Bone turnover during short-term therapy with methylprednisolone or budesonide in Crohn's disease.
BACKGROUND
Glucocorticosteroids are used frequently for the treatment of relapses of Crohn's disease.


OBJECTIVE
To investigate the influence of the new topically active glucocorticosteroid budesonide in comparison with methylprednisolone on bone turnover in a randomized open trial.


METHODS
Twenty-nine patients received either budesonide (controlled ileal release formulation) 9 mg for 10 weeks, or methylprednisolone 32 mg (equivalent to 40 mg prednisone) orally for 3 weeks with subsequent tapering.


RESULTS
Patients who completed the trial with methylprednisolone (n = 8) had suppression of serum osteocalcin (30.2 +/- 2.6 to 20.4 +/- 2.0 ng/mL. P < 0.01), whereas no changes in this parameter of bone synthesis were observed during budesonide treatment (n = 11) (34.8 +/- 3.1 to 33.0 +/- 3.5 ng/mL). Urinary pyridinolines and deoxypyridinolines, highly sensitive markers of bone degradation, did not change in either group.


CONCLUSIONS
Short-term methylprednisolone therapy impairs osteoblast activity in patients with Crohn's disease whereas budesonide does not.
D'Haens
G
G
Department of Gastroenterology, University Hospital of Leuven, Belgium.
Verstraete
A
A
Cheyns
K
K
Aerden
I
I
Bouillon
R
R
Rutgeerts
P
P
D000284:Administration, Oral; D000287:Administration, Topical; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D001842:Bone and Bones / Q000187:drug effects / Q000378:metabolism* / Q000473:pathology; D019819:Budesonide / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D003424:Crohn Disease / Q000150:complications* / Q000188:drug therapy; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D015675:Osteocalcin / Q000378:metabolism
D000893:Anti-Inflammatory Agents; D015675:Osteocalcin; D019819:Budesonide; D008775:Methylprednisolone