Dermatology practical & conceptual · 2025
Risk of Osteoporosis Associated with Glucocorticoid Use in Pemphigus Vulgaris: Insights from a Retrospective Cohort Study.
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Kaya Merve, Saraç Gülhan Aksoy, Acar Onur, Emre Selma, Aktaş Akın
Аннотация
INTRODUCTION: Pemphigus vulgaris (PV) is an autoimmune bullous disease affecting the skin and mucous membranes. Osteoporosis, a significant side effect of commonly used glucocorticoids in treatment, can adversely contribute to the existing morbidity.
OBJECTIVES: This study aimed to assess the impact of glucocorticoid therapy on bone mineral density in patients with PV.
METHODS: Patients newly diagnosed with PV were included in this study. Femur and lumbar T-scores, serum calcium, vitamin D, alkaline phosphatase (ALP), and lactate dehydrogenase (LDH) levels were analyzed before and one year after therapy.
RESULTS: Among 66 patients, the average time to diagnosis was 10.14 months, and the average daily dose of prednisone was 16.95 mg, with 63.6% of patients receiving medium doses. Our data showed no significant change in lumbar T-scores after one year of glucocorticoid treatment, but a significant decrease in femur density was observed. The decrease in femur T-scores was significant in the medium-dose group, while the lumbar T-scores decreased significantly in the high-dose group. There was no significant correlation between T-scores and sex, menopausal state, diagnosis time, or obesity. Additionally, vitamin D and LDH levels significantly increased after treatment, while changes in serum calcium and ALP levels were not significant.
CONCLUSION: Given the multiple factors that reduce bone mineral density in PV patients, the current strategies for glucocorticoid-induced osteoporosis prophylaxis in this group may need re-evaluation, with potential for additional recommendations to be included in pemphigus guidelines.
OBJECTIVES: This study aimed to assess the impact of glucocorticoid therapy on bone mineral density in patients with PV.
METHODS: Patients newly diagnosed with PV were included in this study. Femur and lumbar T-scores, serum calcium, vitamin D, alkaline phosphatase (ALP), and lactate dehydrogenase (LDH) levels were analyzed before and one year after therapy.
RESULTS: Among 66 patients, the average time to diagnosis was 10.14 months, and the average daily dose of prednisone was 16.95 mg, with 63.6% of patients receiving medium doses. Our data showed no significant change in lumbar T-scores after one year of glucocorticoid treatment, but a significant decrease in femur density was observed. The decrease in femur T-scores was significant in the medium-dose group, while the lumbar T-scores decreased significantly in the high-dose group. There was no significant correlation between T-scores and sex, menopausal state, diagnosis time, or obesity. Additionally, vitamin D and LDH levels significantly increased after treatment, while changes in serum calcium and ALP levels were not significant.
CONCLUSION: Given the multiple factors that reduce bone mineral density in PV patients, the current strategies for glucocorticoid-induced osteoporosis prophylaxis in this group may need re-evaluation, with potential for additional recommendations to be included in pemphigus guidelines.