Etidronate prevents steroid-induced bone loss in premenopausal individuals

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J Rheumatol. 2004 Jan;31(1):163-6.

Etidronate prevents high dose glucocorticoid induced bone loss in

premenopausal individuals with systemic autoimmune diseases.

Nakayamada S, Okada Y, Saito K, Tanaka Y.

First Department of Internal Medicine, University of Occupational and

Environmental Health, Kitakyushu, Japan.

OBJECTIVE: To assess the efficacy of etidronate and alfacalcidol in

preventing glucocorticoid induced bone loss in premenopausal women and

men starting high dose glucocorticoid therapy. METHODS: Premenopausal

women (n = 16) and men (n = 5) who had just developed autoimmune

diseases, and who agreed to use high dose glucocorticoid therapy for the

first time, were randomized to receive alfacalcidol (1 micro g/day)

alone (alfacalcidol group, n = 11); or alfacalcidol (1 micro g/day) and

intermittent cyclical etidronate (200 mg/day for 14 days), given for 4

cycles (combined group, n = 10). They were treated with these

medications as well as high dose glucocorticoids for 12 months. RESULTS:

In the alfacalcidol group the percentage changes in bone mineral density

(BMD) of the lumbar spine after 6 and 12 mo of therapy were -9.6 +/-

0.6% and -10.3 +/- 1.0%, respectively. However, in the combined group

the percentage changes in lumbar spine BMD after 6 and 12 mo were -3.8

+/- 1.3% and -4.5 +/- 2.1%. The percentage lumbar spine bone loss rate

in the combined group was significantly lower than in the alfacalcidol

group at both 6 and 12 mo. After 12 mo the percentage change in femoral

neck BMD was increased 2.3 +/- 1.5% in the combined group and was

decreased 2.5 +/- 2.4% in the alfacalcidol group; this difference was

also statistically significant. There were no significant differences in

metabolic bone markers between the groups during the study.

CONCLUSION: The results suggest that etidronate could prevent high dose

glucocorticoid induced bone loss in premenopausal individuals with

systemic autoimmune diseases.

PMID: 14705236

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