RESEARCH - Osteoporosis prophylaxis urged for premenopausal women with SLE taking steroids

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Osteoporosis Prophylaxis Urged for Premenopausal Women With SLE Taking Steroids

NEW YORK (Reuters Health) Dec 26 - Among premenopausal women taking

corticosteroids for systemic lupus erythematosus, various treatments

preserve bone mineral density and " should be considered for

osteoporosis prophylaxis, " according to a report in the December issue

of the Journal of Rheumatology.

" Whether due to the corticosteroid treatment, or to the disease

itself, osteoporosis is being increasingly recognized in patients with

SLE and is an important cause of comorbidity, " write Dr. Swan S. Yeap,

of the University of Malaya, Kuala Lumpur, and colleagues.

In a prospective, randomized controlled study, the researchers

assessed changes in bone mineral density (BMD) in 98 premenopausal

women with SLE undergoing long-term corticosteroid therapy while

taking calcium carbonate 500 mg twice daily (calcium alone),

calcitriol 0.25 mcg twice daily plus calcium carbonate 500 mg twice

daily (calcitriol + calcium), or alendronate 70 mg once a week plus

calcium carbonate 500 mg twice daily (alendronate + calcium).

Of the 98 patients, 77 (78.6%) completed the 2-year study, including

23 taking calcium alone, 27 taking calcitriol + calcium, and 27 taking

alendronate + calcium.

In the alendronate + calcium group, there were significant increases

in BMD at both the lumbar spine (2.69%) and total hip (1.41%) compared

to baseline. There were no significant changes found in the

calcium-alone and the calcitriol + calcium groups, except for a 0.93%

reduction in total hip BMD in the calcium-alone group.

The medications were well tolerated. There were few adverse effects

that required additional drug therapy or withdrawal of treatment.

" Four patients had 5 isolated episodes of hypercalcemia during the

course of the 2 years, all of whom were in the calcitriol + calcium

group, " Dr. Yeap's team notes. " The hypercalcemia resolved by the

following visit with no need for dose adjustment. "

In this cohort of premenopausal women taking corticosteroids for SLE,

the researchers conclude, bone mineral density can be preserved or

increased with prophylactic therapy.

J Rheumatol 2008;35:2344-2347.

http://www.medscape.com/viewarticle/585945

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