Impact of medical therapy for hormone-secreting Pituitary tumors on bone.

Journal

Pituitary

ISSN: 1573-7403

Titre abrégé: Pituitary

Pays: United States

ID NLM: 9814578

Informations de publication

Date de publication:
05 Jul 2024

Historique:

accepted: 22 06 2024

medline: 5 7 2024

pubmed: 5 7 2024

entrez: 5 7 2024

Statut: aheadofprint

Résumé

Bone health is often impaired in patients with hormone-secreting pituitary tumors. Since medical therapy is central to their care, understanding how its use impacts on this is highly important. This review summarizes a systemmatic review of the literature on the effects of medical therapies for hormone-secreting pituitary tumors on bone. In acromegaly, medical therapy lowers bone turnover marker (BTM) levels, consistent with correction of the high bone turnover of active disease, and overall, areal bone mineral density (aBMD) does not change or increases. Somatostatin-receptor ligand (SRL) and pegvisomant-treated acromegaly patients have persistently reduced volumetric BMD and microarchitectural abnormalities of the peripheral skeleton, deficits that are similar to those in surgically-treated patients. Fracture risk remains elevated in medically-treated acromegaly patients but in conjunction with biochemical control the risk is lessened. Treatment of prolactin-secreting tumors with dopamine agonists is associated with improvements in aBMD, but this does not always fully normalize despite effective medical treatment of the prolactinoma. In one cross-sectional study, prolactinoma patients had lower total volumetric BMD and impaired microarchitecture suggesting that bone microstructure does not fully normalize despite dopamine agonist therapy. Cross-sectional studies show a high rate of VF in patients with prolactin-secreting tumors that is lowered on cabergoline therapy, but still the fracture rate of men and postmenopausal women is higher than that of controls in some studies. Studies on the effects of modern-day medical therapy for Cushing's disease on bone are lacking. More research is needed on the effectsof medical therapies for hormone secreting pituitary tumors on bone health.

Identifiants

DOI: 10.1007/s11102-024-01421-z PMID: 38967763

pubmed: 38967763

doi: 10.1007/s11102-024-01421-z

pii: 10.1007/s11102-024-01421-z

doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

Subventions

Organisme : NIDDK NIH HHS

ID : DK110771, DK133392

Pays : United States

Informations de copyright

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