2023-11-13 バッファロー大学(UB)
UB researchers looked at the bone density of 62 children between the ages of 6 and 18 who were taking these drugs and who had a distal fracture, and compared them to 126 matched controls who had had such fractures but weren’t taking these drugs.
◆先行の動物実験では、これらの薬がラットの骨の強度と密度を低下させることが示され、これが子供にも当てはまるかどうかを検証する必要性が浮上した。研究者らは、10年間の小児患者のデータを調査し、これらの薬を服用する子供と服用しない子供の骨密度を比較。結果として、これらの薬を服用した患者は、特に橈骨の骨折の治癒において約20%遅れが見られ、治療期間が長いほど骨密度が低下することが示唆された。
◆研究者は、手術を計画する際に患者の薬物使用に注意を払い、治癒に追加の時間が必要かもしれないことを考慮すべきだと述べています。
<関連情報>
- https://www.buffalo.edu/news/releases/2023/11/ADHD-drugs-delay-kids-bone-healing.html
- https://journals.lww.com/jpo-b/abstract/9900/psychostimulants_prescribed_to_children_for_adhd.151.aspx
橈骨遠位端骨折後にADHDのために小児に処方された精神刺激薬は、投与期間の関数として骨密度を有意に減少させる Psychostimulants prescribed to children for ADHD following distal radius fractures significantly reduce bone density as a function of duration
Ortiz, Layla M.; O’Malley, Natasha; Blum, Kenneth; Hadjiargyrou, Michael; Komatsu, David E.; Thanos, Panayotis K.
Journal of Pediatric Orthopaedics B Published:September 22, 2023
DOI: 10.1097/BPB.0000000000001125
Abstract
Methylphenidate and mixed amphetamine salts (MAS) are psychostimulant medications widely prescribed for various psychiatric disorders. Although these medications are known to adversely impact bone mineral content and density, as well as biomechanical integrity during skeletal development in rats, their effect on bone density in children remains largely unknown. The primary aim of this work was to investigate the effects of methylphenidate and MAS on bone density following distal radius fractures in pediatric populations, and secondarily assess any impact on healing. The retrospective case-control study was designed to assess fracture healing in patients treated with stimulant drugs and matched controls. For the primary outcome, X-rays (n = 188) were evaluated using an optical density image analysis technique to compare bone density throughout the bone healing process. Results showed that methylphenidate and MAS significantly reduced bone healing by approximately 20% following distal radius fractures in these children. The data also suggested that duration of psychostimulant use played a role in bone healing; the longer the treatment (1–5 years), the lower the bone density was observed (by approximately 52%) as compared to controls (no medication). However, subjects taking these drugs for longer than 5 years did not show a significant difference. Our results suggested that children taking psychostimulants for up to 5 years had slower bone healing following distal radius fractures. Orthopedic surgeons planning elective surgeries should be cognizant of this as a potential issue in recovery after any elective bone procedures and preoperatively optimize bone health as well as counsel patients and their families.
