What is the role for bisphosphonates in IBD?

IBD has been associated with an increased risk of osteoporosis and fracture.1 Current guidelines suggest using dual energy x-ray absorptiometry (DXA) to identify IBD patients with osteoporosis as candidates for possible therapy, but focus on IBD patients with established risk factors (ie, postmenopausal women, hypogonadal men or long term (≥3 month) users of glucocorticoids). While the exact role and timing for DXA in IBD is not fully defined, it is even more controversial to consider when therapeutic intervention is indicated. Among the possible choices, bisphosphonates remain the most commonly prescribed pharmacological osteoporosis intervention. While there is little debate when postmenopausal women have osteoporosis-related fractures or osteoporotic bone mineral density (BMD) (ie, T-scores –2.5 or lower),2 3 the use of bisphosphonates when patients with IBD are initiating a limited course of glucocorticoids, when T-scores are not in the osteoporotic range, in men or in premenopausal...
Source: Gut - Category: Gastroenterology Authors: Tags: Commentary Source Type: research