Alexandra Loisel, Anne Li, Karine Briot, Marie-Rose Moro, Chantal Stheneur, Corinne Blanchet
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We excluded reviews, editorials, unfinished trials, expert opinions, book chapters, and case reports. This research followed the PRISMA guidelines.</p><p><strong>Results: </strong>A total of 27 publications were included in this review. The main outcome measured was spinal bone mineral density (BMD). Among 1932 participants (all female), 1439 had AN and the remainder were healthy controls. Monotherapies mostly included various hormonal replacement therapies and bisphosphonates. Combination trials were performed on small numbers or with a modest time range or effect size. Results were statistically significant in 15 studies. Estrogen replacement therapy, bisphosphonates, teriparatide and denosumab showed the most significant effects.</p><p><strong>Conclusions: </strong>These results and our clinical experience in the field allowed us to formulate a treatment algorithm for managing bone loss in patients with anorexia nervosa according to their BMD and pubertal status.</p><p><strong>Level of evidence: </strong>Level I, systematic review.</p>","PeriodicalId":11391,"journal":{"name":"Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity","volume":"30 1","pages":"60"},"PeriodicalIF":2.8000,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12321915/pdf/","citationCount":"0","resultStr":"{\"title\":\"Medication for bone loss in female patients with anorexia nervosa: a systematic review and management algorithm.\",\"authors\":\"Alexandra Loisel, Anne Li, Karine Briot, Marie-Rose Moro, Chantal Stheneur, Corinne Blanchet\",\"doi\":\"10.1007/s40519-025-01758-9\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Anorexia Nervosa can have a major impact on bone health through low bone mass and bone loss. 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引用次数: 0
摘要
目的：神经性厌食症可通过低骨量和骨质流失对骨骼健康产生重大影响。考虑到在这种情况下缺乏预防和治疗骨质流失的共识指南，我们进行了系统的回顾，为临床医生提供实用的治疗指导。方法：系统检索Medline、Cochrane、Psychinfo和Web of Science中2017年3月1日至2024年10月31日的临床研究中的神经性厌食症和（骨质疏松症或骨密度或骨质流失）和（预防或治疗或药物或治疗），并纳入该主题的最后一篇系统综述。我们排除了综述、社论、未完成的试验、专家意见、书籍章节和病例报告。本研究遵循PRISMA指南。结果：本综述共纳入27篇文献。测量的主要结果是脊柱骨密度（BMD）。在1932名参与者（均为女性）中，1439名患有AN，其余为健康对照。单一疗法主要包括各种激素替代疗法和双膦酸盐。组合试验在小数量或适度的时间范围或效应量中进行。15项研究结果有统计学意义。雌激素替代疗法、双膦酸盐、特立帕肽和地诺单抗的效果最为显著。结论：这些结果和我们在该领域的临床经验使我们能够根据骨密度和青春期状态制定神经性厌食症患者骨质流失的治疗算法。证据等级：一级，系统评价。
Medication for bone loss in female patients with anorexia nervosa: a systematic review and management algorithm.
Purpose: Anorexia Nervosa can have a major impact on bone health through low bone mass and bone loss. Considering the lack of consensual guidelines for the prevention and treatment of bone loss in this condition, a systematic review was performed to provide practical treatment guidance for clinicians.
Methods: We systematically searched Medline, Cochrane, Psychinfo, and the Web of Science for anorexia nervosa AND (osteopenia OR osteoporosis OR bone density OR bone loss) AND (prevention OR treatment OR medication OR therapeutic) in clinical studies from March 1st, 2017, to October 31st, 2024, and included the last systematic review on the subject. We excluded reviews, editorials, unfinished trials, expert opinions, book chapters, and case reports. This research followed the PRISMA guidelines.
Results: A total of 27 publications were included in this review. The main outcome measured was spinal bone mineral density (BMD). Among 1932 participants (all female), 1439 had AN and the remainder were healthy controls. Monotherapies mostly included various hormonal replacement therapies and bisphosphonates. Combination trials were performed on small numbers or with a modest time range or effect size. Results were statistically significant in 15 studies. Estrogen replacement therapy, bisphosphonates, teriparatide and denosumab showed the most significant effects.
Conclusions: These results and our clinical experience in the field allowed us to formulate a treatment algorithm for managing bone loss in patients with anorexia nervosa according to their BMD and pubertal status.
期刊介绍：
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity is a scientific journal whose main purpose is to create an international forum devoted to the several sectors of eating disorders and obesity and the significant relations between them. The journal publishes basic research, clinical and theoretical articles on eating disorders and weight-related problems: anorexia nervosa, bulimia nervosa, subthreshold eating disorders, obesity, atypical patterns of eating behaviour and body weight regulation in clinical and non-clinical populations.
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