Effects of monthly intramuscular neridronate in rheumatic patients in chronic treatment with low-dose glucocorticoids.
OBJECTIVE
To assess the effects of intramuscular (im) neridronate (NE) on lumbar and femoral neck BMD and on markers of bone turnover in rheumatic patients under chronic low-dose glucocorticoids (GC) therapy.


METHODS
Sixty-nine osteopoenic and osteoporotic patients, affected by rheumatic diseases and gastric or esophageal conditions which contraindicated treatment with oral bisphosphonates (BPs), were randomly assigned to: Group A (23 patients) administered with daily calcium 1 g and vitamin D 800 UI; Group B (46 patients) receiving daily calcium 1 g, vitamin D 800 UI and im NE 25 mg monthly.


RESULTS
After 12 months of therapy (M12) lumbar BMD was reduced of 2.97% in Group A, and improved of 3.34% (p=0.001) in Group B; at M12, femoral neck BMD was reduced of 2.40% in Group A and improved of 1.78% in Group B (p=0.010). After 6 (M6) and 12 months of therapy, the bone resorption markers were significantly reduced in Group B: OHPr-41.64% at M6 (p<0.001) and -37.91% at M12 (p<0.001); DPD-33.4% at M6 (p<0.001) and -33.18% (p<0.001) at M12: NTX -57.08% (p<0.001) at M6 and -55.95% (p<0.001) at M12; OC-11.62% (p=0.05) at M6 and -12.62% at M12 (p=0.06); B-ALP -13.95 % at M6 (p=0.04) and -0.85% at M12 (NS).


CONCLUSIONS
A twelve-month intramuscular NE treatment in rheumatic patients under GCs therapy improves lumbar and femoral BMD and mainly reduces the markers of bone resorption.
Benucci
M
M
Rheumatology Unit, New Hospital S. Giovanni di Dio, Azienda Sanitaria, Florence, Italy.
Saviola
G
G
Baiardi
P
P
Abdi-Ali
L
L
Povino
M R
MR
Dolenti
S
S
Campostrini
L
L
Sacco
S
S
Manfredi
M
M
Rossini
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018501:Antirheumatic Agents / Q000009:adverse effects*; D015415:Biomarkers / Q000097:blood; D015519:Bone Density / Q000187:drug effects / Q000502:physiology; D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001862:Bone Resorption / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D004164:Diphosphonates / Q000008:administration & dosage / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005269:Femur / Q000187:drug effects / Q000378:metabolism; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D007273:Injections, Intramuscular; D008159:Lumbar Vertebrae / Q000187:drug effects / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000139:chemically induced / Q000188:drug therapy / Q000378:metabolism; D012216:Rheumatic Diseases / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D055815:Young Adult
D018501:Antirheumatic Agents; D015415:Biomarkers; D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D005938:Glucocorticoids; C053389:6-amino-1-hydroxyhexane-1,1-diphosphonate