[Methimazole versus methimazole and diphosphonates in hyperthyroid and osteoporotic patients].
OBJECTIVE
It is well-know that hyperthyroidism is one of the key causes of secondary osteoporosis. High values of thyroid hormones increase the bone mineral turnover speed by promoting osteoclastic and osteoblastic activities. The aim of our study is to evaluate the increase of bone mineral density (BMD) in osteoporotic and hyperthyroid patients treated with only antithyroid drugs versus patients treated with antithyroid drugs and diphosphonates.


METHODS
Twenty-six elderly male patients, 65-75 years, were selected. In all these patients, thyroid function (FT3, FT4, TSH, Tg, AbTg, AbTPO) was evaluated at baseline and after 6 and 12 months from the start of medical treatment; the following were evaluated: BMD, calcium serum, phosphorus serum, alkaline phosphatase, PTH and 24 hours urinary calcium, phosphorus and hydroxyprolin. Thirteen patients (group 1) were treated with antithyroid drugs (methimazole 5-20 mg/die/os) and diphosphonates (alendronate 10 mg/die/os). The control group of 13 patients (group 2) was treated with antithyroid drugs only.


RESULTS
After 6 months of treatment, the patients of group 1 showed a mean increase of 2.5% in lumbar spine BMD compared with a mean increase of 0.3% in group 2 (p<0.01). After 12 months, group 1 showed a mean increase of 6.2% in lumbar spine BMD, compared with a mean increase of 2% in group (p<0.001).


CONCLUSIONS
The combination of antithyroid and diphosphonates drugs appears to be more efficacious than antithyroid therapy alone for the treatment of osteoporosis in male hyperthyroid patients.
Lupoli
G A
GA
Dipartimento di Endocrinologia e Oncologia Molecolare e Clinica, Università degli Studi di Napoli Federico II, Napoli. lupoli@unina.it
Fittipaldi
M R
MR
Fonderico
F
F
Panico
A
A
Colarusso
S
S
Di Micco
L
L
Cavallo
A
A
Costa
L
L
Paglione
A
A
Lupoli
G
G
D000368:Aged; D019386:Alendronate / Q000627:therapeutic use*; D000469:Alkaline Phosphatase / Q000097:blood; D013956:Antithyroid Agents / Q000627:therapeutic use*; D015519:Bone Density / Q000187:drug effects*; D002118:Calcium / Q000097:blood; D016022:Case-Control Studies; D004359:Drug Therapy, Combination; D006801:Humans; D006980:Hyperthyroidism / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D008297:Male; D008713:Methimazole / Q000627:therapeutic use*; D010024:Osteoporosis / Q000097:blood / Q000188:drug therapy / Q000209:etiology*; D010281:Parathyroid Hormone / Q000097:blood; D010758:Phosphorus / Q000097:blood; D016896:Treatment Outcome
D013956:Antithyroid Agents; D010281:Parathyroid Hormone; D010758:Phosphorus; D008713:Methimazole; D000469:Alkaline Phosphatase; D002118:Calcium; D019386:Alendronate