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Therapy Insight: osteoporosis and osteonecrosis in systemic lupus erythematosus.
Nat Clin Pract Rheumatol 2006; 2(10):562-9NC

Abstract

Survival of patients with systemic lupus erythematosus (SLE) has improved over the past decade, thanks to improved treatment of the disease, which now results in fewer fatal complications. This improvement has allowed physicians to focus their attention on the prevention of organ damage caused by this chronic, inflammatory disease, and by the medications used to control the disease. Osteoporosis is common in SLE patients; risk factors for osteoporosis include prolonged use of glucocorticoids, cyclophosphamide and possibly gonadotropin-releasing-hormone agonists. In premenopausal women with SLE, inflammation or SLE-related medications can increase bone turnover, which eventually weakens bone architecture, then reduces bone strength and increases the risk of fracture. Prevention and treatment of osteoporosis in SLE patients should entail a multifaceted approach. Levels of calcium, vitamin D and homocysteine should be evaluated, and age-appropriate supplementation instituted. The bone loss that results from systemic inflammation should be treated by reduction of the inflammation with glucocorticoids, potent anti-inflammatory agents or antiresorptive agents. The efficacy of this therapy can be monitored using bone mineral density scans. This Review briefly discusses the pathophysiology of the localized and generalized osteoporosis and osteonecrosis in SLE patients and recommends therapies to both prevent and treat these unfortunate complications of this disease.

Authors+Show Affiliations

University of California, Davis Medical School, Sacramento, USA. nancy.lane@ucdmc.ucdavis.edu

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

17016482

Citation

Lane, Nancy E.. "Therapy Insight: Osteoporosis and Osteonecrosis in Systemic Lupus Erythematosus." Nature Clinical Practice. Rheumatology, vol. 2, no. 10, 2006, pp. 562-9.
Lane NE. Therapy Insight: osteoporosis and osteonecrosis in systemic lupus erythematosus. Nat Clin Pract Rheumatol. 2006;2(10):562-9.
Lane, N. E. (2006). Therapy Insight: osteoporosis and osteonecrosis in systemic lupus erythematosus. Nature Clinical Practice. Rheumatology, 2(10), pp. 562-9.
Lane NE. Therapy Insight: Osteoporosis and Osteonecrosis in Systemic Lupus Erythematosus. Nat Clin Pract Rheumatol. 2006;2(10):562-9. PubMed PMID: 17016482.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Therapy Insight: osteoporosis and osteonecrosis in systemic lupus erythematosus. A1 - Lane,Nancy E, PY - 2006/01/27/received PY - 2006/08/15/accepted PY - 2006/10/4/pubmed PY - 2006/12/9/medline PY - 2006/10/4/entrez SP - 562 EP - 9 JF - Nature clinical practice. Rheumatology JO - Nat Clin Pract Rheumatol VL - 2 IS - 10 N2 - Survival of patients with systemic lupus erythematosus (SLE) has improved over the past decade, thanks to improved treatment of the disease, which now results in fewer fatal complications. This improvement has allowed physicians to focus their attention on the prevention of organ damage caused by this chronic, inflammatory disease, and by the medications used to control the disease. Osteoporosis is common in SLE patients; risk factors for osteoporosis include prolonged use of glucocorticoids, cyclophosphamide and possibly gonadotropin-releasing-hormone agonists. In premenopausal women with SLE, inflammation or SLE-related medications can increase bone turnover, which eventually weakens bone architecture, then reduces bone strength and increases the risk of fracture. Prevention and treatment of osteoporosis in SLE patients should entail a multifaceted approach. Levels of calcium, vitamin D and homocysteine should be evaluated, and age-appropriate supplementation instituted. The bone loss that results from systemic inflammation should be treated by reduction of the inflammation with glucocorticoids, potent anti-inflammatory agents or antiresorptive agents. The efficacy of this therapy can be monitored using bone mineral density scans. This Review briefly discusses the pathophysiology of the localized and generalized osteoporosis and osteonecrosis in SLE patients and recommends therapies to both prevent and treat these unfortunate complications of this disease. SN - 1745-8382 UR - https://www.unboundmedicine.com/medline/citation/17016482/Therapy_Insight:_osteoporosis_and_osteonecrosis_in_systemic_lupus_erythematosus_ L2 - http://dx.doi.org/10.1038/ncprheum0298 DB - PRIME DP - Unbound Medicine ER -