Pulmonology · Endocrinology · 2 h ago
Adults with cystic fibrosis show ongoing bone mineral density loss
A systematic review and meta-analysis of 12 studies involving 811 adults with cystic fibrosis found declining bone mineral density at the lumbar spine and femoral neck. The included studies predated widespread use of CFTR modulators, limiting their relevance to current treatment-era trends.
- Meta-analysis included 811 adults across 12 studies.
- Femoral-neck BMD declined by 0.90% annually.
- Lumbar-spine BMD declined by 0.28% annually.
- All included studies predated widespread CFTR modulator use.
Cystic fibrosis-related bone disease is an increasing concern as survival improves, but longitudinal bone loss in adults with cystic fibrosis has been incompletely characterized. Researchers reviewed observational studies and randomized-trial control arms reporting at least two DXA scans, at least one year apart, in adults not receiving osteoporosis treatment. The review included 12 studies (811 participants; mean age 21–31 years; mean follow-up 24 months); 10 contributed to the meta-analysis.
Pooled annual bone mineral density change was −0.28% at the lumbar spine (95% CI, −0.56 to −0.01) and −0.90% at the femoral neck (95% CI, −1.29 to −0.52). Heterogeneity was low to moderate. The authors report that femoral-neck loss exceeded what would be expected for age.
The findings indicate progressive bone loss in the studied population and support attention to bone health in adults with cystic fibrosis. However, all included studies predated widespread CFTR modulator use, and confounding and incomplete follow-up were common. The analysis does not establish how contemporary treatments affect bone density, fracture risk, or the optimal monitoring approach.
In practice
In adults with cystic fibrosis represented in these studies, bone mineral density declined over time, particularly at the femoral neck. The results support attention to bone health, but they do not define a specific monitoring schedule or establish effects on fractures. Because all included studies predated widespread CFTR modulator use, the reported rates may not reflect current patients receiving contemporary treatment; confounding and incomplete follow-up also limit interpretation. The findings do not establish that clinical practice should change.
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Osteoporosis International: Longitudinal changes in bone mineral density among adults with cystic fibrosis: a systematic review and meta-analysis ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.