Therapy of steroid-induced bone loss in adult asthmatics with calcium, vitamin D, and a diphosphonate.
In a prospective, controlled, and randomized clinical trial, we examined the effects of treatment with vitamin D (1,000 IU/d), calcium (1 g/d), and ethane-1-hydroxy-1,1-diphosphonate (EHDP; 7.5 mg/kg body weight) on vertebral bone mass in fourteen asthmatics undergoing long-term treatment with systemically applied corticosteroids. The extent of steroid-induced bone loss was judged by vertebral bone density of the lumbar spine measured by dual-photon absorptiometry as well as by vertebral crush fracture incidence examined by conventional X-ray. Results of the measurements before treatment and after six mo were compared with those of an untreated control group of nineteen asthmatics. Bone density increased during the observation period by 5% in the treated group, compared with a decrease of 4.3% in the untreated control group (p < 0.01). Moreover, in the treated group no radiologically visible new fractures occurred; in the control group new fractures were observed in four patients. There were no serious side effects of the applied drugs during the 6-mo period. Therefore, the combination of EHDP, calcium, and vitamin D appears to be a useful regimen for the management of steroid-induced bone loss in adult asthmatics.
Worth
H
H
Department of Medicine, MNR-Clinic, Heinrich-Heine-University, Duesseldorf, Germany.
Stammen
D
D
Keck
E
E
D000305:Adrenal Cortex Hormones / Q000009:adverse effects* / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy*; D015519:Bone Density; D002118:Calcium / Q000008:administration & dosage* / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D012968:Etidronic Acid / Q000008:administration & dosage* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000139:chemically induced / Q000188:drug therapy* / Q000378:metabolism; D011241:Prednisone / Q000009:adverse effects / Q000627:therapeutic use; D011446:Prospective Studies; D011859:Radiography; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000209:etiology; D014807:Vitamin D / Q000008:administration & dosage* / Q000627:therapeutic use
D000305:Adrenal Cortex Hormones; D014807:Vitamin D; D012968:Etidronic Acid; D002118:Calcium; D011241:Prednisone