Patients with Duchenne muscular dystrophy (DMD) appear to have a higher incidence of fractures than the general population, which highlights the need for further osteoporosis mentoring, according to a recently published study in Muscle and Nerve.
“With the increased utilization of corticosteroids and advancements in coordinated multi-disciplinary care, there is a growing population of adults with DMD, warranting a focus on extra-skeletal health outcomes in addition to skeletal outcomes,” the authors wrote.
To deepen their understanding of the clinical characteristics of fractures in patients with DMD and evaluate the bone health monitoring measures in the United Kingdom (UK), the authors performed an extensive review of all adults who received DMD care in Scotland between the years 2013 and 2022. All of the patients included in the study had a genetically confirmed diagnosis and attended at least two follow-up visits.
The study included data from 36 patients, of which 14% experienced fractures during the study period. With the exception of a fracture during an automobile accident, all of them occurred after minor trauma.
Although all patients took corticosteroids at the fracture’s time, only three took vitamin D to prevent osteoporosis. Furthermore, less than half of the patients in the study underwent bone density assessment during the study period.
Learn more about DMD causes and risk factors
Currently, corticosteroids are the only treatment proven to slow down the decrease in muscular and cardiac function in patients with DMD. Guidelines recommend the daily use of corticosteroids like prednisone to improve cardiac and respiratory function and to prevent scoliosis.
Despite their benefits, corticosteroids have adverse effects that should be monitored closely. Common adverse effects include osteopenia and osteoporosis, weight gain, mood disturbances, immunosuppression and high blood glucose.
“Considering the multifaceted health challenges faced by men with DMD, there is a clear need for enhanced and nuanced clinical guidance regarding the monitoring and management of bone health during transitions and throughout adulthood,” the authors concluded.
