Use of Alendronate Sodium (Fosamax) to Ameliorate Osteoporosis in Renal Transplant Patients: A Case-Control Study

Huang, Wen‐Hung; Lee, Shen‐Yang; Weng, Cheng‐Hao; Lai, Ping-Chin

doi:10.1371/journal.pone.0048481

Cited by 10 publications

(16 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…At baseline, patients with osteoporosis received a greater cumulative steroid dose than patients with osteopenia (1326.5 mg vs 724.5 mg; P < .01). 37 In a univariate analysis, prednisolone use was associated with osteoporosis (odds ratio [OR] = 5.18; 95% CI = 1.6-16.4, P < .01). 37 Jeffery et al 32 described prednisone as an independent predictor of low BMD (multivariate, P < .01).…”

Section: Resultsmentioning

confidence: 99%

“…37 In a univariate analysis, prednisolone use was associated with osteoporosis (odds ratio [OR] = 5.18; 95% CI = 1.6-16.4, P < .01). 37 Jeffery et al 32 described prednisone as an independent predictor of low BMD (multivariate, P < .01). Alternatively, Naylor et al 35 found greater glucocorticoid exposure was not associated with a significant change in BMD at the lumbar spine, total hip, and femoral neck ( P > .05), regardless of whether the patient had received osteoporosis treatment before.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Effect of Bisphosphonates on Bone Health in Adult Renal Transplant Patients: Beyond the First Year Posttransplant—A Systematic Review and Meta-Analysis

Lip

Warias

Shamseddin

et al. 2019

Can J Kidney Health Dis

View full text Add to dashboard Cite

Background: Bone mineral density (BMD) decreases postrenal transplantation. Evidence demonstrating the effects of bisphosphonates on BMD and fracture risk beyond 1-year posttransplant is sparse in existing literature, but remains essential to enhance clinical outcomes in this population. Objective: Our study aimed to systematically review and meta-analyze the current literature on the use of any bisphosphonate in the adult renal transplant population beyond the first year of renal transplant to determine its effect on BMD and fracture incidence. Design: We conducted a systematic review and meta-analysis of primary research literature that included full-text, English-language, original randomized clinical trials (RCTs) and observational studies. Setting: Patient data were primarily captured in an outpatient setting across various studies. Patients: Our population of interest was patients older than 18 years who received deceased/living donor kidney transplantation and any bisphosphonate with a follow-up greater than 12 months posttransplantation. Measurements: The primary outcome was change in BMD from baseline. Secondary outcomes were the incidence of fractures and effects of other confounders on bone health. Methods: We included RCTs and observational studies that satisfied our inclusion criteria. Each study was analyzed for risk of bias and data were extrapolated to analyze for overall statistical significance accounting for heterogeneity of studies. Results: Sixteen studies (N = 1762) were analyzed. The follow-up ranged from 12 to 98 months. There was a nonsignificant improvement in BMD with bisphosphonate treatment persisting into the second and third years posttransplant at the lumbar spine. The calculated standardized mean BMD difference was −0.29 (−0.75 to 0.17), P = .22. Only 5 studies reported a total of 43 new fractures. Prednisone ( P < .01), low body weight ( P < .001), low body mass index ( P < .01), and male gender ( P < .05) correlated with reduced lumbar and femoral BMD. Limitations: Limitations of this review include the use of BMD as a surrogate outcome, the bias of the included studies, and the incomplete reporting data in numerous analyzed studies. Conclusions: We demonstrate no statistically significant benefit of bisphosphonate treatment on BMD beyond the first year postrenal transplantation. Despite heterogeneity of treatment, a differential nonsignificant improvement in lumbar spine BMD was consistent and may be clinically relevant. Trial Registration: PROSPERO CRD42019125593

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Effect of Bisphosphonates on Bone Health in Adult Renal Transplant Patients: Beyond the First Year Posttransplant—A Systematic Review and Meta-Analysis

Lip

Warias

Shamseddin

et al. 2019

Can J Kidney Health Dis

View full text Add to dashboard Cite

show abstract

“…In a case-control study, short-term weekly use of alendronate (Fosamax), an oral bisphosphonate, could significantly improve both lumbar spine BMD and bone condition, regardless of effect of immunosuppressant after a long period after renal transplantation [ 110 ]. In a long-term of low-dose weekly use of alendronate (35 mg/week) for long-term renal transplant recipients, authors found alendronate could suppress bone turnover but not fracture in kidney transplant recipients with hyperparathyroidism and chronic kidney disease [ 111 ].…”

