Alendronate improves low bone mineral density induced by steroid therapy in Crohn's disease.
OBJECTIVE
We investigated whether steroid therapy for Crohn's disease (CD) patients influences bone mineral density (BMD), and whether alendronate is effective for improving this loss of BMD.


METHODS
We recruited 16 outpatients with CD. The BMD of the whole body, the lumbar spine, and the proximal femoral neck was measured by dual-energy X-ray absorptimetry. The BMD was expressed as a T score. Some CD patients with low BMD values had been given vitamin K2 or alendronate for one year.


RESULTS
In the steroid-dependent group, the mean dose of prednisolone was 968 mg per year and 2.7 mg per day. Although the duration of the disease was not related to the T score, the amount of total steroids was negatively correlated with the T score among patients taking no preventative drugs. The T score in the vitamin K2 group after one year did was not altered in the 3 areas examined. On the other hand, the T score in the alendronate group increased by 2.8% for the whole body, 4.5% in the lumbar spine, and 3.4% in the proximal femoral neck.


CONCLUSIONS
The BMD of Japanese CD patients was decreased depending on the total amount of steroid administered, and oral alendronate improved the loss of BMD.
Tsujikawa
Tomoyuki
T
Department of Internal Medicine, Shiga University of Medical Science, Otsu. tujikawa@belle.shiga-med.ac.jp
Andoh
Akira
A
Inatomi
Osamu
O
Bamba
Shigeki
S
Nakahara
Tamio
T
Sasaki
Masaya
M
Saito
Haruyasu
H
Fujiyama
Yoshihide
Y
D015502:Absorptiometry, Photon; D000328:Adult; D019386:Alendronate / Q000494:pharmacology* / Q000627:therapeutic use; D000469:Alkaline Phosphatase / Q000097:blood; D015519:Bone Density / Q000187:drug effects* / Q000502:physiology; D050071:Bone Density Conservation Agents / Q000494:pharmacology* / Q000627:therapeutic use; D024042:Collagen Type I / Q000097:blood; D003424:Crohn Disease / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005272:Femur Neck / Q000503:physiopathology; D005938:Glucocorticoids / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D016014:Linear Models; D008159:Lumbar Vertebrae / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000097:blood / Q000139:chemically induced* / Q000517:prevention & control; D010455:Peptides / Q000097:blood; D011239:Prednisolone / Q000009:adverse effects / Q000627:therapeutic use; D013256:Steroids / Q000009:adverse effects* / Q000627:therapeutic use*
D050071:Bone Density Conservation Agents; D024042:Collagen Type I; D005938:Glucocorticoids; D010455:Peptides; D013256:Steroids; C052929:collagen type I trimeric cross-linked peptide; D011239:Prednisolone; D000469:Alkaline Phosphatase; D019386:Alendronate