Osteoporosis in Scleroderma

Author: Shelley Ensz. Scleroderma is highly variable. See Types of Scleroderma. Read Disclaimer
Bone Density
Osteoporosis and Scleroderma
Media Stories
Patient Stories


Osteoporosis is when the bone density is low causing the bones to become porous and prone to fractures. In scleroderma, bone density can decrease due to certain medications, a decrease in exercise, change in diet and factors of the disease itself. It is important to discuss this with your doctor, especially if you have a history of osteoporosis in your family. ISN.

Osteoporosis occurs when the rate of bone resorption exceeds the rate of bone formation creating "porous bones." Most cases of osteoporosis occur as an acceleration of this normal aging process. The condition can also be caused by other disease processes or prolonged use of certain medications that result in bone loss. (Also see Bone Resorption)

Current status of the influence of osteoporosis on periodontology and implant dentistry. The impact of osteoporosis on the periodontal and peri–implant tissues was reviewed to emphasize the importance of oral hygiene measures, and the combined medical/dental assessment when osteoporotic patients are in need of dentoalveolar surgical procedures. PubMed, Curr Opin Endocrinol Diabetes Obes, 2016 Dec;23(6):435-439. (Also see Dental Implants)

The incidence and risk of osteoporosis in patients with anxiety disorder (AD): A Population–based retrospective cohort study. The risk ratios are the highest for osteoporosis within 1 year of AD diagnosis, but the risk remains statistically significant for »1 year and clinicians should pay particular attention to osteoporotic comorbidities in AD patients. PubMed, Medicine (Baltimore), 2016 Sep;95(38):e4912. (Also see Anxiety and Attitude)

Significant bone microarchitecture impairment in premenopausal women with active celiac disease (CD). Patients with symptomatic CD had a greater bone microarchitectural deficit than those with subclinical CD. Bone, 03/14/2015. (Also see Celiac Disease)

Bone Density

Bone Density or Bone Mineral Density (BMD) is a measurement of the compactness of the bone or the amount of bone mass per square centimeter. Bone density measurements are used to diagnosis osteopenia, osteoporosis and fracture risk. ISN.

Hormone therapy and osteoporosis in breast cancer survivors: assessment of risk and adherence to screening recommendations. The natural, age–related reduction in bone density is exacerbated by breast cancer active aromatase inhibitors treatment. PubMed, Osteoporos Int, 11/09/2018. (Also see Cancer)

When to Get Your Bone Density Tested. Updated guidelines can help women decide when to have bone density screening but may discourage men. New York Times, 07/16/2018.

Anxiety tied to fracture risk in postmenopausal women. Older women with higher levels of anxiety than their peers are also more likely to develop poor bone health that increases the risk of fractures, a small study suggests. Reuters Health, 06/13/2018. (Also see Anxiety and Attitude)

Combination therapy of anabolic agents and bisphosphonates on bone mineral density (BMD) in patients with osteoporosis: a meta–analysis of randomised controlled trials. Compared with anabolic monotherapy, the concomitant combination therapy of anabolic agents and bisphosphonates significantly improved the BMD at the total hip and femoral neck. PubMed, BMJ Open, 2018 Mar 1;8(3):e015187.

Incidence and predictors of osteoporotic fractures in patients with Barrett's oesophagus (BO): a population–based nested case–control study. The incidence of osteoporotic fractures was not increased in BO patients compared to the general population and proton pump inhibitors use was not associated with increased fracture risk. PubMed, Aliment Pharmacol Ther, 10/05/2017. (Also see Esophageal (Throat) Involvement)

Bone mineral density (BMD) is decreased in fibromyalgia syndrome (FMS): a systematic review and meta–analysis. In this meta–analysis, we observe that BMD at lumbar spine is decreased in FMS compared with normal individuals. PubMed, Rheumatol Int, 12/05/2016. (Also see Fibromyalgia)

Proton pump inhibitors use and change in bone mineral density. The results of this study showed that PPI use in subjects without risk factors of osteoporosis determined by the femoral T–score compared with the control group was associated with increased risk of developing osteoporosis and osteopenia in the femur bones. Wiley Online Library, 05/31/2016.

Impact of treatment with inhaled corticosteroids (ICS) on bone mineral density (BMD) of patients with asthma: related with age. This study indicates that BMD reduction in ICS users with asthma is dependent on age and appears that younger patients are at greater risk of BMD loss. PubMed, Osteoporos Int, 04/10/2015. (Also see Asthma Treatments)

Osteoporosis and Scleroderma

Trabecular Bone Score (TBS) Reflects Trabecular Microarchitecture Deterioration and Fragility Fracture in Female Adult Patients Receiving Glucocorticoid Therapy: A Pre–Post Controlled Study. These findings suggested that TBS and fracture risk assessment tool adjusted with TBS (T-FRAX) could be used as an adjunct in the evaluation of risk of fragility fractures in patients receiving glucocorticoid therapy. PubMed, Biomed Res Int, 2017;2017:4210217. (Also see Osteoporosis and Glucocorticoids, Steroids (Prednisone)

Bone mineral density (BMD) in patients with scleroderma systematica Low BMI, diffuse scleroderma, disease duration and glucocorticosteroids use are risk factors for reduced BMD and osteoporosis. PubMed,Ter Arkh, 2016;88(5):37-42. (Also see Steroid Warnings for Scleroderma)

Treatments for Osteoporosis

Osteoporosis Treatments and Care. Osteoporosis treatments come in several forms. Many should be started during childhood; others include prescription drugs to treat osteoporosis. Get an overview. WebMD.

Trends and Determinants of Osteoporosis (OP) Treatment and Screening in Patients with Rheumatoid Arthritis (RA) Compared to Osteoarthritis (OA). OP care in RA patients was not better than OA patients, and the relative risk of application of this care has been decreasing in RA and OA patients. PubMed, Arthritis Care Res (Hoboken), 08/03/2017. (Also see Symptoms and Complications of Rheumatoid Arthritis)

Eighteen Months of Treatment With Subcutaneous Abaloparatide (ABL-SC) Followed by 6 Months of Treatment With Alendronate in Postmenopausal Women With Osteoporosis. Use of ABL-SC for 18 months followed by ALN for 6 months improved bone mineral density and reduced fracture risk throughout the skeleton and may be an effective treatment option for postmenopausal women with osteoporosis. PubMed, Mayo Clin Proc, 2017 Feb;92(2):200-210.

Treatment needs and current options for postmenopausal osteoporosis. The more recent advances in bone biology identified new targets for the development of drugs with a more potent and selective activity on either osteoclasts or osteoblasts. PubMed, Expert Opin Pharmacother, 04/07/2016.

Current approaches to osteoporosis treatment. Substantial progress has been made in the past several years in the understanding and modification of osteoporosis management. PubMed, Curr Opin Rheumatol. 2015 May;27(3):216-24.

Media Stories

Osteoporosis drugs may make bones weaker. Drugs used to treat weak bones in elderly patients suffering from osteoporosis may actually make them weaker, research suggests. BBC News, 03/01/2017.

Patient Stories

Edith: MCTD with En Coup de Sabre/Parry Romberg's, Lichen Sclerosus, Rheumatoid Arthritis, Sjogren's My GP is fabulous, but at the end of the day it is not enough. I would be lost without people like you…

Susie: CREST Syndrome I have had CREST syndrome for the past eight years. My specialist is Dr. Frederick Wigley, from Johns Hopkins…

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