Section: Management Of Bone Disease Before and After Organ Transplmentioning

confidence: 99%

Current Status of Research on Osteoporosis after Solid Organ Transplantation: Pathogenesis and Management

Lan

Xie

Peng

et al. 2015

BioMed Research International

View full text Add to dashboard Cite

Improved survival following organ transplantation has brought to the forefront some long-term complications, among which osteoporosis and associated fractures are the major ones that adversely affect the quality of life in recipients. The pathogenesis of osteoporosis in transplant recipients is complex and multifactorial which may be related to increased bone resorption, decreased bone formation, or both. Studies have shown that the preexisting underlying metabolic bone disorders and the use of immunosuppressive agents are the major risk factors for osteoporosis and fractures after organ transplantation. And rapid bone loss usually occurs in the first 6–12 months with a significant increase in fracture risk. This paper will provide an updated review on the possible pathogenesis of posttransplant osteoporosis and fractures, the natural history, and the current prevention and treatment strategies concerning different types of organ transplantation.

show abstract

“…The Institutional Review Board of Chang Gung Memorial Hospital has specifically waived the requirement for consent. All primary data were collected according to Strengthening the Reporting of Observational Studies in Epidemiology guidelines [15]. The form described above was referenced from the previous study [14] and Liu et al’s publication [16].…”

Section: Methodsmentioning

confidence: 99%

Impact of Hepatitis C Virus Infection on Bone Mineral Density in Renal Transplant Recipients

Huang

et al. 2013

PLoS ONE

Self Cite

View full text Add to dashboard Cite

BackgroundThe average prevalence of hepatitis C virus (HCV) infection in renal transplant recipients is 10%. Studies of these patients with HCV infection usually focuses on long-term graft survival and patient survival. Studies of the correlation between HCV infection and bone mineral density (BMD) in renal transplant patients are limited. The aim of this study was to investigate whether HCV infection is a risk factor for BMD change during a short follow-up period.MethodsSeventy-six renal transplant recipients underwent 2 separate dual-energy X-ray absorptiometry (DXA) scans during a mean period of 14 months. Fifteen patients were HCV infection. First bone mineral density (BMD) at the lumbar spine, hip, and femoral neck was determined using dual-energy X-ray absorptiometry (DXA) between September 2008 and March 2009. After that, 34 patients took alendronate sodium 70 mg per week. Subgroups risk factors analysis was also performed into with or without alendronate. Immunosuppressive agents, bisphosphonates, patient characteristics, and biochemical factors were analyzed to identify associations with BMD.ResultsAfter 14 months, in 76 patients, BMD of the lumbar spine had significantly increased (from 0.9 g/cm2 to 0.92 g/cm2, p<0.001), whereas BMD of the hip and femoral neck had not. Multiple linear regression analysis showed that HCV infection was negatively associated with BMD change in the lumbar spine (β : −0.247, 95% CI, −0.035 to −0.002; p = 0.028). Moreover, in subgroup analysis, among 42 patients without alendronate, multiple linear regression analysis showed HCV infection was a risk factor for adverse BMD change of the lumbar spine (β: −0.371, 95% CI, −0.043 to −0.003; p = 0.023).ConclusionHCV infection in renal transplant recipients was a negative risk factor for BMD change in the lumbar spine. Moreover, alendronate may be able to reverse the negative effect of HCV infection on bone in renal transplant recipients.

show abstract

Use of Alendronate Sodium (Fosamax) to Ameliorate Osteoporosis in Renal Transplant Patients: A Case-Control Study

Cited by 10 publications

References 36 publications

Effect of Bisphosphonates on Bone Health in Adult Renal Transplant Patients: Beyond the First Year Posttransplant—A Systematic Review and Meta-Analysis

Effect of Bisphosphonates on Bone Health in Adult Renal Transplant Patients: Beyond the First Year Posttransplant—A Systematic Review and Meta-Analysis

Current Status of Research on Osteoporosis after Solid Organ Transplantation: Pathogenesis and Management

Impact of Hepatitis C Virus Infection on Bone Mineral Density in Renal Transplant Recipients

Contact Info

Product

Resources

About