title: Efficacy of different therapeutic regimens on hepatic osteodystrophy in chronic viral liver disease.
abstract: OBJECTIVE
  Metabolic bone disease is common in patients with chronic liver disease. Comparative studies on the efficacies of antiosteoporotic agents in hepatic osteodystrophy have not been conducted yet. The aim of this study was to evaluate the safety and efficacy of different therapeutic regimens on hepatic osteodystrophy.
  
  
  METHODS
  Eighty-one patients (mean age 48.9 ± 10 years; 50 cases with chronic viral hepatitis and 31 patients with cirrhosis) were enrolled in the study. Treatment groups consisted of 61 patients who had reduced T scores in at least one region, selected randomly and treated for 1 year with vitamin D 400 IU, calcitonin 200 IU, alendronate 10 mg, alendronate 70 mg, or risedronate 5 mg. An untreated group consisting of 20 patients who had no reduction in T scores was followed up during the study period.
  
  
  RESULTS
  No significant adverse effects, including esophageal variceal hemorrhage, were detected. According to the T score at the end of the first year compared with baseline, significant improvements in bone mineral density were observed at all regions with alendronate 70 mg; improvements at the lumbar spine (LS) and distal radius regions with alendronate 10 mg; at the LS and distal radius regions with risedronate; at the LS region with calcitonin; and at the femoral neck region with vitamin D.
  
  
  CONCLUSIONS
  All therapeutic regimens seemed to be safe, and oral biphosphonates were the most effective in preventing both cortical and trabecular bone loss in patients with chronic viral liver disease. Larger studies with longer follow-up are warranted in hepatic osteodystrophy of chronic viral liver diseases.
authors.affiliation: Department of Internal Medicine, Division of Gastroenterology, School of Medicine, Erciyes University, Kayseri, Turkey. yurci@erciyes.edu.tr
authors.forename: Alper
authors.initials: A
authors.lastname: Yurci
authors.forename: Ali Osman
authors.initials: AO
authors.lastname: Kalkan
authors.forename: Omer
authors.initials: O
authors.lastname: Ozbakir
authors.forename: Ahmet
authors.initials: A
authors.lastname: Karaman
authors.forename: Edip
authors.initials: E
authors.lastname: Torun
authors.forename: Mustafa
authors.initials: M
authors.lastname: Kula
authors.forename: Mevlut
authors.initials: M
authors.lastname: Baskol
authors.forename: Sebnem
authors.initials: S
authors.lastname: Gursoy
authors.forename: Mehmet
authors.initials: M
authors.lastname: Yucesoy
authors.forename: Fahri
authors.initials: F
authors.lastname: Bayram
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods; D000328:Adult; D019386:Alendronate / Q000009:adverse effects / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D015519:Bone Density / Q000187:drug effects / Q000502:physiology; D050071:Bone Density Conservation Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001851:Bone Diseases, Metabolic / Q000188:drug therapy* / Q000503:physiopathology / Q000821:virology; D002116:Calcitonin / Q000009:adverse effects / Q000627:therapeutic use; D002908:Chronic Disease; D012968:Etidronic Acid / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D005260:Female; D006525:Hepatitis, Viral, Human / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000517:prevention & control / Q000821:virology; D011446:Prospective Studies; D000068296:Risedronic Acid; D016896:Treatment Outcome; D014807:Vitamin D / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D015415:Biomarkers; D050071:Bone Density Conservation Agents; D014807:Vitamin D; D002116:Calcitonin; D000068296:Risedronic Acid; D012968:Etidronic Acid; D019386:Alendronate