Re: Re: Pulsed Corticosteroids Tied to Notable Bone Loss

[Guest guest]

Jennie,

Fosamax is a bisphosphonate. It's not that you can't be prescribed

bisphosphonates if you are premenopausal, it's just that it must be

undertaken only after very careful consideration. We don't have as much

data on premenopausal women treated with bisphosphonates as we do on

postmenopausal women. Also, bisphosphonates could have dire effects on a

developing fetus, so pregnancy must be strictly avoided while taking

bisphosphonates.

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org

[ ] Re: Pulsed Corticosteroids Tied to Notable Bone

Loss

> " In light of the high rate of bone loss, the researchers suggest that

> prevention with ssphosphonates and estrogen should be considered. "

>

> I have significant bone loss from prednisone, and my treatment is

> extra calcium and weight bearing exercises. Is the estrogen they

> refer to like taking Fosamax? I don't know much about Fosamax, but I

> am not eligible to take that until I reach menopause. That will be

> quite a while since I'm 33 year old. I am not sure what

> sphosphonates are but I guess I should look into that.

>

> Jennie

>

>

> > Pulsed Corticosteroids Tied to Notable Bone Loss

> >

> >

> > NEW YORK (Reuters Health) Jul 30 - Intravenous therapy with pulsed

> > methylprednisolone for rheumatic disorders appears to be associated

> with

> > considerable reduction in bone mineral density, UK researchers

> report in the

> > August issue of the ls of the Rheumatic Diseases.

> >

> > Dr. Emery of Leeds General Infirmary and colleagues note it is

> commonly

> > held that short term pulsed methylprednisolone does not lead to

> long term

> > bone mineral density (BMD) changes.

> >

> > To investigate further, the researchers studied 38 patients, of

> whom 30 were

> > women. All had rheumatic disorders such as rheumatoid arthritis,

> systemic

> > sclerosis and lupus and were undergoing methylprednisolone pulsed

> therapy.

> >

> > The subjects received a mean cumulative dose of 3.0 g of

> methylprednisolone,

> > given as 5.7 pulses over a median of 5.7 months.

> >

> > Most (34 patients) were also pulsed with cyclophosphamide, 20 were

> taking

> > oral corticosteroids and 8 were using estrogen or bisphosphonates.

> >

> > At follow-up, the researchers found that BMD was reduced by a mean

> of 2.2%

> > at the femoral neck, 1.1% at the total hip, and 1.0% at the spine.

> >

> > In patients not receiving antiresorptive treatment, such as

> estrogen or

> > bisphosphonates, and taking oral corticosteroids, the corresponding

> BMD

> > reductions were 4.4%, 2.4% and 2.1%. In patients not taking oral

> > corticosteroids, they amounted to 1.7%, 1.9% and 2.6%.

> >

> > However, in patients taking in estrogen or bisphosphonates, there

> were BMD

> > increases of 1.6%, 3.2% and 4.5%.

> >

> > In light of the high rate of bone loss, the researchers suggest that

> > prevention with ssphosphonates and estrogen should be considered.

> >

> > " This is especially important, " they conclude, " in patients with

> low BMD,

> > high disease activity, and other risk factors for osteoporosis. "

> >

> > Ann Rheum Dis 2004;63:940-944.