Clinical Practice Patterns in Bone Health Assessment and Management in Endogenous Cushing's Syndrome
Authors' conclusion
Our data demonstrate that skeletal impairment and fragility fractures are highly prevalent in endogenous CS, and fracture risk may persist despite remission. However, currently, bone health is inadequately assessed and managed. These findings identify an urgent need for improved awareness, assessment, and management of bone-health in this high-risk population and call for specific evidence-based practice guidelines.
Study context
- Population
- Patients with confirmed endogenous Cushing's Syndrome (CS) treated at a tertiary endocrine centre
- Participants
- 79 patients
- Outcome
- Frequency of bone health assessment (vitamin D measurement) and bone health management (calcium and/or vitamin D optimisation and/or initiation of bone-protective agents)
Methodological detailssingle tertiary endocrine centre
- Single tertiary endocrine centre
Main finding
As reported in the abstract
Vitamin D measured
43%
34/79
Bone health managed
39.2%
31/79
Observational data: associations, not effects.
Further findings
Bone mineral density (BMD) during active CS
- BMD assessed
- 44.3% (35/79)
- Osteoporosis among those assessed
- 22.9%
BMD after CS remission · within a year of CS remission
- Improved BMD observed within a year of CS remission
Fractures · within 2 years of CS diagnosis
- Fractures within 2 years of CS diagnosis
- 17.7% (14/79)
- Additional fractures during follow-up despite CS remission
- 12
Lumbar spine BMD with bone-protective agents
- Bone-protective agents expedited recovery with significant increase in lumbar spine BMD vs those not treated
Original publication
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