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Treatment with oral bisphosphonate
may aid in secondary prevention of glucocorticoid-induced osteoporosis.
Oral bisphosphonate may reduce the development or advancement of vertebral fractures and seems to be useful for preventing glucocorticoid-induced osteoporosis in people with Duchenne Muscular Dystrophy, as elucidated from a study carried out by Nat Nasomyont et al.
Glucocorticoid-elicited osteoporosis with vertebral fractures is frequently observed in people having Duchenne muscular dystrophy. Researchers aimed to investigate the effects of oral bisphosphonate treatment (weekly alendronate) on the severity and prevalence of vertebral fractures via vertebral morphometry assessment.
The radiographs and records of individuals suffering from Duchenne muscular dystrophy were reviewed who had received bisphosphonate therapy and had been subjected to routine spine radiographic monitoring for glucocorticoid-triggered osteoporosis. The endpoints ascertained were severity and prevalence of lumbar and thoracic vertebral fracture, as evaluated by Genant grading of vertebral morphometry, for upto five years of therapy.
Overall, 52 people (median age 11.8 years) had received long-term glucocorticoids therapy (median duration 4.7 years at bisphosphonate start). At baseline, 75% of people were noted to have mild vertebral height loss or fractures. In comparison with the baseline, vertebral fractures prevalence at each year of therapy was not significantly distinct.
In most of the vertebrae (64-80%),
serial radiographs revealed no longitudinal alteration in the severity. In few
participants, there was an improvement in vertebral fracture grade. Thus, there
was a stable prevalence of vertebral fractures and no severity alteration in
most of the vertebrae for up to five years of therapy.
Muscle & Nerve
The Effect of Oral Bisphosphonate Therapy on Vertebral Morphometry and Fractures in Patients with Duchenne Muscular Dystrophy and Glucocorticoid-Induced Osteoporosis
Nat Nasomyont et al.
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