The Effect of Bisphosphonate with Testosterone on Bone Mineral Density in Male Patients with Thalassemia Major

Aims: Thalassemia major patients are at a heightened risk for osteopenia and osteoporosis, influenced by factors including hypogonadism. However, treatment with steroids alone has not consistently yielded substantial improvements in bone density indicators. This study aimed to evaluate the impact of bisphosphonate therapy, both with and without testosterone, on bone density indices in male patients with thalassemia major. Materials & Methods: This quasi-experimental study included 40 male patients with thalassemia major, selected through convenience sampling, and divided into four groups: 1) a hypogonadism group receiving testosterone and alendronate (HTA group), 2) a hypogonadism group receiving testosterone alone (HT group), 3) a non-hypogonadism group treated with alendronate (NHA group), and 4) a hypogonadism group that declined any treatment (H group). Bone density was evaluated using Bone Mineral Densitometry via Dual-energy X-ray absorptiometry, both before and one year after the interventions, with results compared across the groups. Data analysis was conducted using SPSS version 24, with a significance level set at p<0.05. Findings: Thirty-eight participants, with a mean age of 22.46 ± 4.64 years, completed the study. Post-intervention results showed significant improvements in Lumbar Z score (p=0.001), Hip Z score (p=0.001), and Radius Z score (p=0.005) across the four groups. One year after intervention, the HTA group demonstrated greater improvements in bone mineral density compared to the NHA and HT groups. Conclusion: Combining bisphosphonates with testosterone in thalassemia patients with hypogonadism enhances bone density more effectively than treatment with testosterone or bisphosphonates alone.

The Effect of Bisphosphonate with Testosterone on Bone Mineral Density in Male Patients with Thalassemia Major Keywords:

Bisphosphonate , Testosterone , Bone Mineral Density , Thalassemia