Intermittent cyclical etidronate in the prevention of corticosteroid-induced bone loss.
We conducted a prospective study of etidronate's effects on corticosteroid-induced bone loss in postmenopausal women with temporal arteritis for whom high-dose prednisone therapy was indicated. Group A (n = 10) received etidronate (400 mg/day for 2 weeks, then 11 weeks off etidronate; four cycles total) and prednisone: Group B (n = 10) received only prednisone. Vertebral bone mineral density (BMD) was measured blinded by dual X-ray absorptiometry. At 3, 6 and 12 months, vertebral BMD was significantly (P < 0.01) increased in Group A and decreased in Group B, based on mean actual and percent changes in BMD and mean changes in BMD Z-score from baseline. Between-group comparisons were also significant (P < 0.002) at each time point. No adverse events related to etidronate treatment were reported. Our results suggest that corticosteroid-induced bone loss may be prevented by instituting intermittent cyclical etidronate therapy when high-dose prednisone therapy is begun. Further research into bisphosphonate use in corticosteroid-induced bone loss (with larger patient populations, longer follow-up and fracture assessment) is warranted.
Mulder
H
H
Gezondheidscentrum Zuidplein, Rotterdam, The Netherlands.
Struys
A
A
D000305:Adrenal Cortex Hormones / Q000009:adverse effects*; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density / Q000187:drug effects; D004334:Drug Administration Schedule; D012968:Etidronic Acid / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D013700:Giant Cell Arteritis / Q000188:drug therapy; D006801:Humans; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000139:chemically induced* / Q000378:metabolism; D011241:Prednisone / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use
D000305:Adrenal Cortex Hormones; D012968:Etidronic Acid; D011241:Prednisone