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 language | English (US) |
|---|---|
| Pages (from-to) | 562-569 |
| Number of pages | 8 |
| Journal | Nature Clinical Practice Rheumatology |
| Volume | 2 |
| Issue number | 10 |
| DOIs | |
| State | Published - Oct 2006 |
Fingerprint
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 journal › Article
}
TY - JOUR
T1 - Therapy Insight
T2 - Osteoporosis and osteonecrosis in systemic lupus erythematosus
AU - Lane, Nancy E
PY - 2006/10
Y1 - 2006/10
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=33749335316&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33749335316&partnerID=8YFLogxK
U2 - 10.1038/ncprheum0298
DO - 10.1038/ncprheum0298
M3 - Article
C2 - 17016482
AN - SCOPUS:33749335316
VL - 2
SP - 562
EP - 569
JO - Nature reviews. Rheumatology
JF - Nature reviews. Rheumatology
SN - 1759-4790
IS - 10
ER -