Prevention of glucocorticoid-induced osteopenia: effect of oral 25-hydroxyvitamin D and calcium.
Twenty-four patients (9 M and 15 F, age range 51-82) with polymyalgia rheumatica receiving 6-methylprednisolone for a period of 9 months (16 mg/daily/two weeks, 14 mg/daily/two weeks, 12 mg/daily/1 month, 10 mg/daily/1 month, 8 mg/daily/1 month, 6 mg/daily/1 month and 4 mg/daily for the last four months) were randomly assigned to receive either 250HD3 (35 mcg/day for 25 days/month) (Group A) or placebo (Group B) in a double-blind study. All patients also received 500 mg elemental calcium daily. Before and at 3, 6 and 9 months ESR, tenderness on palpation and subjective pain were evaluated. At the same times, mineral metabolism parameters (serum calcium, phosphorus, alkaline phosphatase, 24-h urinary calcium, phosphate and 24-h hydroxyproline excretion) and radial bone mineral content (BMC) were evaluated. Activity indexes (ESR and clinical parameters) improved in both groups. Furthermore, serum alkaline phosphatase and 24-h hydroxyproline excretion decreased significantly only in Group A, and BMC decreased significantly in Group B but rose slightly in Group A. No side effects were observed in any of the patients.
Rheumatic Diseases Unit, University of Pisa, Italy.
O
O
Di Munno
F
F
Beghe
P
P
Favini
P
P
Di Giuseppe
A
A
Pontrandolfo
G
G
Occhipinti
G
G
Pasero
D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D001799:Blood Sedimentation; D001851:Bone Diseases, Metabolic / Q000139:chemically induced / Q000473:pathology / Q000517:prevention & control*; D001842:Bone and Bones / Q000473:pathology; D002112:Calcifediol / Q000627:therapeutic use*; D002118:Calcium / Q000627:therapeutic use*; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D011111:Polymyalgia Rheumatica / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology
D005938:Glucocorticoids; D002112:Calcifediol; D002118:Calcium; D008775:Methylprednisolone