title: Management of beta-thalassemia-associated osteoporosis.
abstract: Beta-Thalassemia-associated osteoporosis is a multifactorial and complex condition. Different acquired and genetic factors are involved in its pathogenesis. These factors produce an imbalance in bone remodeling by inhibiting osteoblast activity and increasing osteoclast function, leading to bone loss and increased fracture risk. The management of patients presenting with thalassemia-associated osteoporosis should consist of the implementation of general measures and the prescription of a specific pharmacological agent, with the aim of reducing fracture risk and preventing disability and deterioration of quality of life. General measures include control of anemia, adequate chelation therapy, healthy nutrition and lifestyle, regular exercise, adequate management of comorbid conditions, hormone replacement therapy in patients with hypogonadism, and vitamin D supplementation/therapy. Among the pharmacological agents currently available for the management of osteoporosis in postmenopausal women and men, bisphosphonates have been shown to improve bone mineral density, to reduce bone turnover, and to decrease bone/back pain in patients with thalassemia-associated osteoporosis, with a good profile of safety and tolerability. On the other hand, there are limited experiences with other pharmacological agents (e.g., denosumab or teriparatide). The complexity of this condition presents diagnostic and therapeutic challenges and underscores the importance of a comprehensive and multidisciplinary approach.
authors.affiliation: Department of Ortho-Geriatrics, Rehabilitation and Stabilization-Frailty Area, Galliera Hospital, Genoa, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Giusti
authors.affiliation: Center of Microcitemia and Congenital Anemias, Galliera Hospital, Genoa, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Pinto
authors.affiliation: Center of Microcitemia and Congenital Anemias, Galliera Hospital, Genoa, Italy.
authors.forename: Gian Luca
authors.initials: GL
authors.lastname: Forni
authors.affiliation: Department of Ortho-Geriatrics, Rehabilitation and Stabilization-Frailty Area, Galliera Hospital, Genoa, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Pilotto
mesh_terms: D000818:Animals; D015519:Bone Density / Q000187:drug effects / Q000502:physiology; D050071:Bone Density Conservation Agents / Q000494:pharmacology / Q000627:therapeutic use*; D002118:Calcium / Q000494:pharmacology / Q000627:therapeutic use; D019587:Dietary Supplements; D004164:Diphosphonates / Q000494:pharmacology / Q000627:therapeutic use; D019468:Disease Management; D006801:Humans; D010024:Osteoporosis / Q000453:epidemiology / Q000378:metabolism / Q000628:therapy*; D014807:Vitamin D / Q000494:pharmacology / Q000627:therapeutic use; D017086:beta-Thalassemia / Q000453:epidemiology / Q000378:metabolism / Q000628:therapy*
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D014807:Vitamin D; D002118:Calcium
keywords: bisphosphonates; fractures; osteoporosis; thalassemia; vitamin D