title: Alendronate in the treatment of low bone mass in steroid-treated boys with Duchennes muscular dystrophy.
abstract: 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.
authors.affiliation: Department of Medicine, Division of Rheumatology, University of Toronto, ON, Canada. g.hawker@utoronto.ca
authors.forename: Gillian A
authors.initials: GA
authors.lastname: Hawker
authors.forename: Rowena
authors.initials: R
authors.lastname: Ridout
authors.forename: Vivien A
authors.initials: VA
authors.lastname: Harris
authors.forename: Cheryl C
authors.initials: CC
authors.lastname: Chase
authors.forename: Lynda J
authors.initials: LJ
authors.lastname: Fielding
authors.forename: W Douglas
authors.initials: WD
authors.lastname: Biggar
mesh_terms: 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*
chemical_list: D005938:Glucocorticoids; D011282:Pregnenediones; C021988:deflazacort; D019386:Alendronate