OPL
osteoporosis associated with pregnancy and lactation
Keywords:
Osteoporosis, pregnacy, lactation, vertebral fractures, romosozumabAbstract
Fracture by osteoporosis associated with pregnancy and lactation is a rare event and its etiology has not yet been established. It occurs most commonly in the third trimester of pregnancy or in the first trimester of breastfeeding, with the spine being the most affected site, in the dorsal and lumbar segments, and may occur in the pelvis, with a lower incidence. A clinical case of a multisegmental idiopathic osteoporotic fracture of the thoracic and lumbar spine in a lactating woman will be presented, where, after the cessation of breastfeeding, treatment with a humanized monoclonal antibody, romosozumab, was instituted.
References
Qian Y, Wang L, Yu L, Huang W. Pregnancy – and lactation – associated osteoporosis with vertebral fractures: a systematic review.
Vanhouten J N, Wysolmerski J J. Low estrogen anda high parathyroid hormone – related peptide levels contribute to accelerated bone resorption and bone loss in lactatin mice. Encocrinology 144(12): 5521-5529
Winter E M, Ireland A, Butterfield N C, Haffner-Luntzer M, Horcajada M-N, Veldhuis-Vlug A G, Oei L, Colaiannig G, Bonnet N. Pregnancy and lactation, a challenge for the skeleton. Endocrine connections, 9:6, R143-R157.
Salari P, Abdollahi M. Influence of pregnancy and lactation on maternal bone health: a systematic review. Journal of Family and reproductive health, Vol. 8, Nº 4, December 2014.
Ijuin A, Yoshikata H, Asano R, Tsuburai T, Kikuchi R, Skakibara H. Teriparatide and e denosumab treatment for pregnancy and lactation – associated osteoporosis with multiple vertebral fractures: a case study. Taiwanese Journal of Obstetrics & Gynecology, 56 (2017) 863-866.
Willems D, Javaid M K, Pinedo-Villanueva R, Libanati C, Yehoshua A, Charokopou M. Importance of time point-specific indirect treatment comparisons of osteoporosis treatments: a systematic literature review and network meta-analyses. Clinical therapeutics, Vol. 44, nº 1, 2022.
Lewiecki EM, Dinavahi RV, Lazaretti-Castro M, et al. One year of romosozumab followed by two years of denosumab maintains fracture risk reductions: results of the frame extension study. J Bone Miner Res. 2019;34(3):419-28.
Ominsky MS, Boyd SK, Varela A, et al. Romosozumab improves bone mass and strength while maintaining bone quality in ovariectomized cynomolgus monkeys. J Bone Miner Res. 2017; 32:788-801.
McClung MR, Brown JP, Diez-Perez A, et al. Effects of 24 Months of treatment with romosozumab followed by 12 Months of denosumab or placebo in postmenopausal women with low bone mineral density: a randomized, double-blind, phase 2, parallel group study. J Bone Miner Res. 2018; 33(8):1397-406.