Alfacalcidol in glucocorticoid-induced osteoporosis: a three year follow-up.

Journal/Book: Z Rheumatol 1998; 57 Suppl. 1: 6 (V 7). 1998;

Abstract: 11st Dept. of Med. 2Dept of Orthop. Semmelweis Univ.; Hetenyi Hosp.; MAV Hosp. Budapest We studied the effect of alphacalcidol on bone metabolism in patients who were recently placed on glucocorticoid therapy. We selected 41 women (age: 32 - 52 yrs) who were previously diagnosed with SLE sclerosis multiplex rheumatoid arthritis or asthma bronchiale. Patients did not have other diseases or did not take drugs known to influence bone metabolism. Patients were randomly enrolled into two groups and were given 5 - 25 mg prednisone daily. After 4 weeks group A (treated; n = 21) received 0.5 - 1.0 g alphacalcidol and group C (control; n = 20) was given 500 mg calcium daily. There was no significant difference in age and steroid doses between groups. Serum calcium (Ca) parathyroid hormone (PTH) osteocalcin (OC) collagen IC-terminal propeptide (CICP) and urinary deoxypyridinoline crosslink excretion (DPD) was measured before glucocorticoid administration and before alphacalcidol or calcium treatment as well as 6 weeks 6 months and 1 2 and 3 years later. Bone miaeral density (BMD) was examined before treatment and 6 months and 1 2 and 3 years later by DEXA and SPA. Forty subjects (A = 20; C = 20) finished the 3 year follow-up. Serum Ca and urinary DPD did not change significantly in either group during the study period. PTH levels increased in both groups significantly after the first 4 weeks of steroid therapy. In group A PTH was reduced to initial level after 6 weeks on alphacalcidol while it remained elevated in group C. OC and CICP decreased significantly (p < 0.001) after 4 weeks on steroid in both groups and increased in group A (OC = 2.32 0.12 3.97 0.17 ng/ml p < 0.001; CICP = 51.2 3.5 75.4 3.1 ng/ml p < 0.001) but not in group C after 6 weeks of treatment and remained unchanged till the end of the third year. ... le

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