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General Updates | Advice for physicians managing bone disease in patients with thalassemia
In this video, Julian Waung, BM, PhD, Whittington Hospital, London, UK, provides practical advice to physicians managing bone disease in patients with thalassemia, highlighting tools and questions used to assess the risk of fracture. This interview took place virtually.
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Transcript
I would start by inquiring about conventional risk factors, and I think to make it easy you could use the FRAX, which is a fracture risk calculator tool, to guide your questions. So those have questions like: are you using steroids? Do you have rheumatoid arthritis? Do you smoke? What’s your alcohol intake? So I think if you go through that list, that’s quite helpful...
I would start by inquiring about conventional risk factors, and I think to make it easy you could use the FRAX, which is a fracture risk calculator tool, to guide your questions. So those have questions like: are you using steroids? Do you have rheumatoid arthritis? Do you smoke? What’s your alcohol intake? So I think if you go through that list, that’s quite helpful.
And then, in terms of disease-specific ones, it’s important to remember that radiotherapy, which can be used for extramedullary hematopoiesis, would be a contraindication to parathyroid hormone analogs. And I think inquiring about whether there have been fractures and how recent they’ve been, because a fracture within the last 24 months is a major risk factor for another fracture, and also, in the UK, in England, would qualify the patient for access to some anabolic treatments.
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