Endocrinology

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Effect of alendronate on bone metabolic indices and bone mineral density in patients treated with high-dose glucocorticoid: A prospective study
Osteoporosis International, 11/25/09

Kaji H et al. – Alendronate was effective in suppressing bone resorption and subsequent BMD decrease at the lumbar spine in patients with high-dose GC treatment.

• Examined prospective effects of daily 5 mg alendronate on bone metabolism and BMD in 20 patients with high-dose GC (at least 40 mg prednisolone/day) and compared to 34 high-dose GC-treated patients without alendronate

• Serum levels of calcium decreased at day 28 in alendronate group
• Urinary calcium excretion significantly increased after day 7 in both groups
• Increase in serum PTH level at day 7 in control group not observed in alendronate group, but PTH levels increased at day 28 and month 3 in alendronate group
• Bone turnover markers, the serum osteocalcin level decreased in both alendronate and control groups, but serum bone-type alkaline phosphatase levels did not show significant changes
• Although urinary type I collagen cross-linked N-telopeptide (NTX) level showed significant increases on days 7 and 28 in control group; such early increases in urinary NTX not observed in alendronate group
• Urinary NTX levels fell slowly in alendronate group significantly
• BMD at lumbar spine significantly decreased from month 1 in control group, whereas in alendronate group, BMD at lumbar spine maintained almost the same level at all time points observed

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