Exercise effects on glucocorticoid-induced bone loss in adults: a systematic review and meta-analysis

Kast S, Jakob F, Kohl M, von Stengel S, Kerschan-Schindl K, Lange U, Thomasius F, Kemmler W (2022)

Publication Type: Journal article, Review article

Publication year: 2022

Journal

Rheumatology Advances in Practice Oxford University Press

Book Volume: 7

Journal Issue: 1

DOI: 10.1093/rap/rkad019

Abstract

Objectives Due to their pronounced anti-inflammatory and immunosuppressive effects, glucocorticoids (GCs) are widely used in inflammatory conditions and organ transplants. Unfortunately, GC-induced osteoporosis is one of the most common causes of secondary osteoporosis. The aim of the present systematic review and meta-analysis was to determine the effect of exercise added to GC therapy on BMD at the lumbar spine or femoral neck in people on GC therapy. Methods A systematic literature search of five electronic databases included controlled trials with a duration of >6 months and at least two study arms [glucocorticoids (GCs) and GCs and exercise (GC + EX)] were conducted up to 20 September 2022. Studies involving other pharmaceutical therapies with relevant effects on bone metabolism were excluded. We applied the inverse heterogeneity model. Outcome measures were standardized mean differences (SMDs) with 95% CIs for BMD changes at the lumbar spine (LS) and femoral neck (FN). Results We identified three eligible trials with a total of 62 participants. In summary, the GC + EX intervention indicated statistically significantly higher SMDs for LS-BMD [SMD 1.50 (95% CI 0.23, 2.77)] but not for FN-BMD [0.64 (95% CI -0.89, 2.17)] compared with GC treatment alone. We observed substantial heterogeneity (LS-BMD I-2 = 71%, FN-BMD I-2 = 78%) between the study results. Conclusion Although more well-designed exercise studies are needed to address the issue of exercise effects on GC-induced osteoporosis (GIOP) in more detail, upcoming guidelines should pay more attention to the aspect of exercise for bone strengthening in GIOP. Registration number PROSPERO: CRD42022308155

Authors with CRIS profile

Stephanie Kast Institute of Radiology Simon von Stengel Institute of Radiology Wolfgang Kemmler Lehrstuhl für Medizinische Physik und Mikrogewebetechnik

Involved external institutions

Medizinische Universität Wien AT Austria (AT) Justus-Liebig-Universität Gießen DE Germany (DE) Frankfurter Hormon und Osteoporosezentrum DE Germany (DE) Julius-Maximilians-Universität Würzburg DE Germany (DE) Hochschule Furtwangen DE Germany (DE)

How to cite

APA:

Kast, S., Jakob, F., Kohl, M., von Stengel, S., Kerschan-Schindl, K., Lange, U.,... Kemmler, W. (2022). Exercise effects on glucocorticoid-induced bone loss in adults: a systematic review and meta-analysis. Rheumatology Advances in Practice, 7(1). https://doi.org/10.1093/rap/rkad019

MLA:

Kast, Stephanie, et al. "Exercise effects on glucocorticoid-induced bone loss in adults: a systematic review and meta-analysis." Rheumatology Advances in Practice 7.1 (2022).

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