The prevalence of vertebral fractures was stable at 1 to 5 years of treatment with oral bisphosphonate therapy in patients with Duchenne muscular dystrophy (DMD). The severity of the fractures was also the same overall for up to 5 years of treatment. This is according to the results of a new study published in the journal Muscle & Nerve.
Based on these results, the authors of the study concluded that bisphosphonate may be beneficial for the secondary prevention of osteoporosis induced by glucocorticoid treatment in patients with DMD. The authors state that this therapy may mitigate the development or progression of vertebral fractures in most patients.
Glucocorticoids are commonly prescribed to patients with DMD. Research has shown that they can prolong the patients’ ability to walk independently as well as their survival. However, they can have many side effects including osteoporosis that may lead to frequent vertebral fractures.
Bisphosphonates can effectively treat osteoporosis in adults, including osteoporosis induced by glucocorticoid use. They can also be used to prevent and treat osteoporosis in children with DMD and have been shown to improve their bone mineral density.
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In the present study, a team of researchers led by Meilan M. Rutter, MD, reviewed the radiographs and medical records of all DMD patients treated with oral bisphosphonates between 2010 and 2017. This was completed at Cincinnati Children’s Hospital Medical Center in Ohio to evaluate the effects of the therapy on the prevalence and severity of vertebral fractures.
Researchers found that most patients had mild vertebral height loss or fractures at baseline. When they evaluated the prevalence of vertebral fractures at each year of bisphosphonates treatment, the researchers found no statistically significant difference from baseline. There was also no change in longitudinal severity in most vertebrae. The treatment led to improvement for some patients in vertebral fracture grade.
They concluded that bisphosphonate seems to be beneficial in patients with DMD. They added that a randomized controlled study in DMD patients with early signs of bone fragility would be ideal to better determine the efficacy of oral bisphosphonate in the prevention of osteoporosis.
Nasomyont N, Tian C, Hornung L, et al. The effect of oral bisphosphonate therapy on vertebral morphometry and fractures in patients with Duchenne muscular dystrophy and glucocorticoid-induced osteoporosis. Muscle Nerve. Published online September 10, 2021. doi:10.1002/mus.27416