Trabecular bone score in patients with liver transplants after 1 year of risedronate treatment

Abstract

SummaryThe aim of this study was to analyse the effect of risedronate on Trabecular Bone Score in liver transplant patients with low bone mass, during 1-year follow-up. In this retrospective cohort study, trabecular bone score (TBS) was calculated from dual X-ray absorptiometry images of the lumbar spine (LS), collected from a prospective randomized open-label 1-year trial performed in liver recipient patients. A total of 89 patients with osteopenia or osteoporosis were randomized to receive RIS plus calcium and vitamin D3 or calcium and vitamin D3. TBS was low in both groups at baseline, 6 and 12 months. Baseline TBS at the LS showed degraded microarchitecture in 22.8% of patients, partially degraded in 40.3%, and normal values in 36.8% of the patients. After 1 year of treatment, no difference in TBS was observed between both groups. No correlations were found between bone mineral density (BMD) and TBS values at any follow-up time point. No relationship was found between BMD, TBS or immunosuppressive drugs with incidental fracture. No significant effect in TBS was observed in liver transplant patients treated with RIS or calcium and vitamin D3 after 1 year of follow-up. In these patients, the clinical usefulness of this new tool should be established.

Factors associated with degraded trabecular bone score in heart transplant recipients

“…In a study of LTR, 36.8% had normal, 40.3% had partially degraded, and 22.8% had degraded TBS 25 . Contrasting these results, partially degraded TBS was less prevalent in our cohort.…”

“…Contrasting these results, partially degraded TBS was less prevalent in our cohort. In part, these differences could be explained by use of higher thresholds for TBS categories in our cohort that were recommended in regards to more recent meta‐analysis by McCloskey et al 29 In accordance with our results, there was a negative correlation between TBS and BMI in LTR, while discordantly there was no correlation of TBS with age in LTR, either at baseline or follow‐up 25 . It is likely that organ‐specific pathophysiological processes affect bone microstructure differently.…”

“…After 1 year of antiresorptive treatment, there was no improvement in TBS. TBS did not correlate with BMD, immunosuppressive drugs, or incident fracture 25 …”

“…More than 15 years post kidney transplantation, TBS was comparable to healthy controls, despite significantly lower BMD 24 . One study evaluated TBS in liver transplant recipients (LTR) 25 . In LTR, TBS was decreased in almost two‐thirds of patients immediately after the transplantation.…”

Postransplantation metabolic bone disease

“…Otros estudios con ibandronato, ácido zolendrónico y pamidronato,en diferentes TxO han demostrado también eficacia en la prevención de la pérdida ósea (46). Recientemente, describimos que 45 pacientes con TxH y tratados con Risedronato (RSN) presentaron aumento significativo de la masa ósea lumbar a los 6 y 12 meses comparados con los tratados con calcio y vitamina D (Figura 6) (47).La utilización del índice trabecular TBS, no demostró mejoría en la microestructura trabecular en el año transcurrido de terapia con risedronato, sugiriendo la necesidad de terapia más prolongada (48).…”