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Effect of Oral Bisphosphonates on Vertebral Fractures in Males Living with HIV: A Seven Year Study. | LitMetric

AI Article Synopsis

  • Osteoporosis and vertebral fractures (VFs) are common in males living with HIV, and while bisphosphonates improve bone mineral density (BMD), their effect on VFs is less clear.
  • In a study of 118 males with HIV, researchers followed patients for about 7 years to assess the long-term benefits of oral bisphosphonates on VFs, revealing that many patients still experienced new fractures despite treatment.
  • The study also highlighted that factors like age, HIV duration, and hormone levels influenced bone health, and it noted a significant number of patients discontinued bisphosphonates, indicating challenges with treatment adherence and the need for better management of hormonal health.

Article Abstract

Osteoporosis and vertebral fractures (VFs) are frequently observed in males living with HIV (MLWH). While bisphosphonates seem effective on bone mineral density (BMD) in MLWH, data on VFs are lacking. In this real-life longitudinal study performed on 118 MLWH (median age 53) who were followed-up for a median of 7 years, we aimed to evaluate the long-term efficacy of oral bisphosphonates on VFs in MLWH. The inclusion criteria were age >18, stable HIV infection, bisphosphonate-naïve, blood samples from the same laboratory, and three densitometries and morphometries performed with the same densitometer. At baseline, VFs were detected in 29/118 patients (24.6%). Patients with VFs were older ( 0.042), had longer HIV infection duration ( 0.046) and antiretroviral exposure ( 0.025), and demonstrated higher luteinizing hormone levels (LH, 0.044). Of the 29 patients with VFs at inclusion, 11 developed new VFs, of which 8 were under oral bisphosphonates ( 0.018). Among the 89 without basal VFs, 11 developed VFs, of which 2 were under oral bisphosphonates. Patients with a worsened bone condition (regarding BMD and/or new VFs, n. 32) had more frequently high LH levels (>9.4 mIU/mL, 0.046) and higher HCV co-infection compared to patients with a stable bone condition ( 0.045). It should be noted that 38.6% of patients discontinued oral bisphosphonates due to medical indication or personal choice, and 14.0% never started them. In conclusion, we found that oral bisphosphonates were not completely effective in preventing VFs, especially in patients with VFs at baseline; this is probably due to the multifactorial pathogenesis of fragility fractures in this population. A poor adherence to treatment and attention to gonadal function are also important issues in this population.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11546889PMC
http://dx.doi.org/10.3390/jcm13216526DOI Listing

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