Anabolic therapy in b-thalassaemia major induced osteoporosis: case report and literature review

Trotta, A.; Corrado, Addolorata; Cantatore, Francesco Paolo

doi:10.4081/reumatismo.2010.119

Cited by 6 publications

(8 citation statements)

References 52 publications

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“…In these cases, the use of teriparatide is contraindicated 16 . To date, only three case reports have been published on the use of this drug in a corresponding number of βTh-patients with serious TBD and pathological fractures, and the truth is that, in all three, the results were very encouraging, with notable increases in BMD in the lumbar spine, the femoral neck and the total hip, at 12 and 18 months [120][121][122] . Of course, more data are clearly required to substantiate both the efficacy and safety of teriparatide for its generalized use in severe TBD.…”

Section: Al Denosumab Increases Bmd In Patients With Thalassemiamajomentioning

confidence: 99%

A contemporary therapeutic approach to bone disease in beta-thalassemia - a review

Stefanopoulos

Παπαϊωάννου

Papavassiliou

et al. 2018

JFSF

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Homozygous beta-thalassemia represents a serious hemoglobinopathy, in which an amazing prolongation in the survival rate of patients has been achieved over recent decades. A result of this otherwise positive evolution is the fact that bone problems have become a major issue in this group of patients. Through an in-depth review of the related literature, the purpose of this study is to present and comment on the totality of the data that have been published to date pertaining to the prevention and treatment of thalassemia bone-disease, focusing on: the contribution of diet and lifestyle, the treatment of hematologic disease and its complications, the management of hypercalciuria, the role of vitamins and minerals and the implementation of anti-osteoporosis medical regimen. In order to comprehensively gather the above information, we mainly reviewed the international literature through the PubMed database, searching for the preventive and therapeutic data that have been published pertaining to thalassemia bone-disease over the last twenty-nine years. There is no doubt that thalassemia bone-disease is a complication of a multi-factorial etiopathology, which does not follow the rules of classical postmenopausal osteoporosis. Bisphosphonates have been the first line of treatment for many years now, with varied and usually satisfactory results. In addition, over the last few years, more data have arisen for the use of denosumab, teriparatide, and other molecules that are in the clinical trial phase, in beta-thalassemia.

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Section: Al Denosumab Increases Bmd In Patients With Thalassemiamajomentioning

confidence: 99%

A contemporary therapeutic approach to bone disease in beta-thalassemia - a review

Stefanopoulos

Παπαϊωάννου

Papavassiliou

et al. 2018

JFSF

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“…The experience with pharmacological agents in the management of thalassemia‐associated osteoporosis is mainly confined to the bisphosphonates (BPs), with five well‐designed RCTs demonstrating their efficacy on surrogate and secondary outcomes (BMD and markers of bone turnover) . Very limited clinical data about the use of teriparatide, denosumab, and strontium ranelate have been reported in the literature , …”

Section: Pharmacological Agentsmentioning

confidence: 99%

“…It potently increases BMD and reduces fracture risk in both men and women . The clinical use of teriparatide in thalassemic patients is limited to case reports . In these reports, it was shown to improve BMD and to be safe and well tolerated.…”

Section: Pharmacological Agentsmentioning

confidence: 99%

Management of beta‐thalassemia–associated osteoporosis

Giusti

Pinto

Forni

2016

Annals of the New York Academy of Sciences

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Beta-Thalassemia-associated osteoporosis is a multifactorial and complex condition. Different acquired and genetic factors are involved in its pathogenesis. These factors produce an imbalance in bone remodeling by inhibiting osteoblast activity and increasing osteoclast function, leading to bone loss and increased fracture risk. The management of patients presenting with thalassemia-associated osteoporosis should consist of the implementation of general measures and the prescription of a specific pharmacological agent, with the aim of reducing fracture risk and preventing disability and deterioration of quality of life. General measures include control of anemia, adequate chelation therapy, healthy nutrition and lifestyle, regular exercise, adequate management of comorbid conditions, hormone replacement therapy in patients with hypogonadism, and vitamin D supplementation/therapy. Among the pharmacological agents currently available for the management of osteoporosis in postmenopausal women and men, bisphosphonates have been shown to improve bone mineral density, to reduce bone turnover, and to decrease bone/back pain in patients with thalassemia-associated osteoporosis, with a good profile of safety and tolerability. On the other hand, there are limited experiences with other pharmacological agents (e.g., denosumab or teriparatide). The complexity of this condition presents diagnostic and therapeutic challenges and underscores the importance of a comprehensive and multidisciplinary approach.

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“…Bifosfanat tedavileri kemik mineral dansitesinde ve hastalar›n yaflam kalitesinde art›fl ile iliflkilidir. [11,12] Bu hastalarda gerekli görüldü¤ünde D vitamini deste¤i de yap›labilir. D vitamini deste¤inin bu hastalarda kemik parametreleri üzerinde olumlu etkileri olsa da kemik rezorpsiyonu üzerine bir etkisi yoktur.…”

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“…[9] Hormonal destek, kalsiyum ve D vitamini destekleri, etkili demir flelasyon tedavileri ve hemoglobin seviyelerinin normal de¤erlere çekil-mesine ra¤men bu hastalar kemik kaybetmeye devam etmektedirler ve bifosfanat tedavisi bu hastalarda kurtar›c› olabilmektedir. [11,12] Talasemi majörü olan hastalar›n endokrin fonksiyonlar›nda da bozulmalar mevcuttur. Bu hastalarda büyüme geliflme gerili¤i, hipogonadizm, hipotiroidizm, hipoparatiroidizm, gecikmifl puberte, diabetes mellitus, adrenal yetersizlik ve kardiyak yetmezlik de geliflebilmektedir.…”

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