Alendronate for Glucocorticoid-Induced Osteoporosis
Source: Saag KG, et al. N Engl J Med 1998;339:292-299.
Osteoporosis is a not infrequent serious consequence of chronic glucocorticoid therapy. Data are conflicting about the success of estrogen, vitamin D, and calcitonin to prevent such steroid-induced bone loss. The current study was undertaken to assess the capacity of alendronate, an anti-resorption agent, to prevent and treat such bone loss.
To be included in the trial, study subjects from the United States and 15 other countries (n = 560) had to be using chronic steroid therapy of at least 7.5 mg/d of prednisone (or the equivalent). One-third of the study group was male. In addition to 800-1000 mg calcium and 250-500 IU vitamin D daily, all patients received alendronate in doses ranging from 2.5 to 10 mg/d for 48 weeks.
Increases in lumbar spine, trochanter, femoral neck, and total body bone mineral density (BMD) were seen in patients receiving at least 5 mg alendronate daily (2.5 mg alendronate produced only a trend toward significant increased BMD).
Patients were stratified by duration of steroid use. The authors point out that long-term and high-dose steroid users enjoyed no less BMD benefit than other groups, suggesting the appropriateness of alendronate both for prevention and therapy of osteoporosis induced by chronic glucocorticoid therapy.
The Therapeutics and Drugs Briefs in this issue were written by Louis Kuritzky, MD, Courtesy Clinical Assistant Professor, University of Florida, Gainesville.
You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content