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Ann Rheum Dis 1998;57:724-727 doi:10.1136/ard.57.12.724
  • 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

  1. Piet Geusensa,b,c,
  2. Jan Dequekerd,
  3. Johan Vanhoofa,
  4. Rita Stalmansa,
  5. Steven Boonene,
  6. Jo Jolyd,
  7. Jos Nijsd,
  8. Jef Rausa,b
  1. aL Willems-Instituut, Diepenbeek, Belgium, bLimburgs Universitair Centrum, Diepenbeek, Belgium, cDepartment of Rheumatology, Akademisch Ziekenhuis Maastricht, the Netherlands, dArthritis and Metabolic Bone Disease Research Unit, K U Leuven, Belgium, eDepartment of Geriatric Medicine, K U Leuven, Belgium
  1. Professor P Geusens, Dr L Willems-Intituut, Limburgs Universitair Centrum, B-3590 Diepenbeek, Belgium.
  • Accepted 3 September 1998

Abstract

OBJECTIVE To study the effect of cyclic etidronate in secondary prevention of corticosteroid induced osteoporosis.

METHODS A double blind, randomised placebo controlled study comparing cyclic etidronate and placebo during two years in 37 postmenopausal women receiving long term corticosteroid treatment, mainly for polymyalgia rheumatica (40% of the patients) and rheumatoid arthritis (30%). Bone density was measured in the lumbar spine, femoral neck, and femoral trochanter.

RESULTS After two years of treatment there was a significant difference between the groups in mean per cent change from baseline in bone density in the spine in favour of etidronate (p=0.003). The estimated treatment difference (mean (SD)) was 9.3 (2.1)%. Etidronate increased bone density in the spine (4.9 (2.1)%, p<0.05) whereas the placebo group lost bone (−2.4 (1.6)%). At the femoral neck there 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 estimated difference 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 occurred in the hip in placebo treated patients.

CONCLUSIONS Cyclic etidronate is an effective treatment for postmenopausal women receiving corticosteroid treatment and is well tolerated.

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