RESEARCH - Alendronate protects premenopausal women from bone loss and fracture associated with high-dose steroid therapy

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J Rheumatol. 2008 Nov;35(11):2249-54.

Alendronate protects premenopausal women from bone loss and fracture

associated with high-dose glucocorticoid therapy.

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

First Department of Internal Medicine, University of Occupational and

Environmental Health, Kitakyushu, Japan.

OBJECTIVE: We assessed the efficacy of bisphosphonate in premenopausal

women (n = 47) commencing high-dose glucocorticoid (GC) therapy in

protection against induced bone loss and bone fracture. METHODS.

Subjects had just developed systemic autoimmune diseases and were

randomized to be treated with 1 mg/kg/day prednisolone and

alfacalcidol 1 microg/day alone (alfacalcidol group; n = 22), or

prednisolone and alfacalcidol 1 microg/day with alendronate 5 mg/day

(alendronate group; n = 25), each for 18 months.

RESULTS: The percentage changes in lumbar spine bone mineral density

(BMD) after 6 months of the therapy were -10.5% +/- 0.8% in the

alfacalcidol group, but only -2.1% +/- 1.2% in the combined group. The

rate of bone loss in the lumbar spine was significantly lower in the

combined group than in the alfacalcidol group at 6 months. At 12

months of treatment, the percentage change in lumbar spine BMD was

increased by 1.7% +/- 1.4% in the combined group, but decreased by

9.9% +/- 1.9% in the alfacalcidol group; the difference was

significant. Bone fracture occurred at 12 months or later in 4

patients of the alfacalcidol groups, but not in the combined group,

even at up to 18 months.

CONCLUSION: Our results indicate that alendronate with alfacalcidol

can maintain BMD and protects against high-dose GC-induced bone loss

and bone fracture.

PMID: 19031508

http://www.ncbi.nlm.nih.gov/pubmed/19031508

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