The Utility of Prophylactic Zoledronic Acid in Patients Undergoing Lung Transplantation
| Autor: | Duncan J. Topliss, Eldho Paul, Shoshana Sztal-Mazer, Miranda Paraskeva, Elisabeth Ng |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
musculoskeletal diseases 0301 basic medicine medicine.medical_specialty Endocrinology Diabetes and Metabolism medicine.medical_treatment Osteoporosis 030209 endocrinology & metabolism Zoledronic Acid 03 medical and health sciences 0302 clinical medicine Bone Density Internal medicine medicine Humans Lung transplantation Radiology Nuclear Medicine and imaging Orthopedics and Sports Medicine In patient Femur Retrospective Studies Bone mineral Lung Bone Density Conservation Agents Diphosphonates business.industry medicine.disease Transplantation Zoledronic acid medicine.anatomical_structure Female 030101 anatomy & morphology business Lung Transplantation medicine.drug |
| Zdroj: | Journal of Clinical Densitometry. 24:581-590 |
| ISSN: | 1094-6950 |
| Popis: | Osteoporosis is prevalent among lung transplant candidates and is exacerbated post-transplant by immunosuppressive therapy. Low bone mineral density (BMD) is a well-recognized surrogate for fragility fracture risk, which is associated with significant morbidity and mortality. Intravenous zoledronic acid (ZA) effectively reduces BMD loss and prevents fractures in postmenopausal osteoporosis. Many groups, ours included, prophylactically treat lung transplant recipients (LTR) with bisphosphonates, but no documented consensus currently exists. Our protocol comprises ZA every 6-months from transplant wait-listing, with interval reassessment to guide ongoing treatment. We evaluate the impact of a dose of ZA within 6 months of transplantation on BMD and fracture occurrence. A retrospective analysis was performed on all adult LTR from April 2012 to October 2014, of which 60 met our inclusion criteria. LTR who received ZA within 6 months of transplantation (n = 37) were compared to those who did not (n = 23), and followed up for a minimum of three years. Outcome measures were BMD change at the lumbar spine and femur (primary), and fracture occurrence (secondary). LTR treated with ZA within 6 months of transplantation experienced a median BMD change of +8.11% at the lumbar spine and +1.39% at the femur, compared to −1.20% and −3.92%, respectively, in LTR who did not receive a ZA dose within 6 months of transplantation (p = 0.002 & p = 0.008 respectively). Our findings indicate that prophylactic ZA within 6 months of transplantation prevents BMD loss in LTR. |
| Databáze: | OpenAIRE |
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