The effect of bisphosphonate with and without testosterone on bone mineral density in male patients with Beta-Thalassemia major

Aims:  We aimed to evaluate the effect of treatment with testosterone with and without bisphosphonates on bone density in patients with thalassemia major. Methods: This Quasi-experimental study was performed on patients with thalassemia major. Four groups were included in the study ۱: patients with hypogonadism who were treated with testosterone and alendronate (HTA group, n=۱۱), ۲: patients with hypogonadism who were treated with testosterone (HT group, n=۱۲), ۳: patients with hypogonadism who did not receive any treatment (H group, n=۵), and ۴: patients without hypogonadism who were treated with alendronate (NHA group, n=۱۰). The status of bone density was assessed before and after interventions and compared across the study groups. Findings: A total of ۳۸ subjects with mean age of ۲۲.۴۶ ± ۴.۶۴ years were investigated.The mean difference of Z score of the lumbar region before and after the intervention in the four groups was -۱.۶۵±۰.۶۵, -۲۶±۰.۴۸, ۰.۰۰±۰.۰۰ and -۰.۳۲±۰.۲۱ respectively, that there was a significant difference between the four groups (P < ۰.۰۰۱). The mean difference of Z score of the hip region before and after the intervention in the four groups were -۱.۳۵±۰.۵۸, -۵۷±۰.۳۷, ۰.۰۰±۰.۰۰ and -۰.۳۲±۰.۲۱ respectively, that there was a significant difference between the four groups (P < ۰.۰۰۱). Conclusion: Adding bisphosphonates to testosterone in thalassemia patients with hypogonadism will improve bone density as well as reduce pain intensity in these patients. Also, administration of bisphosphonates in thalassemia patients without hypogonadism can be very effective in improving bone density and bone pain in these patients.

Keywords:

Beta-Thalassemia , testosterone , Bone Density , pediatrics