Osteoporose e o uso de alendronato na distrofia muscular de Duchenne

USA – trinta e nove pacientes com Duchenne foram estudados aos 12 anos de idade com a densitometria óssea. A densidade óssea encontrava-se diminuída nesta idade, sugerindo a necessidade que os estudos sejam feitos em idades mais jovens. Os que usavam corticóides tinham densidade óssea menor. Os tratados com alendronato tiveram aumento não significativo da densidade óssea, especialmente por se tratar de um número pequeno de pacientes.

O resumo em inglês pode ser lido abaixo:

(Muscle & Nerve, 2013) Bone density and alendronate effects in Duchenne muscular dystrophy patients

Caroline Houston, Katherine Mathews and Amal Shibli-Rahhal – USA

Abstract

Introduction: Patients with DMD have low bone mineral density (BMD) and are at high risk for fractures. We examined changes in BMD and the effects of alendronate in DMD patients treated at our institution in the last decade.

Methods: Retrospective cohort study of 39 DMD patients.

Results: Patients had screening dual energy x-ray absorptiometry (DXA) at an average age of 12 years. The vast majority had low Z-scores at the total hip and lumbar spine. Patients treated with glucocorticoids had a significantly lower Z-score at the spine than those not treated with glucocorticoids. Z-scores at the hip trended down without alendronate (P= 0.07) and trended up with alendronate (P= 0.4).

Discussion: By age 12 years, most patients with DMD had low Z-scores. They may have benefitted from earlier screening. Z-score at the hip trended downward without alendronate and trended upward (stabilized) with alendronate, but these trends were not statistically significant