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Immunosuppressive therapy and the skeleton.

E Shane1, S Epstein

  • 1Division of Endocrinology, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA.

Trends in Endocrinology and Metabolism: TEM
|May 1, 1994
PubMed
Summary
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Glucocorticoids and immunosuppressive drugs can cause osteoporosis and fractures, especially after organ transplantation. Early evaluation and monitoring of bone health are crucial for patients on these medications.

Area of Science:

  • Endocrinology
  • Orthopedics
  • Pharmacology

Background:

  • Glucocorticoids and immunosuppressive drugs, like cyclosporine A, are widely used in clinical practice.
  • A common application is immunosuppression following organ transplantation.
  • These medications have significant, often detrimental, effects on skeletal health.

Purpose of the Study:

  • To highlight the skeletal risks associated with immunosuppressive drug therapy.
  • To emphasize the importance of early osteoporosis detection and management in transplant patients.

Main Methods:

  • Review of clinical literature on immunosuppressive drugs and bone health.
  • Analysis of common sequelae of organ transplantation related to bone metabolism.

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Main Results:

  • Osteoporosis and fractures are frequent complications in patients receiving immunosuppressive therapy.
  • Immunosuppressive drugs exert diverse effects on the skeleton, increasing fracture risk.

Conclusions:

  • Patients on immunosuppressive drugs require thorough osteoporosis assessment before or at therapy initiation.
  • Regular bone density measurements and monitoring of bone turnover markers are essential.
  • Proactive strategies to prevent bone loss should commence early in immunosuppressive treatment regimens.