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Novel approaches to bone comorbidity in Cushing’s disease: an update

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Abstract

Skeletal complications are frequent and clinically relevant findings in Cushing’s disease (CD) since an uncoupled suppressed bone formation and enhanced bone resorption leads to a marked skeletal damage with a rapid increase of fracture risk. Reduced Bone Mineral Density (BMD) has been consistently reported and osteopenia or osteoporosis are typical findings in patients with CD. Vertebral Fractures (VFs) are frequently reported and may occur even in patients with an only mild reduction of BMD, representing nowadays a still under- or misdiagnosed comorbidity of these patients being frequently asymptomatic. A novel approach combining different available tools such as BMD evaluation and vertebral morphometry, in order to improve diagnosis, management, and follow-up of bone comorbidity in all patients affected by CD, is needed. This approach is foreseen to be a crucial part of management of patients with CD, particularly in Pituitary Tumor Center of Excellence since VFs, the landmark of the bone involvement, may occur early in the history of the disease and may represent a relevant risk factor for further fractures, reduced quality of life and survival and need for pharmacologic prevention and treatment.

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Authors and Affiliations

  1. Institute of Endocrine and Metabolic Sciences, Università Vita-Salute San Raffaele and IRCCS Ospedale San Raffaele, Via Olgettina, 58, 20132, Milan, Italy

    Stefano Frara, Luigi di Filippo, Mauro Doga, Paola Loli & Andrea Giustina

  2. Division of Endocrinology, Department of Medicine, Santiago de Compostela University (USC), Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain

    Felipe F. Casanueva

Authors
  1. Stefano Frara
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  2. Luigi di Filippo
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  3. Mauro Doga
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  4. Paola Loli
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  5. Felipe F. Casanueva
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  6. Andrea Giustina
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All authors (SF, LdF, MD, PL, FFC, and AG) contributed equally.

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Correspondence to Andrea Giustina.

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Author Andrea Giustina is consultant to company Abiogen SpA, Recordati SpA and Takeda Pharmaceutical Co; Author Andrea Giustina is grant recipient from Pfizer and Takeda Pharmaceutical Co.

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Frara, S., di Filippo, L., Doga, M. et al. Novel approaches to bone comorbidity in Cushing’s disease: an update. Pituitary 25, 754–759 (2022). https://doi.org/10.1007/s11102-022-01252-w

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