Two-year risedronate treatment for osteoporosis in patients with esophageal varices: a non-randomized clinical trial

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dc.contributor.authorSantos, Lívia Alves Amaral [UNESP]
dc.contributor.authorLima, Talles Bazeia [UNESP]
dc.contributor.authorde Carvalho Nunes, Hélio Rubens [UNESP]
dc.contributor.authorQi, Xingshun
dc.contributor.authorRomeiro, Fernando Gomes [UNESP]
dc.contributor.institutionUniversidade Estadual Paulista (UNESP)
dc.contributor.institutionGeneral Hospital of Shenyang Military Command
dc.date.accessioned2023-03-01T20:53:52Z
dc.date.available2023-03-01T20:53:52Z
dc.date.issued2022-01-01
dc.description.abstractBackground: Bisphosphonates are the mainstay of osteoporosis treatment, but their use for patients with esophageal varices has been avoided due to the risk of esophagitis, which may cause variceal bleeding. Since most clinical trials assessing osteoporosis treatment last 2–3 years, this study aimed to evaluate a 2-year risedronate treatment for patients with esophageal varices and liver cirrhosis. Methods: The study received Institutional Review Board approval, and the sample was divided into two groups according to bone mineral density (BMD). Cirrhosis severity and endoscopic findings at baseline were similar between the groups. The intervention group had 51 patients with osteoporosis, who received oral risedronate 35 mg weekly plus calcium and vitamin D supplements. The control group had 51 patients with osteopenia, receiving only the supplements. Scheduled esophagogastroduodenoscopies and BMD measurements were carried out. Results: The adjusted esophagitis risk was higher in the intervention group; however, none of the subjects had digestive bleeding. Lumbar spine BMD increased in the intervention group (− 3.06 ± 0.71 to − 2.33 ± 0.90; p < 0.001) and in the control group (− 1.38 ± 0.77 to − 1.10 ± 1.05; p = 0.012). Femoral neck BMD did not change in the intervention group (− 1.64 ± 0.91 to − 1.71 ± 0.95; p = 0.220), but tended to decrease in the control group (− 1.00 ± 0.74 to − 1.09 ± 0.82; p = 0.053). Conclusion: Oral risedronate was effective and did not cause gastrointestinal bleeding in cirrhotic patients with esophageal varices under endoscopic surveillance. Graphic abstract: [Figure not available: see fulltext.]en
dc.description.affiliationInternal Medicine Department Botucatu Medical School Gastroenterology Division-São Paulo State University (UNESP), Rubião Júnior s/n, SP
dc.description.affiliationPublic Health Department Botucatu Medical School São Paulo State University (UNESP)
dc.description.affiliationGeneral Hospital of Shenyang Military Command, Sheng
dc.description.affiliationUnespInternal Medicine Department Botucatu Medical School Gastroenterology Division-São Paulo State University (UNESP), Rubião Júnior s/n, SP
dc.description.affiliationUnespPublic Health Department Botucatu Medical School São Paulo State University (UNESP)
dc.identifierhttp://dx.doi.org/10.1007/s12072-022-10366-z
dc.identifier.citationHepatology International.
dc.identifier.doi10.1007/s12072-022-10366-z
dc.identifier.issn1936-0541
dc.identifier.issn1936-0533
dc.identifier.scopus2-s2.0-85133166304
dc.identifier.urihttp://hdl.handle.net/11449/241256
dc.language.isoeng
dc.relation.ispartofHepatology International
dc.sourceScopus
dc.subjectBisphosphonates
dc.subjectBone mineral density
dc.subjectCirrhosis
dc.subjectDual-energy X-ray absorptiometry
dc.subjectEndoscopy
dc.subjectEsophageal varices
dc.subjectEsophagitis
dc.subjectGastrointestinal hemorrhage
dc.subjectOsteopenia
dc.subjectOsteoporosis
dc.titleTwo-year risedronate treatment for osteoporosis in patients with esophageal varices: a non-randomized clinical trialen
dc.typeArtigo
unesp.author.orcid0000-0002-9394-6895[5]

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