Alendronate in the treatment of low bone mass in steroid-treated boys with Duchennes muscular dystrophy.
OBJECTIVE
To examine alendronates side-effect profile and effect on bone mineral density (BMD) in deflazacort-treated boys with Duchennes muscular dystrophy (DMD) and low BMD.


METHODS
Before-after trial.


METHODS
Neuromuscular clinic at a children's hospital in Canada between 1999 and 2000.


METHODS
All consenting boys with DMD who had z scores less than -1.00 (spine and/or total body) and in whom BMD testing was feasible.


METHODS
Boys received .08 mg.kg(-1) .d(-1) of alendronate orally, with 750 mg of daily calcium and 1000 IU of vitamin D. BMD, height, weight, physical activity, Tanner stage, and adverse effects were followed for 2 years.


METHODS
BMD z scores at the lumbar spine (L1-4) and total body.


RESULTS
Of the 42 eligible boys assessed, 23 had low BMD; for 16 of the 23, future BMD testing was feasible. Mean age was 10.8 years (range, 6.9-15.6 y). Mean baseline z scores at the total body and spine were -0.80 and -1.94, respectively. At 2 years, mean z scores were unchanged. Furthermore, alendronate response varied by baseline age. In multivariable analysis, improvement in total body and spine z scores was associated with younger age at baseline ( P =.01 for both).


CONCLUSIONS
In deflazacort-treated boys, alendronate had a positive effect on BMD z scores; the effect was greatest when given early in the course of disease.
Hawker
Gillian A
GA
Department of Medicine, Division of Rheumatology, University of Toronto, ON, Canada. g.hawker@utoronto.ca
Ridout
Rowena
R
Harris
Vivien A
VA
Chase
Cheryl C
CC
Fielding
Lynda J
LJ
Biggar
W Douglas
WD
D019386:Alendronate / Q000494:pharmacology* / Q000627:therapeutic use*; D015519:Bone Density / Q000187:drug effects*; D001842:Bone and Bones / Q000187:drug effects; D002648:Child; D005938:Glucocorticoids / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D020388:Muscular Dystrophy, Duchenne / Q000188:drug therapy*; D011282:Pregnenediones / Q000494:pharmacology / Q000627:therapeutic use*
D005938:Glucocorticoids; D011282:Pregnenediones; C021988:deflazacort; D019386:Alendronate