Bisphosphonate Use for Glucocorticoid-Induced Osteoporosis in Elderly Patients with Immune Thrombocytopenia Receiving Prolonged Steroid Therapy: A Single Institute Retrospective Study.
Bisphosphonate Use for Glucocorticoid-Induced Osteoporosis in Elderly Patients with Immune Thrombocytopenia Receiving Prolonged Steroid Therapy: A Single Institute Retrospective Study.
复制标题
DOI：
10.3390/hematolrep14030039
复制
发表时间：
2022-09-19
影响因子：
0.9
通讯作者：
中科院分区：
文献类型：
--
作者：
泼尼松龙用作免疫性血小板减少症 (ITP) 的标准初始治疗，是骨质疏松症的重要危险因素。为了调查接受长期类固醇治疗的老年 ITP 患者糖皮质激素诱导的骨质疏松症 (GIO) 的预防，检查了 GIO 预防与双能 X 射线吸收测定法 (DXA) 扫描、FRAX® 和 Garvan 工具在泼尼松龙初始负荷期间评分变化的真实世界数据之间的关联。在我们的研究所，2014年至2021年间，22名年龄≥70岁的ITP患者接受了0.5-1.0 mg/kg泼尼松龙2-3周作为初始ITP治疗。通过DXA扫描测量的股骨颈骨矿物质密度（BMD）被输入FRAX®，以确定在泼尼松龙初始负荷期间双磷酸盐的风险适应方法。根据 DXA 扫描测量的 <-1.0 股骨颈 BMD T 分数施用双膦酸盐。 FRAX® 和 Garvan 工具的较差评分与原发性 GIO 中使用双磷酸盐进行短期骨折预防相关；然而，没有发生断裂事件，FRAX® 和 Garvan 工具确定的概率也没有显着差异。在泼尼松龙初始负荷期间，给予双膦酸盐处方可能会阻止接受长期类固醇治疗的老年 ITP 患者的 BMD 降低。
Prednisolone, used as a standard initial treatment for immune thrombocytopenia (ITP), is an important risk factor for osteoporosis. To investigate the prevention of glucocorticoid-induced osteoporosis (GIO) in elderly ITP patients receiving prolonged steroid therapy, associations between GIO prevention and the real-world data of score changes of a dual-energy X-ray absorptiometry (DXA) scan, FRAX® and the Garvan tool during the initial loading of prednisolone were examined. In our institute, 22 ITP patients aged ≥ 70 years received 0.5–1.0 mg/kg prednisolone for 2–3 weeks as the initial ITP treatment between 2014 and 2021. The femoral neck bone mineral density (BMD) measured by DXA scan was entered into FRAX® to define the risk-adapted approach to bisphosphonate during the initial loading of prednisolone. Bisphosphonate was administered according to <−1.0 femoral neck BMD T-score measured by DXA scan. Worse scores of FRAX® and the Garvan tool were associated with bisphosphonate use for short-term fracture prevention in primary GIO; however, there were no incidents of fracture or significant differences in probabilities determined by FRAX® and the Garvan tool. During the initial loading of prednisolone, prescribing bisphosphonate might prevent the reduction in BMD in elderly patients with ITP receiving prolonged steroid therapy.
登录
查看更多内容
对医疗统计信息的自由使用的易于使用的软件“ EZR”的调查。
影响因子：
4.8
作者：
Kanda Y
通讯作者：
Kanda Y
影响因子：
13.3
作者：
Buckley, Lenore;Guyatt, Gordon;McAlindon, Timothy
通讯作者：
McAlindon, Timothy
影响因子：
6.5
作者：
Hill, Quentin A.;Grainger, John D.;Compston, Juliet E.
通讯作者：
Compston, Juliet E.
影响因子：
168.9
作者：
Gasbarrini, A;Franceschi, F;Gasbarrini, G
通讯作者：
Gasbarrini, G
影响因子：
4.2
作者：
Rizzoli, R.;Adachi, J. D.;Reginster, J. Y.
通讯作者：
Reginster, J. Y.