Bone protection with salmon calcitonin (sCT) in the long-term steroid therapy of chronic sarcoidosis.
Prednisone-induced osteoporosis is very frequent in the long-term treatment of sarcoidosis (sarcoidosis 4:45-48, 1987). The aim of this work is to evaluate if salmon Calcitonin (sCT) is able to prevent osteopenia in the long-term. We have studied 53 patients with chronic histologically-proven sarcoidosis, all needing steroids, in a follow-up of 15 months; 20 of them were protected with sCT (100 I.U. i.m. daily for one month, then every two days for all the time of the study), 33 were unprotected. The two groups were matched for age, sex and total dose of prednisone. In order to overcome the differences of Vertebral Cancellous Mineral Content (VCMC) due to age and sex, we express VCMC in terms of Z score, i.e. the number of standard deviations above or below our normal means: initial Z score was -1.77 +/- 0.16 in the sCT group and -0.99 +/- 0.17 in the other group (P less than .05). For each subject we calculated the Mineral Loss (ML) in % of the initial value. At the end of the study ML% averaged -2.15(+/- 2.27) in the sCT protected group, and -14.11(+/- 2.08) in the unprotected group (P less than .001). We have also analysed the results limited to pts with initial Z score under -1 (19 sCT protected pts vs 18 unprotected). In these subgroups the ML% after 15 months averaged -13.62(+/- 2.9) in the unprotected group and -2.80(+/- 2.29) in the protected one (P less than .01). Finally we have studied another subgroup, i.e. 21 postmenopausal females: 9 were sCT protected, 12 were unprotected.(ABSTRACT TRUNCATED AT 250 WORDS)
Rizzato
G
G
Sarcoidosis Clinic, Niguarda Hospital, Milan, Italy.
Tosi
G
G
Schiraldi
G
G
Montemurro
L
L
Zanni
D
D
Sisti
S
S
D000328:Adult; D002116:Calcitonin / Q000627:therapeutic use*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008593:Menopause; D008875:Middle Aged; D008903:Minerals / Q000032:analysis; D010024:Osteoporosis / Q000139:chemically induced / Q000378:metabolism / Q000517:prevention & control*; D011241:Prednisone / Q000009:adverse effects* / Q000627:therapeutic use; D012507:Sarcoidosis / Q000188:drug therapy*; D013131:Spine / Q000032:analysis
D008903:Minerals; C028815:salmon calcitonin; D002116:Calcitonin; D011241:Prednisone