Rapid Bone Mineral Density Declines Increase Vertebral Fracture Risk in COPD – Endocrinology Advisor

In elderly patients with chronic obstructive pulmonary disease (COPD), quick decline in bone mineral density (BMD) is associated with an greater chance for vertebral fracture, according to look at outcomes published in Respiratory Medicine.
Men and women (mean age, 72.5±8.1 years) diagnosed with COPD or at possibility for COPD and who had annual BMD measurements in 3 frame components ≥3 times all through a 3-year duration were enrolled (N=111) in the look at.

Researchers assessed institutions between bisphosphonate cure and BMD decline, adding in patients in a separate diagnosis who were now not treated with this therapy at baseline then again started  and endured remedy throughout follow-up (n=41).

At the time of study enrollment and every year thereafter, the researchers got a full clinical and smoking history and suggestions on pharmacologic treatment, disease exacerbations, and comorbid conditions. An exacerbation of COPD turned into defined as the need for systemic corticosteroids or antibiotics or hospitalization.
No difference turned into observed among the 2 businesses in terms of swift decliners (n=33) and nonrapid decliners (n=78) in terms of BMD at enrollment. Despite this lack of difference at baseline, swift decliners had more vertebral fractures during a 3-year length as compared with nonrapid decliners (20.7% vs 5.6%, respectively; P =.02).

Compared with non-swift decliners, swift decliners were older (71.2±8.0 years vs 75.4±7.6 years, respectively; P =.01), had a cut body mass index (23.9±3.2 kg/m2 vs 22.6±2.4 kg/m2, respectively; P =.03), were less likely to have interaction in day-to-day undertaking (20.8% vs 36.7%, respectively; P =.09), and more likely to have anemia (11.5% vs 39.4%, respectively; P <.01).

Patients who initiated bisphosphonate and persisted treatment proven better annual adjustments in BMD in comparison with patients who were not treated with bisphosphonate (lumbar spine: 2.30% vs 0.59%; P <.0001; correct femur: 0.33% vs −0.34%; P <.0001; left femur: −0.17% vs −0.42%; P =.008).

The small number of ladies in the study (5.4%), small pattern size, and small number of patients who used drugs to enhance BMD were a few of the study’s limitations.
Based on their findings, the researchers recommended that “bisphosphonate could alter BMD decline for the nested group of patients with COPD.”
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Kameyama N, Chubachi S, Sasaki M, et al. Predictive and editing factors of bone mineral density decline in patients with COPD. Respir Med. 2019;148:13-23.

This article initially appeared on Pulmonology Advisor