THE USE OF ANABOLIC THERAPY IN PATIENTS WITH BETATHALASSEMIA MAJOR-INDUCED OSTEOPOROSIS – REVIEW OF
THE LITERATURE
LUMINIȚA-NICOLETA CIMA¹*, SIMONA FICA¹,²
¹“Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
²Department of Endocrinology, Diabetes and Metabolic Disorders, Elias Hospital, Bucharest, Romania
*corresponding author: luminitasapera82@yahoo.com, luminita.cima@gmail.com
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Abstract:
Osteopenia/osteoporosis (OP) in young adults with beta thalassemia major (BTM) is a prominent cause of morbidity despite
adequate transfusion and iron chelation therapy; the reported frequency of OP varies from 13.6% to 50%, with an additional
45% affected by osteopenia. The pathogenesis of OP in BTM is multifactorial and is related to chronic anaemia with
secondary bone marrow expansion, associated endocrinopathies, nutritional deficiencies and genetic factors. These factors
lead to OP/osteoporosis by increasing osteoclast activity and impairing osteoblast function. OP is a prominent cause of
morbidity in BTM because of the increased risk for vertebral and long bone fractures. Although the bisphosphonates are the
most used treatment for osteoporosis in BTM, in some cases there is a poor clinical response with new fractures occurring
during treatment; therefore, at least in these patients, we suggest that decreased bone formation is the predominant
mechanism of BTM-induced-OP and anabolic treatment could be the most appropriate therapy.

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