Optimization of osteoporosis and osteopenia management among renal transplant recipients

Abstract Background Osteoporosis and osteopenia occur frequently in renal transplant recipients due to long-term use of immune-suppressants including corticosteroids. Previous treatment options like bisphosphonates had acceptable but rather unsatisfactory results after transplant. The aim of the cur...

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Autores principales:	Mohammed K. Afifi, Ahmed S. Kenawy, Heba H. El Demellawy, Amany A. Azouz, Torki Al-Otaibi, Osama Gheith, Mohamed Abd ElMonem, Mohamed S. AbdElhalim, Raghda R. S. Hussein
Formato:	article
Lenguaje:	EN
Publicado:	SpringerOpen 2021
Materias:	Denosumab Ibandronate Transplant Osteoporosis Osteopenia Therapeutics. Pharmacology RM1-950 Pharmacy and materia medica RS1-441
Acceso en línea:	https://doaj.org/article/43a3a8f01b2a442087716d99e6b0b46f
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spelling	oai:doaj.org-article:43a3a8f01b2a442087716d99e6b0b46f2021-11-28T12:30:08ZOptimization of osteoporosis and osteopenia management among renal transplant recipients10.1186/s43094-021-00378-12314-7253https://doaj.org/article/43a3a8f01b2a442087716d99e6b0b46f2021-11-01T00:00:00Zhttps://doi.org/10.1186/s43094-021-00378-1https://doaj.org/toc/2314-7253Abstract Background Osteoporosis and osteopenia occur frequently in renal transplant recipients due to long-term use of immune-suppressants including corticosteroids. Previous treatment options like bisphosphonates had acceptable but rather unsatisfactory results after transplant. The aim of the current study is to directly compare the efficacy of denosumab and oral ibandronate in late RTR with low bone mineral density. Results The study was conducted Iin Hamed Al-Essa Kidney transplant center, Kuwait, in 2020. The data of 52 denosumab and 48 ibandronate patients were collected at the baseline and after one year of treatment. Spine and hip T-score readings, side effects, and other laboratory results were analyzed to evaluate the use of both medications. The mean number of months after transplant was 25 (± 13.9) months. After one year of treatment, denosumab alleviated both spinal osteoporosis and osteopenia T-score values from −3.13 to −2.4 (p = 0.008) and from −1.9 to −1.5 (p = 0.015), respectively. Besides, it reduced hip osteoporosis and osteopenia insignificantly from −3.45 to −3.1 and from −1.5 to −1.3, respectively (p > 0.05). Ibandronate improved spinal osteopenia from −1.6 to −1.55 (p = 0.97) and failed to show any positive impact on other sites; the spinal osteoporosis changed from −2.8 to −3 and hip osteoporosis and osteopenia changed from −3.1 to −3.12 and from −1.4 to −1.45, respectively (p > 0.05). The use of ibandronate was more associated with gastrointestinal tract (GIT) side effects, while hypocalcemia episodes were significantly higher in the denosumab group. Conclusion Denosumab improved both spinal and hip T-score values in comparison with ibandronate in RTR. Close monitoring is required for denosumab patients to prevent the associated hypocalcemia. Graphical AbstractMohammed K. AfifiAhmed S. KenawyHeba H. El DemellawyAmany A. AzouzTorki Al-OtaibiOsama GheithMohamed Abd ElMonemMohamed S. AbdElhalimRaghda R. S. HusseinSpringerOpenarticleDenosumabIbandronateTransplantOsteoporosisOsteopeniaTherapeutics. PharmacologyRM1-950Pharmacy and materia medicaRS1-441ENFuture Journal of Pharmaceutical Sciences, Vol 7, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Denosumab Ibandronate Transplant Osteoporosis Osteopenia Therapeutics. Pharmacology RM1-950 Pharmacy and materia medica RS1-441
spellingShingle	Denosumab Ibandronate Transplant Osteoporosis Osteopenia Therapeutics. Pharmacology RM1-950 Pharmacy and materia medica RS1-441 Mohammed K. Afifi Ahmed S. Kenawy Heba H. El Demellawy Amany A. Azouz Torki Al-Otaibi Osama Gheith Mohamed Abd ElMonem Mohamed S. AbdElhalim Raghda R. S. Hussein Optimization of osteoporosis and osteopenia management among renal transplant recipients
description	Abstract Background Osteoporosis and osteopenia occur frequently in renal transplant recipients due to long-term use of immune-suppressants including corticosteroids. Previous treatment options like bisphosphonates had acceptable but rather unsatisfactory results after transplant. The aim of the current study is to directly compare the efficacy of denosumab and oral ibandronate in late RTR with low bone mineral density. Results The study was conducted Iin Hamed Al-Essa Kidney transplant center, Kuwait, in 2020. The data of 52 denosumab and 48 ibandronate patients were collected at the baseline and after one year of treatment. Spine and hip T-score readings, side effects, and other laboratory results were analyzed to evaluate the use of both medications. The mean number of months after transplant was 25 (± 13.9) months. After one year of treatment, denosumab alleviated both spinal osteoporosis and osteopenia T-score values from −3.13 to −2.4 (p = 0.008) and from −1.9 to −1.5 (p = 0.015), respectively. Besides, it reduced hip osteoporosis and osteopenia insignificantly from −3.45 to −3.1 and from −1.5 to −1.3, respectively (p > 0.05). Ibandronate improved spinal osteopenia from −1.6 to −1.55 (p = 0.97) and failed to show any positive impact on other sites; the spinal osteoporosis changed from −2.8 to −3 and hip osteoporosis and osteopenia changed from −3.1 to −3.12 and from −1.4 to −1.45, respectively (p > 0.05). The use of ibandronate was more associated with gastrointestinal tract (GIT) side effects, while hypocalcemia episodes were significantly higher in the denosumab group. Conclusion Denosumab improved both spinal and hip T-score values in comparison with ibandronate in RTR. Close monitoring is required for denosumab patients to prevent the associated hypocalcemia. Graphical Abstract
format	article
author	Mohammed K. Afifi Ahmed S. Kenawy Heba H. El Demellawy Amany A. Azouz Torki Al-Otaibi Osama Gheith Mohamed Abd ElMonem Mohamed S. AbdElhalim Raghda R. S. Hussein
author_facet	Mohammed K. Afifi Ahmed S. Kenawy Heba H. El Demellawy Amany A. Azouz Torki Al-Otaibi Osama Gheith Mohamed Abd ElMonem Mohamed S. AbdElhalim Raghda R. S. Hussein
author_sort	Mohammed K. Afifi
title	Optimization of osteoporosis and osteopenia management among renal transplant recipients
title_short	Optimization of osteoporosis and osteopenia management among renal transplant recipients
title_full	Optimization of osteoporosis and osteopenia management among renal transplant recipients
title_fullStr	Optimization of osteoporosis and osteopenia management among renal transplant recipients
title_full_unstemmed	Optimization of osteoporosis and osteopenia management among renal transplant recipients
title_sort	optimization of osteoporosis and osteopenia management among renal transplant recipients
publisher	SpringerOpen
publishDate	2021
url	https://doaj.org/article/43a3a8f01b2a442087716d99e6b0b46f
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Optimization of osteoporosis and osteopenia management among renal transplant recipients

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