NEW YORK (Reuters Health), Aug 17 - In a study of patients with rheumatic diseases, alendronate was more effective than alfacalcidol at preventing glucocorticoid-induced bone loss, according to a report in the New England Journal of Medicine for August 17.
The study involved 201 rheumatic disease patients who were starting steroid therapy at a dose equivalent to at least 7.5 mg of prednisone per day were randomized to receive a daily dose of alendronate (10 mg) or alfacalcidol (1 microgram) with the opposite agent given in placebo form.
The main outcome, according to lead author Dr. Ron N. J. de Nijs and colleagues, was the change in lumbar spine bone mineral density (BMD) at 18 months. In addition, the researchers also looked at the rate of morphometric vertebral deformities.
A total of 163 patients completed the study, including 79 in the alendronate group and 85 in the alfacalcidol group, Dr. de Nijs, from the University Medical Center in Utrecht, Netherlands, and colleagues note.
While lumbar spine BMD rose by 2.1% in the alendronate group, it fell by 1.9% in the alfacalcidol group, the researchers report. Moreover, vertebral deformities were also more common in the alfacalcidol group, and three patients in that group had symptomatic vertebral fractures.
"Alendronate may inhibit bone loss in glucocorticoid-induced osteoporosis more effectively than does alfacalcidol," the investigators conclude. "The benefits of bisphosphonates in glucocorticoid-induced osteoporosis have been ascribed primarily to their antiresorptive effect and secondarily to possible inhibition of apoptosis of osteoblasts."
Last Updated: 2006-08-17 10:44:17 -0400 (Reuters Health)
N Engl J Med 2006;355:675-684.
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