Journalartikel

Jahr der Veröffentlichung: 2017

Zeitschrift: Clinical Transplantation

Bandnummer: 31

Heftnummer: 11

ISSN: 0902-0063

eISSN: 1399-0012

DOI Link: https://doi.org/10.1111/ctr.13122

Verlag: Wiley

Abstract: 

Background Heart transplantation (HTX) is an established therapy for end-stage heart disease. The aim of this study was to determine whether application of oral bisphosphonates is effective in preventing osseous complications after HTX.

Methods Thirty-three cardiac transplant recipients were treated with alendronate 70 mg/wk or risedronate 35 mg/wk in combination with 1000 mg calcium and 800 IU vitamin D. Markers of bone metabolism and dual-energy X-ray absorptiometry (DXA) were determined directly after HTX and 2 years later. Primary endpoints were changes in bone mineral density (BMD), markers of bone metabolism (osteocalcin, crosslaps), serum levels of the cytokines osteoprotegerin (OPG), receptor activator of NF kappa-B ligand (RANKL), and incidence of fractures.

Results Eight patients presented with osteoporosis, and 16 patients with osteopenia by DXA without prevalent fractures. Over 2 years, the BMD improved in 2 patients from osteoporosis to osteopenia, and overall BMD remained stable, and fractures did not occur. In addition, the serum levels of OPG increased (P < .0005), and the RANKL levels (P < .001) as well as the RANKL/OPG-ratio decreased significantly (P < .0005). The serum crosslaps showed no significant changes. The BMD showed a significant association with the increased 25-vitamin D levels only in females (P < .001).

Conclusions In heart transplanted patients, weekly oral bisphosphonates in combination with calcium and vitamin D supplementation preserved bone mass, prevented uncoupling of bone resorption/formation and fractures. Bone density should be measured and adequately treated, that is, with regular bisphosphonates.

Harvard-Zitierstil: Lange, U., Classen, K., Mueller-Ladner, U. and Richter, M. (2017) Weekly oral bisphosphonates over 2 years prevent bone loss in cardiac transplant patients, Clinical Transplantation, 31(11), Article e13122. https://doi.org/10.1111/ctr.13122

APA-Zitierstil: Lange, U., Classen, K., Mueller-Ladner, U., & Richter, M. (2017). Weekly oral bisphosphonates over 2 years prevent bone loss in cardiac transplant patients. Clinical Transplantation. 31(11), Article e13122. https://doi.org/10.1111/ctr.13122