Etidronate versus fluoride for treatment of osteopenia in primary biliary cirrhosis: preliminary results after 2 years.
OBJECTIVE
Because osteopenia increases morbidity of primary biliary cirrhosis (PBC), the effects of cyclical etidronate vs. sodium fluoride on bone mass were compared in patients with PBC.


METHODS
Thirty-two women with PBC were randomly assigned to receive etidronate (400 mg/day during 14 days every 3 months) or fluoride (50 mg/day, enteric-coated tablets). Bone mineral density of the lumbar spine and proximal femur were measured initially and every 6 months. Bone fractures were also evaluated.


RESULTS
Sixteen patients were allocated into each group, which were comparable with respect to the severity of PBC and osteopenia. Thirteen patients with etidronate and 10 patients with fluoride completed 2 years in the study. In the etidronate group, bone mineral density increased in the lumbar spine (P = 0.02) and did not change in the proximal femur. In the fluoride group, lumbar bone mineral density did not change but femoral bone mass decreased, particularly in the Ward's triangle. Two patients in the fluoride and none in the etidronate group developed new vertebral fractures, and the number of new nonvertebral fractures was similar in both groups. Neither treatment impaired liver function or cholestasis.


CONCLUSIONS
Cyclical etidronate is more effective and better tolerated than sodium fluoride in preventing bone loss in PBC.
Guañabens
N
N
Metabolic Bone Diseases Unit, Hospital Clinic i Provincial, University of Barcelona, Spain.
Parés
A
A
Monegal
A
A
Peris
P
P
Pons
F
F
Alvarez
L
L
de Osaba
M J
MJ
Roca
M
M
Torra
M
M
Rodés
J
J
D015502:Absorptiometry, Photon; D015519:Bone Density / Q000187:drug effects; D001851:Bone Diseases, Metabolic / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology*; D004334:Drug Administration Schedule; D012968:Etidronic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging; D005500:Follow-Up Studies; D006801:Humans; D008105:Liver Cirrhosis, Biliary / Q000150:complications*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008875:Middle Aged; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012969:Sodium Fluoride / Q000008:administration & dosage / Q000627:therapeutic use*; D013669:Technetium Tc 99m Medronate / Q000031:analogs & derivatives; D013997:Time Factors
D019275:Radiopharmaceuticals; C024226:technetium Tc 99m hydroxymethylene diphosphonate; D012969:Sodium Fluoride; D012968:Etidronic Acid; D013669:Technetium Tc 99m Medronate