Management of male osteoporosis.
The objective of this study was to evaluate the efficacy of treatments for male osteoporosis selected based on the cause of the disease.


METHODS
Sixty-three men with osteoporosis (T-score at the lumbar spine and/or femoral neck lower than -2.5) with a mean age of 53+/-11 years were studied. Forty-three (68.3%) had a history of fracturing without trauma (vertebral fractures, 37 patients, 57%). Treatments were as follows: idiopathic osteoporosis: calcium and vitamin D supplements (N = 10) or cyclical etidronate for 2 weeks followed by calcium and vitamin D supplements for 76 days (N = 29); moderate idiopathic phosphate diabetes: calcitriol and phosphate (N = 15); idiopathic hypercalciuria: hydrochlorothiazide (N = 6); and hypogonadism: testosterone (N = 3).


RESULTS
Percentage change in bone mineral density (mean +/- standard error of the mean) after 18 months: calcium and vitamin D (lumbar spine: 0.6+/-2; femoral neck: 2.2+/-2.2); etidronate (lumbar spine: 3.6+/-1.4*; femoral neck: 0.5+/-1); calcitriol (lumbar spine: 7.0+/-3.5*; femoral neck: 0.0+/-1.4); thiazide diuretic (lumbar spine: 1+/-3.2; femoral neck: -2.3+/-3.7); and testosterone (lumbar spine: 6.8+/-6.4; femoral neck: 2.5+/-2.7), where *P < 0.05 versus baseline. Gastrointestinal side effects occurred in three patients (4.8%), including two on calcitriol-phosphate therapy and one on etidronate therapy. Of the six (9.5%) patients who experienced incident fractures, four were on etidronate, one on calcitriol-phosphate, and one on calcium-vitamin D. No patients discontinued their treatment because of side effects.


CONCLUSIONS
Etidronate and the combination of calcitriol-phosphate produce a significant increase in lumbar spine bone mass in men with idiopathic osteoporosis or moderate idiopathic phosphate diabetes.
Cortet
B
B
Service de rhumatologie, hĵpital Roger-Salengro, CHRU Lille, France. bcortet@chru-lille.fr
Vasseur
J
J
Grardel
B
B
Catanzariti
L
L
Marchandise
X
X
Delcambre
B
B
D015502:Absorptiometry, Photon; D015519:Bone Density; D002117:Calcitriol / Q000627:therapeutic use; D002118:Calcium / Q000008:administration & dosage / Q000652:urine; D019587:Dietary Supplements; D012968:Etidronic Acid / Q000627:therapeutic use; D005272:Femur Neck / Q000000981:diagnostic imaging; D006801:Humans; D006852:Hydrochlorothiazide / Q000627:therapeutic use; D006934:Hypercalcemia / Q000150:complications / Q000188:drug therapy; D007006:Hypogonadism / Q000150:complications / Q000188:drug therapy; D007015:Hypophosphatemia, Familial / Q000150:complications / Q000188:drug therapy; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000209:etiology / Q000378:metabolism / Q000628:therapy*; D010710:Phosphates / Q000627:therapeutic use; D013739:Testosterone / Q000627:therapeutic use; D014807:Vitamin D / Q000008:administration & dosage
D010710:Phosphates; D006852:Hydrochlorothiazide; D014807:Vitamin D; D013739:Testosterone; D002117:Calcitriol; D012968:Etidronic Acid; D002118:Calcium