Therapy Insight: Osteoporosis and osteonecrosis in systemic lupus erythematosus

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

Survival of patients with systemic lupus erythematosus (SLE) has improved over the past decade, thanks to improved treatment of the disease, which now results in fewer fatal complications. This improvement has allowed physicians to focus their attention on the prevention of organ damage caused by this chronic, inflammatory disease, and by the medications used to control the disease. Osteoporosis is common in SLE patients; risk factors for osteoporosis include prolonged use of glucocorticoids, cyclophosphamide and possibly gonadotropin-releasing-hormone agonists. In premenopausal women with SLE, inflammation or SLE-related medications can increase bone turnover, which eventually weakens bone architecture, then reduces bone strength and increases the risk of fracture. Prevention and treatment of osteoporosis in SLE patients should entail a multifaceted approach. Levels of calcium, vitamin D and homocysteine should be evaluated, and age-appropriate supplementation instituted. The bone loss that results from systemic inflammation should be treated by reduction of the inflammation with glucocorticoids, potent anti-inflammatory agents or antiresorptive agents. The efficacy of this therapy can be monitored using bone mineral density scans. This Review briefly discusses the pathophysiology of the localized and generalized osteoporosis and osteonecrosis in SLE patients and recommends therapies to both prevent and treat these unfortunate complications of this disease.

Original languageEnglish (US)
Pages (from-to)562-569
Number of pages8
JournalNature Clinical Practice Rheumatology
Volume2
Issue number10
DOIs
StatePublished - Oct 2006

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Osteonecrosis
Systemic Lupus Erythematosus
Osteoporosis
Inflammation
Bone and Bones
Glucocorticoids
Therapeutics
Bone Density Conservation Agents
Bone Remodeling
Homocysteine
Gonadotropin-Releasing Hormone
Vitamin D
Bone Density
Cyclophosphamide
Chronic Disease
Anti-Inflammatory Agents
Calcium
Physicians
Survival

ASJC Scopus subject areas

  • Rheumatology

Cite this

Therapy Insight : Osteoporosis and osteonecrosis in systemic lupus erythematosus. / Lane, Nancy E.

In: Nature Clinical Practice Rheumatology, Vol. 2, No. 10, 10.2006, p. 562-569.

Research output: Contribution to journalArticle

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