University of Iowa researchers, et al., report in the July 30 issue of The New England Journal of Medicine that the drug alendronate (marketed as Fosamax) may help prevent and treat steroid-induced osteoporosis.
UI researchers, led by Kenneth Saag, M.D., assistant professor of internal medicine, and investigators from 14 other U.S. and 22 international sites, detail the results of two 48-week studies of 477 men and women ages 17 to 83 receiving 7.5 mg or greater of prednisone (or equivalent) daily. The studies examined the effectiveness of alendronate in preventing and treating osteoporosis among patients undergoing steroid therapy.
"Steroids such as prednisone are often prescribed by doctors for a number of medical conditions, including rheumatoid arthritis, asthma and inflammatory bowel disease," Saag said. "While steroids are effective in treating these diseases, osteoporosis is often an unavoidable, yet serious, long-term side effect."
Patients in the studies received either an oral dose of alendronate (5 mg to 10 mg) or an inactive placebo. All the patients also were given calcium (800 mg to 1000 mg) and vitamin D supplements (250 to 500 IU), which are currently recommended for preventing and treating steroid-induced osteoporosis.
The researchers found that either dose of alendronate, added to calcium and Vitamin D, significantly increased bone mineral density (BMD) -- the most important predictor of fracture risk -- at the spine and hip in men and women taking steroids compared with placebo (calcium and vitamin D). The results were consistent, regardless of the patient's age, gender, underlying disease, dosage or length of time on steroid therapy.
Increase in spine BMD was highest in post-menopausal women not taking estrogen
who received 10 mg of alendronate, the researchers noted. Post-menopausal women
taking steroid treatments are among those at the highest risk for
steroid-induced osteoporosis, due to the combined detrimental effec
Contact: L.E. Ohman
University of Iowa