Cyclical etidronate increases bone density in the spine and hip of postmenopausal women receiving long term corticosteroid treatment. A double blind, randomised placebo controlled study

doi:10.1136/ard.57.12.724

Annals of the Rheumatic Diseases 1998;57:724-727; doi:10.1136/ard.57.12.724

Ann Rheum Dis 1998;57:724-727 ( December )

Extended reports

Cyclical etidronate increases bone density in the spine and hip of postmenopausal women receiving long term corticosteroid treatment. A double blind, randomised placebo controlled study Piet Geusens,^a^b^c Jan Dequeker,^d Johan Vanhoof,^a Rita Stalmans,^a Steven Boonen,^e Jo Joly,^d Jos Nijs,^d Jef Raus^a^b

^a L Willems-Instituut, Diepenbeek, Belgium, ^b Limburgs Universitair Centrum, Diepenbeek, Belgium, ^c Department of Rheumatology, Akademisch Ziekenhuis Maastricht, the Netherlands, ^d Arthritis and Metabolic Bone Disease Research Unit, K U Leuven, Belgium, ^e Department of Geriatric Medicine, K U Leuven, Belgium

Correspondence to: Professor P Geusens, Dr L Willems-Intituut, Limburgs Universitair Centrum, B-3590 Diepenbeek, Belgium.

Accepted for publication 3 September 1998

OBJECTIVE $---$ To study the effect of cyclic etidronate in secondary prevention of corticosteroid inducedosteoporosis.
METHODS $---$ A double blind, randomised placebo controlled study comparing cyclic etidronate and placebo during two years in 37 postmenopausalwomen receiving long term corticosteroid treatment, mainly forpolymyalgia rheumatica (40% of the patients) and rheumatoid arthritis(30%). Bone density was measured in the lumbar spine, femoralneck, and femoraltrochanter.
RESULTS $---$ After two years of treatment there was a significant difference between the groups in mean per cent change from baseline inbone density in the spine in favour of etidronate (p=0.003). Theestimated treatment difference (mean (SD)) was 9.3 (2.1)%. Etidronateincreased bone density in the spine (4.9 (2.1)%, p<0.05) whereasthe placebo group lost bone ( $-$ 2.4 (1.6)%). At the femoral neckthere was an estimated difference of 5.3 (2.6)% between the groups(etidronate: 3.6 (1.4)%, p<0.05, placebo: $-$ 2.4 (2.1)%). The estimateddifference at the trochanter was 8.2 (3.0) (etidronate: 9.0 (1.5)%,p<0.0001, placebo: 0.5 (2.3)%). No significant bone loss occurredin the hip in placebo treatedpatients.
CONCLUSIONS $---$ Cyclic etidronate is an effective treatment for postmenopausal women receiving corticosteroid treatment and is welltolerated.

Keywords: etidronate; calcium; bone density; corticosteroid induced osteoporosis

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