Document Detail


Bisphosphonates in patients with autoimmune rheumatic diseases: Can they be used in women of childbearing age?
MedLine Citation:
PMID:  20307690     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Autoimmune rheumatic diseases (ARD) are prevalent in women during their childbearing age. For their treatment, high doses of corticosteroid (CS) for long-term periods are often required, increasing the risk of bone loss. According to recent guidelines, bisphosphonates (BP) should be used as first line treatment to prevent CS induced osteoporosis. However, due to their long-term release from bone and their ability to cross the placenta, it has been suggested to avoid BP in women during their fertile years. BP seem to decrease foetus bone length in pregnant animals, but not in humans, at least, when they are administered at therapeutic dosage. BP are embryo toxic in animals when used at high dosage. In a systematic literature review, we found 58 women treated with BP close before or during pregnancy, showing no related congenital malformations. However, the Unit of Clinical and Epidemiological Genetics in University of Padova collected ten cases of women treated with BP during pregnancy, reporting 20% of congenital malformations. Thus, we suggest to avoid BP during pregnancy and caution with their use in fertile women. When they have to be given before pregnancy, specific affinities of the BP have to be considered to plan the washout period beforehand.
Authors:
Inès Losada; Leonardo Sartori; Elena Di Gianantonio; Margherita Zen; Maurizio Clementi; Andrea Doria
Publication Detail:
Type:  Journal Article; Review     Date:  2010-03-20
Journal Detail:
Title:  Autoimmunity reviews     Volume:  9     ISSN:  1873-0183     ISO Abbreviation:  Autoimmun Rev     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-01     Completed Date:  2010-08-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101128967     Medline TA:  Autoimmun Rev     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  547-52     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Elsevier B.V. All rights reserved.
Affiliation:
Servicio de Medicina Interna, Hospital Son Llatzer, Mallorca, Spain.
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MeSH Terms
Descriptor/Qualifier:
Adrenal Cortex Hormones / adverse effects
Animals
Autoimmune Diseases / drug therapy*
Bone and Bones / drug effects*
Diphosphonates / adverse effects*
Embryo, Mammalian / drug effects*
Female
Humans
Osteoporosis / chemically induced,  prevention & control
Pregnancy / drug effects*
Rheumatic Diseases / drug therapy*
Chemical
Reg. No./Substance:
0/Adrenal Cortex Hormones; 0/Diphosphonates

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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