Stress fractures in systemic lupus erythematosus after long-term MTX use successfully treated by MTX discontinuation and individualized bone-specific therapy

T Rolvien; A M Creutzfeldt; A W Lohse; M Amling

doi:10.1177/0961203319841434

Stress fractures in systemic lupus erythematosus after long-term MTX use successfully treated by MTX discontinuation and individualized bone-specific therapy

Standard

Stress fractures in systemic lupus erythematosus after long-term MTX use successfully treated by MTX discontinuation and individualized bone-specific therapy. / Rolvien, T ; Creutzfeldt, A M ; Lohse, A W ; Amling, M.

In: LUPUS, Vol. 28, No. 6, 05.2019, p. 790-793.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Rolvien, T , Creutzfeldt, AM , Lohse, AW & Amling, M 2019, 'Stress fractures in systemic lupus erythematosus after long-term MTX use successfully treated by MTX discontinuation and individualized bone-specific therapy', LUPUS, vol. 28, no. 6, pp. 790-793. https://doi.org/10.1177/0961203319841434

APA

Rolvien, T., Creutzfeldt, A. M., Lohse, A. W., & Amling, M. (2019). Stress fractures in systemic lupus erythematosus after long-term MTX use successfully treated by MTX discontinuation and individualized bone-specific therapy. LUPUS, 28(6), 790-793. https://doi.org/10.1177/0961203319841434

Vancouver

Rolvien T , Creutzfeldt AM , Lohse AW , Amling M. Stress fractures in systemic lupus erythematosus after long-term MTX use successfully treated by MTX discontinuation and individualized bone-specific therapy. LUPUS. 2019 May;28(6):790-793. https://doi.org/10.1177/0961203319841434

Bibtex

@article{dd20fffe503c414fa8e6ece296ea7039,

title = "Stress fractures in systemic lupus erythematosus after long-term MTX use successfully treated by MTX discontinuation and individualized bone-specific therapy",

abstract = "We report the case of a 64-year-old woman with systemic lupus erythematosus (SLE) and recurrent bilateral stress fractures of the calcaneus due to long-term methotrexate (MTX) use. A detailed skeletal assessment pointed to osteoporomalacia with pronounced trabecular thinning and increased bone resorption. After years of unsuccessful treatment with bisphosphonates, a combined bone-specific denosumab-teriparatide treatment was initiated, and additional belimumab treatment was started to avoid intermittent steroid usage. As these measures did not lead to a significant improvement of the bone situation, MTX was eventually discontinued. This was followed by a rapid clinical improvement. In a follow-up MRI scan after 18 months, the stress fractures had almost disappeared. Furthermore, the bone density and microarchitecture markedly improved. In conclusion, this case demonstrates that MTX discontinuation/replacement in combination with an individualized and state-of-the-art bone-specific therapy is effective in SLE patients with stress fractures after long-term MTX use.",

keywords = "Journal Article",

author = "T Rolvien and Creutzfeldt, {A M} and Lohse, {A W} and M Amling",

year = "2019",

month = may,

doi = "10.1177/0961203319841434",

language = "English",

volume = "28",

pages = "790--793",

journal = "LUPUS",

issn = "0961-2033",

publisher = "SAGE Publications",

number = "6",

}

RIS

TY - JOUR

T1 - Stress fractures in systemic lupus erythematosus after long-term MTX use successfully treated by MTX discontinuation and individualized bone-specific therapy

AU - Rolvien, T

AU - Creutzfeldt, A M

AU - Lohse, A W

AU - Amling, M

PY - 2019/5

Y1 - 2019/5

N2 - We report the case of a 64-year-old woman with systemic lupus erythematosus (SLE) and recurrent bilateral stress fractures of the calcaneus due to long-term methotrexate (MTX) use. A detailed skeletal assessment pointed to osteoporomalacia with pronounced trabecular thinning and increased bone resorption. After years of unsuccessful treatment with bisphosphonates, a combined bone-specific denosumab-teriparatide treatment was initiated, and additional belimumab treatment was started to avoid intermittent steroid usage. As these measures did not lead to a significant improvement of the bone situation, MTX was eventually discontinued. This was followed by a rapid clinical improvement. In a follow-up MRI scan after 18 months, the stress fractures had almost disappeared. Furthermore, the bone density and microarchitecture markedly improved. In conclusion, this case demonstrates that MTX discontinuation/replacement in combination with an individualized and state-of-the-art bone-specific therapy is effective in SLE patients with stress fractures after long-term MTX use.

AB - We report the case of a 64-year-old woman with systemic lupus erythematosus (SLE) and recurrent bilateral stress fractures of the calcaneus due to long-term methotrexate (MTX) use. A detailed skeletal assessment pointed to osteoporomalacia with pronounced trabecular thinning and increased bone resorption. After years of unsuccessful treatment with bisphosphonates, a combined bone-specific denosumab-teriparatide treatment was initiated, and additional belimumab treatment was started to avoid intermittent steroid usage. As these measures did not lead to a significant improvement of the bone situation, MTX was eventually discontinued. This was followed by a rapid clinical improvement. In a follow-up MRI scan after 18 months, the stress fractures had almost disappeared. Furthermore, the bone density and microarchitecture markedly improved. In conclusion, this case demonstrates that MTX discontinuation/replacement in combination with an individualized and state-of-the-art bone-specific therapy is effective in SLE patients with stress fractures after long-term MTX use.

KW - Journal Article

U2 - 10.1177/0961203319841434

DO - 10.1177/0961203319841434

M3 - SCORING: Journal article

C2 - 30947618

VL - 28

SP - 790

EP - 793

JO - LUPUS

JF - LUPUS

SN - 0961-2033

IS - 6

ER -