Re: Pulsed Corticosteroids Tied to Notable Bone Loss

[Guest guest]

" 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.