Two-year risedronate treatment for osteoporosis in patients with esophageal varices: a non-randomized clinical trial
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNESP |
Texto Completo: | http://dx.doi.org/10.1007/s12072-022-10366-z http://hdl.handle.net/11449/241256 |
Resumo: | Background: 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.] |
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Two-year risedronate treatment for osteoporosis in patients with esophageal varices: a non-randomized clinical trialBisphosphonatesBone mineral densityCirrhosisDual-energy X-ray absorptiometryEndoscopyEsophageal varicesEsophagitisGastrointestinal hemorrhageOsteopeniaOsteoporosisBackground: 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.]Internal Medicine Department Botucatu Medical School Gastroenterology Division-São Paulo State University (UNESP), Rubião Júnior s/n, SPPublic Health Department Botucatu Medical School São Paulo State University (UNESP)General Hospital of Shenyang Military Command, ShengInternal Medicine Department Botucatu Medical School Gastroenterology Division-São Paulo State University (UNESP), Rubião Júnior s/n, SPPublic Health Department Botucatu Medical School São Paulo State University (UNESP)Universidade Estadual Paulista (UNESP)General Hospital of Shenyang Military CommandSantos, Lívia Alves Amaral [UNESP]Lima, Talles Bazeia [UNESP]de Carvalho Nunes, Hélio Rubens [UNESP]Qi, XingshunRomeiro, Fernando Gomes [UNESP]2023-03-01T20:53:52Z2023-03-01T20:53:52Z2022-01-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttp://dx.doi.org/10.1007/s12072-022-10366-zHepatology International.1936-05411936-0533http://hdl.handle.net/11449/24125610.1007/s12072-022-10366-z2-s2.0-85133166304Scopusreponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPengHepatology Internationalinfo:eu-repo/semantics/openAccess2024-09-03T14:12:02Zoai:repositorio.unesp.br:11449/241256Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestrepositoriounesp@unesp.bropendoar:29462024-09-03T14:12:02Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)false |
dc.title.none.fl_str_mv |
Two-year risedronate treatment for osteoporosis in patients with esophageal varices: a non-randomized clinical trial |
title |
Two-year risedronate treatment for osteoporosis in patients with esophageal varices: a non-randomized clinical trial |
spellingShingle |
Two-year risedronate treatment for osteoporosis in patients with esophageal varices: a non-randomized clinical trial Santos, Lívia Alves Amaral [UNESP] Bisphosphonates Bone mineral density Cirrhosis Dual-energy X-ray absorptiometry Endoscopy Esophageal varices Esophagitis Gastrointestinal hemorrhage Osteopenia Osteoporosis |
title_short |
Two-year risedronate treatment for osteoporosis in patients with esophageal varices: a non-randomized clinical trial |
title_full |
Two-year risedronate treatment for osteoporosis in patients with esophageal varices: a non-randomized clinical trial |
title_fullStr |
Two-year risedronate treatment for osteoporosis in patients with esophageal varices: a non-randomized clinical trial |
title_full_unstemmed |
Two-year risedronate treatment for osteoporosis in patients with esophageal varices: a non-randomized clinical trial |
title_sort |
Two-year risedronate treatment for osteoporosis in patients with esophageal varices: a non-randomized clinical trial |
author |
Santos, Lívia Alves Amaral [UNESP] |
author_facet |
Santos, Lívia Alves Amaral [UNESP] Lima, Talles Bazeia [UNESP] de Carvalho Nunes, Hélio Rubens [UNESP] Qi, Xingshun Romeiro, Fernando Gomes [UNESP] |
author_role |
author |
author2 |
Lima, Talles Bazeia [UNESP] de Carvalho Nunes, Hélio Rubens [UNESP] Qi, Xingshun Romeiro, Fernando Gomes [UNESP] |
author2_role |
author author author author |
dc.contributor.none.fl_str_mv |
Universidade Estadual Paulista (UNESP) General Hospital of Shenyang Military Command |
dc.contributor.author.fl_str_mv |
Santos, Lívia Alves Amaral [UNESP] Lima, Talles Bazeia [UNESP] de Carvalho Nunes, Hélio Rubens [UNESP] Qi, Xingshun Romeiro, Fernando Gomes [UNESP] |
dc.subject.por.fl_str_mv |
Bisphosphonates Bone mineral density Cirrhosis Dual-energy X-ray absorptiometry Endoscopy Esophageal varices Esophagitis Gastrointestinal hemorrhage Osteopenia Osteoporosis |
topic |
Bisphosphonates Bone mineral density Cirrhosis Dual-energy X-ray absorptiometry Endoscopy Esophageal varices Esophagitis Gastrointestinal hemorrhage Osteopenia Osteoporosis |
description |
Background: 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.] |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-01-01 2023-03-01T20:53:52Z 2023-03-01T20:53:52Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.1007/s12072-022-10366-z Hepatology International. 1936-0541 1936-0533 http://hdl.handle.net/11449/241256 10.1007/s12072-022-10366-z 2-s2.0-85133166304 |
url |
http://dx.doi.org/10.1007/s12072-022-10366-z http://hdl.handle.net/11449/241256 |
identifier_str_mv |
Hepatology International. 1936-0541 1936-0533 10.1007/s12072-022-10366-z 2-s2.0-85133166304 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Hepatology International |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.source.none.fl_str_mv |
Scopus reponame:Repositório Institucional da UNESP instname:Universidade Estadual Paulista (UNESP) instacron:UNESP |
instname_str |
Universidade Estadual Paulista (UNESP) |
instacron_str |
UNESP |
institution |
UNESP |
reponame_str |
Repositório Institucional da UNESP |
collection |
Repositório Institucional da UNESP |
repository.name.fl_str_mv |
Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP) |
repository.mail.fl_str_mv |
repositoriounesp@unesp.br |
_version_ |
1810021396154155008 |