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29.06.2022 | Original Article

Two-year risedronate treatment for osteoporosis in patients with esophageal varices: a non-randomized clinical trial

verfasst von: Lívia Alves Amaral Santos, Talles Bazeia Lima, Hélio Rubens de Carvalho Nunes, Xingshun Qi, Fernando Gomes Romeiro

Erschienen in: Hepatology International | Ausgabe 6/2022

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Abstract

Background

Bisphosphonates are the mainstay of osteoporosis treatment, but their use for patients with esophageal varices has been avoided due to the risk of esophagitis, which may cause variceal bleeding. Since most clinical trials assessing osteoporosis treatment last 2–3 years, this study aimed to evaluate a 2-year risedronate treatment for patients with esophageal varices and liver cirrhosis.

Methods

The study received Institutional Review Board approval, and the sample was divided into two groups according to bone mineral density (BMD). Cirrhosis severity and endoscopic findings at baseline were similar between the groups. The intervention group had 51 patients with osteoporosis, who received oral risedronate 35 mg weekly plus calcium and vitamin D supplements. The control group had 51 patients with osteopenia, receiving only the supplements. Scheduled esophagogastroduodenoscopies and BMD measurements were carried out.

Results

The adjusted esophagitis risk was higher in the intervention group; however, none of the subjects had digestive bleeding. Lumbar spine BMD increased in the intervention group (− 3.06 ± 0.71 to − 2.33 ± 0.90; p < 0.001) and in the control group (− 1.38 ± 0.77 to − 1.10 ± 1.05; p = 0.012). Femoral neck BMD did not change in the intervention group (− 1.64 ± 0.91 to − 1.71 ± 0.95; p = 0.220), but tended to decrease in the control group (− 1.00 ± 0.74 to − 1.09 ± 0.82; p = 0.053).

Conclusion

Oral risedronate was effective and did not cause gastrointestinal bleeding in cirrhotic patients with esophageal varices under endoscopic surveillance.

Graphic abstract

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Titel: Two-year risedronate treatment for osteoporosis in patients with esophageal varices: a non-randomized clinical trial
verfasst von: Lívia Alves Amaral Santos
Talles Bazeia Lima
Hélio Rubens de Carvalho Nunes
Xingshun Qi
Fernando Gomes Romeiro
Publikationsdatum: 29.06.2022
Verlag: Springer India
Erschienen in: Hepatology International / Ausgabe 6/2022
Print ISSN: 1936-0533
Elektronische ISSN: 1936-0541
DOI: https://doi.org/10.1007/s12072-022-10366-z

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Two-year risedronate treatment for osteoporosis in patients with esophageal varices: a non-randomized clinical trial