Glucocorticoids, widely used in inflammatory disorders, rapidly increase bone fragility and, therefore, fracture risk. However, common bone densitometry measurements are not sensitive enough to detect these changes. Moreover, densitometry only partially recognizes treatment-induced fracture reductions in osteoporosis. Patients were allocated into groups receiving calcium + vitamin D (Ca+D) supplements or anti-osteoporotic drugs (risedronate, denosumab, teriparatide) and measured BMD and Bone Scores. Although Ca+D-treated patients exhibited substantial and significant deterioration, risedronate-treated patients exhibited no significant change, and both denosumab- and teriparatide-treated participants exhibited significantly improved Bone Scores 7 weeks after initial treatment compared with baseline; these trends remained stable for 20 weeks. In contrast, no densitometry changes were observed during this study period.
J Bone Miner Res. 2015 Sep;30(9):1651-6. doi: 10.1002/jbmr.2497. Epub 2015 Jun 11.
End-stage renal disease patients undergoing transplant surgery have damaged bone health parameters (density, microarchitecture, and mechanical properties) despite acceptably controlled hyperparathyroidism. To treat these patients, a kidney transplant is needed. Detecting abnormalities in the bone of kidney transplant patients may assist in identifying patients at high risk of post-transplantation fractures.
https://www.ncbi.nlm.nih.gov/pubmed/28497224
Osteoporos Int. 2017 Sep;28(9):2723-2727. doi: 10.1007/s00198-017-4065-5. Epub 2017 May 11.
Despite persistent decrease in BMD, trabecular microarchitecture and Bone Scores remain normal in long-term kidney transplant recipients, suggesting important recovery of bone health.
https://www.ncbi.nlm.nih.gov/pubmed/27467533
Transplantation. 2017 Jun;101(6):1290-1294. doi: 10.1097/TP.0000000000001328.