Elevated Incidence of Fractures in Solid-Organ Transplant Recipients on Glucocorticoid-Sparing Immunosuppressive Regimens
This study was conducted to assess the occurrence of fractures in solid-organ transplant recipients. Methods. Medical record review and surveys were performed. Patients received less than 6 months of glucocorticoids. Results. Of 351 transplant patients, 175 patients provided fracture information, wi...
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| Format: | Article |
| Language: | English |
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Wiley
2011-01-01
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| Series: | Journal of Osteoporosis |
| Online Access: | http://dx.doi.org/10.4061/2011/591793 |
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| author | B. J. Edwards A. Desai J. Tsai H. Du G. R. Edwards A. D. Bunta A. Hahr M. Abecassis S. Sprague |
| author_facet | B. J. Edwards A. Desai J. Tsai H. Du G. R. Edwards A. D. Bunta A. Hahr M. Abecassis S. Sprague |
| author_sort | B. J. Edwards |
| collection | DOAJ |
| description | This study was conducted to assess the occurrence of fractures in solid-organ transplant recipients. Methods. Medical record review and surveys were performed. Patients received less than 6 months of glucocorticoids. Results. Of 351 transplant patients, 175 patients provided fracture information, with 48 (27.4%) having fractured since transplant (2–6 years). Transplants included 19 kidney/liver (50% male), 47 kidney/pancreas (53% male), 92 liver (65% male), and 17 pancreas transplants (41% male). Age at transplant was 50.8±10.3 years. Fractures were equally seen across both genders and transplant types. Calcium supplementation (n=94) and bisphosphonate therapy (n=52) were observed, and an association with a lower risk of fractures was noted for bisphosphonate users (OR=0.45 95% C.I. 0.24, 0.85). Fracture location included 8 (16.7%) foot, 12 (25.0%) vertebral, 3 (6.3%) hand, 2 (4.2%) humerus, 5 (10.4%) wrist, 10 (20.8%) fractures at other sites, and 7 (14.6%) multiple fractures. The estimated relative risk of fracture was nearly seventeen-times higher in male liver transplant recipients ages 45–64 years compared with the general male population, and comparable to fracture rates on conventional immunosuppressant regimens. Conclusion. We identify a high frequency of fractures in transplant recipients despite limited glucocorticoid use. |
| format | Article |
| id | doaj-art-b05f7d51c20d4035823e5483d4d41013 |
| institution | Kabale University |
| issn | 2042-0064 |
| language | English |
| publishDate | 2011-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Osteoporosis |
| spelling | doaj-art-b05f7d51c20d4035823e5483d4d410132025-02-03T05:58:08ZengWileyJournal of Osteoporosis2042-00642011-01-01201110.4061/2011/591793591793Elevated Incidence of Fractures in Solid-Organ Transplant Recipients on Glucocorticoid-Sparing Immunosuppressive RegimensB. J. Edwards0A. Desai1J. Tsai2H. Du3G. R. Edwards4A. D. Bunta5A. Hahr6M. Abecassis7S. Sprague8Bone Health and Osteoporosis Center, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USANorthShore University HealthSystem, Evanston, IL 60201, USABone Health and Osteoporosis Center, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USANorthShore University HealthSystem, Evanston, IL 60201, USABone Health and Osteoporosis Center, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USABone Health and Osteoporosis Center, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USABone Health and Osteoporosis Center, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USAKovler Transplant Center, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USANorthShore University HealthSystem, Evanston, IL 60201, USAThis study was conducted to assess the occurrence of fractures in solid-organ transplant recipients. Methods. Medical record review and surveys were performed. Patients received less than 6 months of glucocorticoids. Results. Of 351 transplant patients, 175 patients provided fracture information, with 48 (27.4%) having fractured since transplant (2–6 years). Transplants included 19 kidney/liver (50% male), 47 kidney/pancreas (53% male), 92 liver (65% male), and 17 pancreas transplants (41% male). Age at transplant was 50.8±10.3 years. Fractures were equally seen across both genders and transplant types. Calcium supplementation (n=94) and bisphosphonate therapy (n=52) were observed, and an association with a lower risk of fractures was noted for bisphosphonate users (OR=0.45 95% C.I. 0.24, 0.85). Fracture location included 8 (16.7%) foot, 12 (25.0%) vertebral, 3 (6.3%) hand, 2 (4.2%) humerus, 5 (10.4%) wrist, 10 (20.8%) fractures at other sites, and 7 (14.6%) multiple fractures. The estimated relative risk of fracture was nearly seventeen-times higher in male liver transplant recipients ages 45–64 years compared with the general male population, and comparable to fracture rates on conventional immunosuppressant regimens. Conclusion. We identify a high frequency of fractures in transplant recipients despite limited glucocorticoid use.http://dx.doi.org/10.4061/2011/591793 |
| spellingShingle | B. J. Edwards A. Desai J. Tsai H. Du G. R. Edwards A. D. Bunta A. Hahr M. Abecassis S. Sprague Elevated Incidence of Fractures in Solid-Organ Transplant Recipients on Glucocorticoid-Sparing Immunosuppressive Regimens Journal of Osteoporosis |
| title | Elevated Incidence of Fractures in Solid-Organ Transplant Recipients on Glucocorticoid-Sparing Immunosuppressive Regimens |
| title_full | Elevated Incidence of Fractures in Solid-Organ Transplant Recipients on Glucocorticoid-Sparing Immunosuppressive Regimens |
| title_fullStr | Elevated Incidence of Fractures in Solid-Organ Transplant Recipients on Glucocorticoid-Sparing Immunosuppressive Regimens |
| title_full_unstemmed | Elevated Incidence of Fractures in Solid-Organ Transplant Recipients on Glucocorticoid-Sparing Immunosuppressive Regimens |
| title_short | Elevated Incidence of Fractures in Solid-Organ Transplant Recipients on Glucocorticoid-Sparing Immunosuppressive Regimens |
| title_sort | elevated incidence of fractures in solid organ transplant recipients on glucocorticoid sparing immunosuppressive regimens |
| url | http://dx.doi.org/10.4061/2011/591793 |
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