Zoledronic Acid in Osteoporosis Secondary to Mastocytosis

Association between rheumatoid arthritis and systemic mastocytosis: a case report and literature review

“…Treatment with bisphosphonates and Vitamin D supplementation in association with antihistaminergic drugs leads to absence of bone complication during 10 years with normal BMD values. Such beneficial effects of bisphosphonates treatment in patient suffering from osteoporosis secondary to mastocytosis was already reported [15,17,[19][20][21][22]. Our patient underwent a vertebroplasty after traumatic spinal fracture only 2 years after bisphosphonates cessation but 7 years after patient quit antihistamine treatment.…”

“…Histamine acts directly on osteoclasts by promoting osteoclast formation directly through paracrine action on the precursors and indirectly through increased osteoblasts secretion of RANKL [16]. Moreover, heparin and bone resorptive cytokines (IL-1, IL-6 TNFalpha) are known to play a role in osteoclast activation by mast cells [17].…”

MANAGEMENT OF ENDOCRINE DISEASE: Secondary osteoporosis: pathophysiology and management

“…However, the mechanisms responsible for osteoporosis and increased fracture risk need further study so that targeted therapies can be evaluated. Bisphosphonates such as alendronate, pamidronate and zoledronic acid can improve BMD and decrease bone resorption in patients with mastocytosis (176, 177) .…”

MR-based trabecular bone microstructure is not altered in subjects with indolent systemic mastocytosis

“…DXA-based BMD values are most commonly used by clinicians in their treatment decision to preserve ISM associated bone loss, for example, by zoledronic acid prescription [11]. T-scores relate the individual BMD to a 30-year old healthy cohort of the same sex, while Z-scores give the relationship with the subject's own age group.…”

“…However, more than 50% of peripheral osteoporotic fractures occur in subjects with BMD values not yet in the osteoporotic range [10]. Therefore, it would be beneficial to establish early imaging biomarkers which could support clinicians in their treatment decision to prevent ISM-associated bone loss, for example, as shown for zoledronic acid [11].…”