A randomized, placebo-controlled study on the effect of cyclic intermittent etidronate therapy on the bone mineral density changes associated with six months of gonadotropin-releasing hormone agonist treatment.
OBJECTIVE
Our purpose was to determine whether intermittent cyclic etidronate therapy blocks the decline in bone density associated with gonadotropin-releasing hormone agonist therapy.


METHODS
Thirty-one premenopausal subjects who needed treatment with leuprolide (Lupron) 3.75 mg monthly for 6 months were randomized to etidronate or placebo. Bone turnover was assessed by measurement of serum calcium, phosphorus, alkaline phosphatase, and fasting urinary calcium/creatinine ratios. Bone density was measured by dual energy x-ray absorptiometry.


RESULTS
Gonadotropin-releasing hormone treatment produced a significant decrease (4% to 10%) in bone density at the anteroposterior and lateral spine in placebo-treated patients (11). No significant change was demonstrated in etidronate-treated patients (15). Significant increases in serum calcium, phosphorus, alkaline phosphatase, and urinary calcium/creatinine ratios were noted in the placebo group. No significant change in these parameters were evident in the etidronate group.


CONCLUSIONS
Etidronate blocks bone mineral density changes associated with gonadotropin-releasing hormone agonist therapy and normalizes serum and urine indicators of bone turnover.
Mukherjee
T
T
Department of Obstetrics and Gynecology, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
Barad
D
D
Turk
R
R
Freeman
R
R
D000328:Adult; D015519:Bone Density / Q000187:drug effects*; D016723:Bone Remodeling / Q000187:drug effects; D004311:Double-Blind Method; D004715:Endometriosis / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D004958:Estradiol / Q000097:blood; D012968:Etidronic Acid / Q000008:administration & dosage*; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists / Q000627:therapeutic use*; D006801:Humans; D007889:Leiomyoma / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D008875:Middle Aged; D011446:Prospective Studies; D014594:Uterine Neoplasms / Q000097:blood / Q000503:physiopathology / Q000628:therapy*
D007987:Gonadotropin-Releasing Hormone; D004958:Estradiol; D012968:Etidronic Acid