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Corticosteroid-induced bone loss. A longitudinal study of alternate day therapy in patients with bronchial asthma using quantitative computed tomography

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Summary

Treatment with corticosteroids can produce osteoporosis. It is generally held that bone loss occurs when steroids are administered daily, but recent findings indicate that bone may also be lost on alternate day therapy. Cortical and trabecular bone, which may be affected differently, can be assessed independently, by quantitative computed tomography. This technique has been applied to the appendicular skeleton in following 20 patients with bronchial asthma during one year of chronic alternate day corticosteroid therapy. The trabecular bone loss was considerable; prednisone 25 mg on alternate days caused an average reduction in trabecular bone of 3.5% over one year. Bone loss was dose- and agedependent. Young patients on 50 mg/2 days lost up to 17% trabecular bone in one year. Cortical bone was not significantly affected over the same period.

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References

  1. Fauci A (1978) Alternate-day corticosteroid therapy. Am J Med 64: 729–731

    Google Scholar 

  2. Sheagren J, Jowsey J, Bird D et al. (1977) Effect on bone growth of daily versus alternate-day corticosteroid administration. J Lab Clin Med 89: 120–130

    Google Scholar 

  3. Gluck O, Murphy W, Hahn T et al. (1981) Bone loss in adults receiving alternate day glucocorticoid therapy. Arthritis Rheum 24: 892–898

    Google Scholar 

  4. Chesney R, Mazess R, Rose P et al. (1978) Effect of prednisone on growth and bone mineral content in childhood glomerular disease. Am J Dis Child 132: 768–772

    Google Scholar 

  5. Rüegsegger P, Anliker M, Dambacher M (1981) Quantification of trabecular bone with low dose computed tomography. J Comput Assist Tomogr 5: 384–390

    Google Scholar 

  6. Rüegsegger P, Stebler B, Dambacher M (1982) Quantitative computed tomography of bone. Mayo Clin Proc 57 [Suppl]: 96–103

    Google Scholar 

  7. Saville PD, Kharmosh O (1967) Osteoporosis of rheumatoid arthritis: Influence of age, sex and corticosteroids. Arthritis Rheum 10: 423–430

    Google Scholar 

  8. Bradley BWD, Ansell BM (1960) Fractures in Still's disease. Ann Rheum Dis 19: 135–142

    Google Scholar 

  9. Courpron P (1981) Bone tissue mechanisms underlying osteoporoses. Orthop Clin North Am 12: 541

    Google Scholar 

  10. Ringe J (1982) Die klinische Bedeutung der direkten Messung des Knochenmineralgehaltes, Urban und Schwarzenberg, Wien München Baltimore

    Google Scholar 

  11. Rüegsegger P, Dambacher MA, Rüegsegger E, Fischer JA, Anliker M (1983) Bone loss in pre- and postmenopausal women — A cross sectional and longitudinal study using quantitative computed tomogrphy. J Bone Joint Surg (in press)

  12. Olah AJ, Rüegsegger P, Dambacher MA (1983) Comparison of histomorphometry and computed tomography in quantitative trabecular bone. Proceedings of the Symposium on Clinical Disorders of Bone and Mineral Metabolism. Excerpta Medica (in press)

  13. Bressot C, Meunier P, Chapuy M et al. (1979) Histomorphometric profile, pathophysiology and reversibility of corticosteroid-induced osteoporosis. Metab Bone Dis Rel Res 1: 303–311

    Google Scholar 

  14. Jowsey J, Riggs B (1970) Bone formation in hypercortisonism. Acta Endocrinol 63: 21–28

    Google Scholar 

  15. Jee W, Clark I (1981) Glucocorticoid-induced osteoporosis. In: DeLuca HF et al. (eds) Oteoporosis, recent advances in pathogenesis and treatment. University Park Press, Baltimore, pp 331–342

    Google Scholar 

  16. Frost H (1979) Treatment of osteoporoses by manipulation of coherent bone cell populations. Clin Orthop Rel Res 143: 227–244

    Google Scholar 

  17. Ortega E, Rodriguez C, Strand L et al. (1976) Metabolic effects of cloprednol. A new systemic corticosteroid. J Clin Pharmacol 16: 122–129

    Google Scholar 

  18. Krokowski E (1977) Empfehlungen zur individuellen Natriumfluoriddosierung für die Osteoporosetherapie. Krankenhausarzt 50: 235–243

    Google Scholar 

  19. Mueller MN (1976) Effects of corticosteroids on bone mineral in rheumatoid arthritis and asthma. Am J Roentgenol 126: 1300

    Google Scholar 

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Authors and Affiliations

  1. Institute for Biomedical Engineering, University of Zürich and Federal Institute of Technology, Zürich, Switzerland

    P. Rüegsegger, T. C. Medici & M. Anliker

  2. Department of Internal Medicine, University Hospital, Zürich, Switzerland

    P. Rüegsegger, T. C. Medici & M. Anliker

Authors
  1. P. Rüegsegger
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  2. T. C. Medici
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  3. M. Anliker
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Rüegsegger, P., Medici, T.C. & Anliker, M. Corticosteroid-induced bone loss. A longitudinal study of alternate day therapy in patients with bronchial asthma using quantitative computed tomography. Eur J Clin Pharmacol 25, 615–620 (1983). https://doi.org/10.1007/BF00542348

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  • DOI: https://doi.org/10.1007/BF00542348

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