Ibandronate increases cortical bone density in patients with systemic lupus erythematosus on long-term glucocorticoid.
BACKGROUND
The purpose of this research is to assess the effects of oral ibandronate on bone microarchitecture by using high-resolution peripheral quantitative computed tomography (HR-pQCT) in patients with systemic lupus erythematosus (SLE) taking a long-term glucocorticoid.


METHODS
In this double-blind placebo-controlled study, 40 Chinese female SLE patients taking prednisolone were randomly assigned to receive either monthly oral ibandronate (150 mg) or placebo with daily 1-hydroxycholecalciferol (Alfacalcidol; 1 μg) and calcium supplement for 12 months. Assessments of bone microarchitecture by using HR-pQCT and area bone mineral density (aBMD) of the lumbar spine and hip with dual-energy x-ray absorptiometry (DXA) were performed at baseline and 12 months.


RESULTS
No differences in baseline characteristics were found between the two groups. After 12 months, no statistical differences were noted in any of the bone densities, microarchitectural parameters, or percentage changes of these parameters, as measured with HR-pQCT or DXA between the two groups. However, within the active group, the percentage improvement was significant in cortical bone density (P = 0.023) which was absent in the placebo group. Improvement was also seen in the aBMD of both the lumbar spine (P < 0.0001) and the hip (P < 0.005). In the placebo group, the percentage increase in trabecular separation was significant (P = 0.04), and the percentage improvement in aBMD in the spine also was significant (P = 0.049).


CONCLUSIONS
Oral ibandronate treatment improves microarchitecture in SLE patients taking long-term glucocorticoid assessed with HR-pQCT, and this new technology may have a role in assessing bony changes in future longitudinal studies in SLE patients.


BACKGROUND
ClinicalTrials.gov identifier: NCT00668330.
Li
Edmund K
EK
Department of Medicine, The Chinese University of Hong Kong, Prince Wales Hospital, 30-32 Ngan Shing Street, Sha Tin, NT, Hong Kong, PR China. edmundli@cuhk.edu.hk
Zhu
Tracy Y
TY
Hung
Vivian Y
VY
Kwok
Anthony W
AW
Lee
Vivian W
VW
Lee
Kenneth K
KK
Griffith
James F
JF
Li
Martin
M
Wong
Kong Chiu
KC
Leung
Ping Chung
PC
Qin
Ling
L
Tam
Lai Shan
LS
D015502:Absorptiometry, Photon; D000328:Adult; D015519:Bone Density / Q000187:drug effects*; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D004164:Diphosphonates / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D050723:Fractures, Bone / Q000517:prevention & control; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D006887:Hydroxycholecalciferols / Q000627:therapeutic use; D000077557:Ibandronic Acid; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy*; D008875:Middle Aged; D010024:Osteoporosis / Q000517:prevention & control; D011239:Prednisolone / Q000009:adverse effects; D015898:Tomography Scanners, X-Ray Computed
D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D005938:Glucocorticoids; D006887:Hydroxycholecalciferols; D011239:Prednisolone; D000077557:Ibandronic Acid; C008088:alfacalcidol