden Geçirilmesi

What We Learn from Bone Complications in Congenital Diseases? Thalassemia, an Example

Osteoporosis in young adults: pathophysiology, diagnosis, and management

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