title: Effect of zoledronic acid on bone mineral density in patients of celiac disease: a prospective, randomized, pilot study.
abstract: OBJECTIVE
  The symptoms of celiac disease (CD) are varied and metabolic bone disease (MBD) is less recognized amongst all manifestations in CD patients. Bone disease in CD is attributed to secondary hyperparathyroidism, which in turn is associated with increased bone remodelling. Improvement in bone mineral density (BMD) with gluten free diet (GFD) is known, but the data on efficacy of bisphosphonates in CD patients are limited. Bisphosphonates being a potent inhibitor of bone resorption may be useful in patients with CD having low BMD. The aim of the present investigation was to study the effect of zoledronic acid on BMD in CD patients.
  
  
  METHODS
  A total of 28 CD patients were randomized to receive GFD, calcium and cholecalciferol (group A), and zoledronic acid (group B). Baseline biochemical tests and T-score by dual energy x-ray absorptiometer were done and repeated after 12 months.
  
  
  RESULTS
  The T-score showed improvement in the control arm (group A) from -3.31 ± 1.46 to -2.12 ± 1.44, a gain of 35.9 per cent (P<0.05) and in drug arm (group B) -2.82 ± 1.27 to -1.06 ± 1.84, registering a gain of 62.4 per cent (P<0.001). However, there was no difference in improvement of T-score in zoledronic acid group as compared to the control group.
  
  
  CONCLUSIONS
  Administration of zoledronic acid was not found to be better than GFD alone in increasing BMD in CD patients with low BMD in this pilot study.
authors: Mukul
authors: M
authors: Kumar
authors: Ashu
authors: A
authors: Rastogi
authors: Department of Endocrinology, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
authors: Sanjay Kumar
authors: SK
authors: Bhadada
authors: Anil
authors: A
authors: Bhansali
authors: Kim
authors: K
authors: Vaiphei
authors: Rakesh
authors: R
authors: Kochhar
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D015519:Bone Density / Q000187:drug effects*; D002118:Calcium / Q000008:administration & dosage; D002446:Celiac Disease / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D002762:Cholecalciferol / Q000008:administration & dosage; D055050:Diet, Gluten-Free; D004164:Diphosphonates / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007093:Imidazoles / Q000008:administration & dosage*; D008297:Male; D010865:Pilot Projects; D000077211:Zoledronic Acid
chemical_list: D004164:Diphosphonates; D007093:Imidazoles; D002762:Cholecalciferol; D000077211:Zoledronic Acid; D002118:Calcium