Incidence, prevalence, and predictors of osteoporotic fracture in adult lung transplant recipients
Background: As life expectancy following lung transplantation (LT) improves, vulnerability to glucocorticoid-induced osteoporotic fractures is increased. Our institution offers LT recipients protocolized antiresorptive therapy, with zoledronic acid (ZA) used first line. Methods: Adults who underwent...
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| Language: | English |
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Elsevier
2025-02-01
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| Series: | JHLT Open |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2950133424001319 |
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| author | Elisabeth Ng Shanal Kumar Eldho Paul Daniel Bennett Luisa Rosi Louise Fuller Lauren Chiu Shoshana Sztal-Mazer Steven Ivulich Greg Snell Leon A. Bach Kathryn L. Hackman |
| author_facet | Elisabeth Ng Shanal Kumar Eldho Paul Daniel Bennett Luisa Rosi Louise Fuller Lauren Chiu Shoshana Sztal-Mazer Steven Ivulich Greg Snell Leon A. Bach Kathryn L. Hackman |
| author_sort | Elisabeth Ng |
| collection | DOAJ |
| description | Background: As life expectancy following lung transplantation (LT) improves, vulnerability to glucocorticoid-induced osteoporotic fractures is increased. Our institution offers LT recipients protocolized antiresorptive therapy, with zoledronic acid (ZA) used first line. Methods: Adults who underwent LT from January 2012 to December 2018 and survived at least 6 months were retrospectively studied. Coprimary outcomes were incidence, prevalence, and predictors of osteoporotic fractures and major osteoporotic fractures post-LT. Results: Four hundred and five LT recipients (41% female, median age 59 years) had a median follow-up of 4.9 years (interquartile range 3.4-6.7). Osteoporotic fracture prevalence was 12% (n = 49) pre-LT and 15% (n = 60) post-LT. Major osteoporotic fracture post-LT occurred in 11% (n = 45). Antiresorptive therapy was received by 47% pre- and 89% post-LT. On multivariate analysis, risk factors for osteoporotic fracture were pre-LT osteoporotic fracture (hazard ratio (HR) 2.32 (95% confidence interval (CI) 1.09-4.96)), female sex (HR 2.08 (95% CI 1.09-3.94)), glucocorticoid use pre-LT (HR 2.08 (95% CI 1.09-3.99)), and time (months) to first ZA infusion post-LT (HR 1.04 (95% CI 1.01-1.06)). Risk factors for major osteoporotic fracture were pre-LT osteoporotic fracture, female sex, age, and time to first ZA infusion. Conclusion: LT recipients receiving protocolized antiresorptive treatment post-LT had a low incidence of osteoporotic fracture. |
| format | Article |
| id | doaj-art-15263505bd1e45469e99d76b96a548b4 |
| institution | Kabale University |
| issn | 2950-1334 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JHLT Open |
| spelling | doaj-art-15263505bd1e45469e99d76b96a548b42025-02-09T05:01:56ZengElsevierJHLT Open2950-13342025-02-017100182Incidence, prevalence, and predictors of osteoporotic fracture in adult lung transplant recipientsElisabeth Ng0Shanal Kumar1Eldho Paul2Daniel Bennett3Luisa Rosi4Louise Fuller5Lauren Chiu6Shoshana Sztal-Mazer7Steven Ivulich8Greg Snell9Leon A. Bach10Kathryn L. Hackman11Department of Endocrinology and Diabetes, Alfred Health, Melbourne, Victoria, AustraliaMonash Centre for Health Research and Implementation, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia; Adult Cystic Fibrosis Centre, The Prince Charles Hospital, Brisbane, Queensland, AustraliaMonash Centre for Health Research and Implementation, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia; Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, AustraliaDepartment of Medicine (Alfred), Monash University, Melbourne, Victoria, AustraliaDepartment of Medicine (Alfred), Monash University, Melbourne, Victoria, AustraliaDepartment of Medicine (Alfred), Monash University, Melbourne, Victoria, Australia; Department of Physiotherapy, Alfred Health, Melbourne, Victoria, AustraliaDepartment of Medicine (Alfred), Monash University, Melbourne, Victoria, AustraliaDepartment of Endocrinology and Diabetes, Alfred Health, Melbourne, Victoria, Australia; Department of Medicine (Alfred), Monash University, Melbourne, Victoria, AustraliaDepartment of Pharmacy, Alfred Health, Melbourne, Victoria, AustraliaDepartment of Respiratory Medicine, Alfred Health, Melbourne, Victoria, AustraliaDepartment of Endocrinology and Diabetes, Alfred Health, Melbourne, Victoria, Australia; Department of Medicine (Alfred), Monash University, Melbourne, Victoria, AustraliaDepartment of Endocrinology and Diabetes, Alfred Health, Melbourne, Victoria, Australia; Department of Medicine (Alfred), Monash University, Melbourne, Victoria, Australia; Corresponding author: Kathryn L. Hackman, Department of Endocrinology and Diabetes, Alfred Health, Melbourne, Victoria, Australia.Background: As life expectancy following lung transplantation (LT) improves, vulnerability to glucocorticoid-induced osteoporotic fractures is increased. Our institution offers LT recipients protocolized antiresorptive therapy, with zoledronic acid (ZA) used first line. Methods: Adults who underwent LT from January 2012 to December 2018 and survived at least 6 months were retrospectively studied. Coprimary outcomes were incidence, prevalence, and predictors of osteoporotic fractures and major osteoporotic fractures post-LT. Results: Four hundred and five LT recipients (41% female, median age 59 years) had a median follow-up of 4.9 years (interquartile range 3.4-6.7). Osteoporotic fracture prevalence was 12% (n = 49) pre-LT and 15% (n = 60) post-LT. Major osteoporotic fracture post-LT occurred in 11% (n = 45). Antiresorptive therapy was received by 47% pre- and 89% post-LT. On multivariate analysis, risk factors for osteoporotic fracture were pre-LT osteoporotic fracture (hazard ratio (HR) 2.32 (95% confidence interval (CI) 1.09-4.96)), female sex (HR 2.08 (95% CI 1.09-3.94)), glucocorticoid use pre-LT (HR 2.08 (95% CI 1.09-3.99)), and time (months) to first ZA infusion post-LT (HR 1.04 (95% CI 1.01-1.06)). Risk factors for major osteoporotic fracture were pre-LT osteoporotic fracture, female sex, age, and time to first ZA infusion. Conclusion: LT recipients receiving protocolized antiresorptive treatment post-LT had a low incidence of osteoporotic fracture.http://www.sciencedirect.com/science/article/pii/S2950133424001319lung transplantationosteoporosisfractureboneantiresorptivemortality |
| spellingShingle | Elisabeth Ng Shanal Kumar Eldho Paul Daniel Bennett Luisa Rosi Louise Fuller Lauren Chiu Shoshana Sztal-Mazer Steven Ivulich Greg Snell Leon A. Bach Kathryn L. Hackman Incidence, prevalence, and predictors of osteoporotic fracture in adult lung transplant recipients JHLT Open lung transplantation osteoporosis fracture bone antiresorptive mortality |
| title | Incidence, prevalence, and predictors of osteoporotic fracture in adult lung transplant recipients |
| title_full | Incidence, prevalence, and predictors of osteoporotic fracture in adult lung transplant recipients |
| title_fullStr | Incidence, prevalence, and predictors of osteoporotic fracture in adult lung transplant recipients |
| title_full_unstemmed | Incidence, prevalence, and predictors of osteoporotic fracture in adult lung transplant recipients |
| title_short | Incidence, prevalence, and predictors of osteoporotic fracture in adult lung transplant recipients |
| title_sort | incidence prevalence and predictors of osteoporotic fracture in adult lung transplant recipients |
| topic | lung transplantation osteoporosis fracture bone antiresorptive mortality |
| url | http://www.sciencedirect.com/science/article/pii/S2950133424001319 |
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