Osteoporosis in Primary Biliary Cholangitis: Prevalence, Impact and Management Challenges.
cholestatic liver disease
fractures
metabolic bone disease
osteoporosis
primary biliary cholangitis
Journal
Clinical and experimental gastroenterology
ISSN: 1178-7023
Titre abrégé: Clin Exp Gastroenterol
Pays: New Zealand
ID NLM: 101532800
Informations de publication
Date de publication:
2020
2020
Historique:
received:
01
09
2019
accepted:
31
12
2019
entrez:
6
2
2020
pubmed:
6
2
2020
medline:
6
2
2020
Statut:
epublish
Résumé
Primary biliary cholangitis (PBC) is a chronic, cholestatic condition associated with symptoms that directly impact the quality of life in those afflicted with the disease. In addition to pruritus and fatigue, patients with PBC may develop metabolic bone disease from reduced bone density, such as osteopenia and osteoporosis. Osteoporosis increases the risk of fractures, as well as morbidity and mortality. The prevalence of osteoporosis in PBC is expected to increase in conjunction with the rising prevalence of PBC as a whole. Timely diagnosis, prevention and management of osteoporosis are crucial in order to optimize the quality of life. There is a paucity of data evaluating the management of osteoporosis in PBC. The optimal timing for diagnosis and monitoring is not yet established and is guided by expert opinion. National guidelines recommend screening for osteoporosis at the time of diagnosis of PBC. Monitoring strategies are based on results of initial screening and individual risk factors for bone disease. Identifying reduced bone density is imperative to institute timely preventive and treatment strategies. However, treatment remains challenging as efficacious therapies are currently lacking. The data on treatment of osteoporosis in PBC are mostly extrapolated from postmenopausal osteoporosis literature. However, this data has not directly translated to useful treatment strategies for PBC-related osteoporosis, partly because of the different pathophysiological mechanisms of the two diseases. The lack of useful preventive measures and efficacious treatment strategies remains the largest pitfall that challenges the management of patients with PBC. In this review, we comprehensively outline the epidemiology, clinical implications and challenges, as well as management strategies of PBC-related osteoporosis.
Identifiants
pubmed: 32021374
doi: 10.2147/CEG.S204638
pii: 204638
pmc: PMC6970242
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
17-24Informations de copyright
© 2020 Trivedi et al.
Déclaration de conflit d'intérêts
HDT receives educational funding from NIH T32 (5T32DK007760-19). CJD, DG and AB have no financial disclosures. There are no conflicts of interest in the creation of this manuscript.
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