Drug-induced disorders of the musculoskeletal system
https://doi.org/10.37489/2588-0519-GCP-0004
EDN: FOMLTQ
Abstract
Drug-induced disorders of the musculoskeletal system represent a significant category of adverse drug reactions (ADRs). This review systematizes the main types of iatrogenic damage to bones, muscles, and joints, classified as osteopathies, myopathies, and arthropathies. Risk groups include children, the elderly, and postmenopausal women, with polypharmacy being a significant contributing factor. The article examines antenatal drug-induced embryopathies (e. g., associated with thalidomide, vitamin A, anticonvulsants, warfarin) and postnatal lesions. Key postnatal disorders discussed are statin-induced myopathy, glucocorticoid-induced myopathy and osteoporosis, musculoskeletal complications of immune checkpoint inhibitors, colchicine and propofol toxicity. Drug-induced osteopathies, particularly secondary osteoporosis from glucocorticoids, anticonvulsants, and other long-term medications, are analyzed. The review also covers drug-induced arthropathies, such as drug-induced lupus and fluoroquinolone-associated tendinopathy and arthropathy. The mechanisms underlying these ADRs, including dose-dependency, metabolic pathways, and immune-mediated processes, are considered. The conclusion emphasizes the importance of clinician awareness of the potential for musculoskeletal toxicity when prescribing these medications to enable timely diagnosis, management, and prevention.
About the Authors
S. S. Postnikov
N. I. Pirogov Russian National Research Medical University
Russian Federation
Competing Interests:
Russian Federation
Sergey S. Postnikov — Dr. Sci. (Med.), Professor, Department of Clinical Pharmacology named after Yu. B. Belousov, Institute of Clinical Medicine
Moscow
Competing Interests:
The authors declare no conflict of interest.
N. V. Teplova
N. I. Pirogov Russian National Research Medical University
Russian Federation
Competing Interests:
Russian Federation
Natalia V. Teplova — Dr. Sci. (Med.), Professor, Head of the Department of Clinical Pharmacology named after Yu. B. Belousov
Moscow
Competing Interests:
The authors declare no conflict of interest.
A. N. Gratsianskaya
N. I. Pirogov Russian National Research Medical University
Russian Federation
Competing Interests:
Russian Federation
Anna N. Gratsianskaya — Cand. Sci. (Med.), Associate Professor, Department of Clinical Pharmacology named after Yu. B. Belousov
Moscow
Competing Interests:
The authors declare no conflict of interest.
M. N. Kostyleva
N. I. Pirogov Russian National Research Medical University
Russian Federation
Competing Interests:
Russian Federation
Maria N. Kostyleva — Cand. Sci. (Med.), Associate Professor of the Department of Clinical Pharmacology named after Yu. B. Belousov
Moscow
Competing Interests:
The authors declare no conflict of interest.
L. B. Belousova
N. I. Pirogov Russian National Research Medical University
Russian Federation
Competing Interests:
Russian Federation
Ludmila B. Belousova — laboratory assistant, Department of Clinical Pharmacology named after Yu. B. Belousov, Institute of Clinical Medicine
Moscow
Competing Interests:
The authors declare no conflict of interest.
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Review
For citations:
Postnikov S.S., Teplova N.V., Gratsianskaya A.N., Kostyleva M.N., Belousova L.B. Drug-induced disorders of the musculoskeletal system. Kachestvennaya Klinicheskaya Praktika = Good Clinical Practice. 2025;(4):48-54. (In Russ.) https://doi.org/10.37489/2588-0519-GCP-0004. EDN: FOMLTQ
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