title: Comparison of changes in bone mineral in idiopathic and secondary osteoporosis following therapy with cyclical disodium etidronate and high dose calcium supplementation.
abstract: OBJECTIVE
  Our clinical practice has been to offer treatment with cyclical disodium etidronate and high dose calcium supplements (1500-1600 mg/day) to all female patients with osteoporosis who are unable or unwilling to take hormone replacement therapy (HRT), and male osteoporotics. In a retrospective study we compared the effect of this treatment on measures of bone mineral over a 12-month period in women with post-menopausal and secondary osteoporosis. We also assessed its effects in 10 male osteoporotics.
  
  
  METHODS
  A retrospective analysis of 83 consecutive patients with osteoporosis who completed 12 months of treatment with disodium etidronate and calcium and who had a dual energy X-ray absorptiometry (DEXA) scan at baseline and following 12 months of therapy.
  
  
  METHODS
  The study included 73 women (45 post-menopausal and 28 secondary osteoporotics) and 10 men with established osteoporosis as shown by spinal and femoral bone mineral densities (BMD) > 2 standard deviations (SD) below young normals, and radiological evidence of osteoporosis.
  
  
  METHODS
  Each patient had routine biochemistry at baseline, an X-ray of thoracic and lumbar spine and a DEXA scan of lumbar spine (L2-L4) and femoral neck. The DEXA scan was repeated following 12 months of therapy.
  
  
  RESULTS
  There was no difference between increase in spinal BMD in the post-menopausal (5.7%) versus secondary osteoporotic group (6.7%). There was a significant increase in spinal BMD at 12 months in the 10 male osteoporotics (9.0%, P < 0.01). No overall change in femoral neck BMD was noted.
  
  
  CONCLUSIONS
  Cyclical disodium etidronate given with high dose calcium supplements is equally effective in increasing spinal bone mineral density in post-menopausal and secondary osteoporosis. It also results in a significant rise in spinal bone mineral density in male osteoporotics. Whether this produces a reduction in fracture rates is unknown.
authors.affiliation: Department of Endocrinology, University of Leeds, General Infirmary at Leeds, UK.
authors.forename: S M
authors.initials: SM
authors.lastname: Orme
authors.forename: M
authors.initials: M
authors.lastname: Simpson
authors.forename: S P
authors.initials: SP
authors.lastname: Stewart
authors.forename: B
authors.initials: B
authors.lastname: Oldroyd
authors.forename: C F
authors.initials: CF
authors.lastname: Westmacott
authors.forename: M A
authors.initials: MA
authors.lastname: Smith
authors.forename: P E
authors.initials: PE
authors.lastname: Belchetz
mesh_terms: D015519:Bone Density / Q000187:drug effects*; D002118:Calcium / Q000008:administration & dosage*; D012968:Etidronic Acid / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000188:drug therapy* / Q000503:physiopathology; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy / Q000503:physiopathology; D012189:Retrospective Studies; D013131:Spine / Q000503:physiopathology
chemical_list: D012968:Etidronic Acid; D002118:Calcium