Frontiers in Endocrinology · 4 authors, 4 centres
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This narrative review synthesizes expert knowledge on managing the transition from pediatric to adult care for young adults with metabolic bone disorders. It highlights the need for intentional, multidisciplinary transition planning to address specific challenges like medication access, surveillance, and specialist continuity.
This narrative review synthesizes existing research and clinical guidelines for the transition of young adults with metabolic bone diseases (including primary disorders like hypophosphatasia, X-linked hypophosphatemic rickets, and osteogenesis imperfecta) from pediatric to adult care. The authors discuss key transition considerations such as final adult height, fertility, heritability, and access to specialists. They note that while robust transition programs exist for other chronic conditions, gaps remain for metabolic bone disorders. The review emphasizes the complexity of longitudinal care, including challenges in interpreting dual-energy X-ray absorptiometry (DXA) results across different scanners and skeletal sites, managing disease-specific medications, and ensuring insurance coverage. Limitations include the reliance on historical data that may not reflect current treatment advances and the lack of formal guidelines synthesizing outcomes into actionable recommendations. The implications support the development of dedicated transition infrastructure and evidence-based clinical practices.
