A recent review in the journal Cells suggests that bone disease in systemic mastocytosis (SM) should be managed proactively, with increased emphasis on monitoring bone health and personalized care that aims to control the disease.
In SM, immune cells called mast cells release substances that disturb the normal balance of bone health. They slow down the cells that build bone and increase the cells that break down bone. This can lead to weaker bone in some areas of the skeleton (a condition called osteoporosis) and bone that becomes unusually hard in other areas (osteosclerosis). Both cause pain and lead to bone fractures.
The review highlights the potential of KIT-targeting tyrosine kinase inhibitors to reverse osteoporosis and osteosclerosis by reducing the number of mast cells and restoring a healthy balance between cells that build bone and cells that break down bone.
The review also discusses other treatment options. These include bisphosphonates and denosumab, which help slow bone breakdown; interferon-alpha, which can help control mast cells; and newer medicines like romosozumab, which can help build bone. Each therapy works in a different way to protect bone health.
Read more about SM treatment and care
According to the authors of the review, treatment should involve a combination of bone-protecting medicines, SM-targeting therapies and data-guided, personalized care. “Ultimately, only a truly integrated approach […] will allow SM-related bone disease to be managed proactively, leading to a marked improvement in patients’ quality of life,” the review’s authors said.
The review’s authors stress the need for a thorough evaluation of bone health in people with SM. This may involve blood tests, DXA scans to measure bone density and advanced imaging like MRI or CT scans. They also note that machine learning tools may help doctors better predict fracture risk and tailor treatments to each patient.
Despite recent progress, challenges remain. The question of when anti-osteoporotic therapy should be initiated remains unresolved. There is also a lack of evidence to guide treatment decisions in SM-related bone disease.
Sign up here to get the latest news, perspectives, and information about SM sent directly to your inbox. Registration is free and only takes a minute.
