Pharmacological Management of Bone Loss in Patients with Spondylodiscitis: A Systematic Review
Abstract
Introduction: Lytic bone defects are a common and devastating consequence of spondylodiscitis, often leading to vertebral collapse and spinal instability. Currently, there are no established guidelines for pharmacological management of this condition in conjunction with antibiotic therapy. Objective: To review the existing scientific evidence on the pharmacological treatment of bone loss secondary to spondylodiscitis. Materials and Methods: A systematic search was conducted in major medical databases to identify studies evaluating the use of teriparatide, romosozumab, or denosumab in patients with lytic bone defects associated with pyogenic spondylodiscitis or Pott’s disease. Results: Two studies reported improved bone mineral density and enhanced osteoblastic activity following the use of teriparatide in patients with bone loss or osteoporosis associated with vertebral infection. Adverse reactions were minimal, and no interactions with antibiotic therapy were observed. In one of the studies, treatment was supplemented with romosozumab. A third study demonstrated improved outcomes in infected osteoblasts. Conversely, the use of bisphosphonates and denosumab was associated with poor outcomes and worsening of the infection. Conclusions: Anabolic agents such as teriparatide and romosozumab appear to be promising options for managing bone loss and severe osteoporosis in the context of vertebral infections, with a favorable safety profile. However, clinical trials are needed to confirm their efficacy.Downloads
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