Alendronate increases lumbar spine bone mineral density in patients with Crohn's disease

Haderslev, Kent V.; Tjellesen, Lone; Sørensen, Helle; Staun, Michael

doi:10.1053/gast.2000.16518

Cited by 147 publications

(81 citation statements)

References 36 publications

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“…Alendronate increased spinal BMD at the first assessment (6 months), showing that it promotes rapid increases in BMD. Increases in BMD of the femoral neck were smaller than in spinal BMD, similar to previous bisphosphonate studies in patients with CD 12 or other diseases 26,27 that have shown a strong improvement in BMD at the lumbar spine but mild at the femoral neck. These data indicate that the structural and mechanical properties of the lumbar spine are more sensitive to alendronate than that of the femoral neck.…”

Section: Discussionsupporting

confidence: 88%

See 1 more Smart Citation

Clinical trial: comparison of alendronate and alfacalcidol in glucocorticoid‐associated osteoporosis in patients with ulcerative colitis

Kitazaki

Mitsuyama

Masuda

et al. 2009

Aliment Pharmacol Ther

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Section: Discussionsupporting

confidence: 88%

“…[9][10][11] Trials limited to patients with CD have examined bisphosphonate therapy. 12,13 Bisphosphonate was effective for the treatment of osteoporosis in 29 patients with CD and 19 with UC in a double-blind, placebo-controlled trial.…”

Section: Introductionmentioning

confidence: 99%

Clinical trial: comparison of alendronate and alfacalcidol in glucocorticoid‐associated osteoporosis in patients with ulcerative colitis

Kitazaki

Mitsuyama

Masuda

et al. 2009

Aliment Pharmacol Ther

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“…Otherwise, these effects were only seen in high dosage of alendronate (40 mg/day intravenously and over 90 consecutive days) (41). In IBD, pamidronate, alendronate, and risedronate were effective in increasing BMD compared to placebo (42)(43)(44)(45). The Cystic Fibrosis Foundation Bone Health Consensus Committee recommends the use of bisphosphonates in adults if BMD Z-score is lower than -2.0, or if it is lower than -1.0 with history of fragility fractures, if they are awaiting lung transplant or experience BMD loss greater than 3%-5%/year (36).…”

Section: Bisphosphonatesmentioning

confidence: 99%

Osteoporosis and inflammation

Lacativa

Farias

2010

Arq Bras Endocrinol Metab

196

138

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SUMMARYSeveral inflammatory diseases such as rheumatoid arthritis, systemic lupus erythematosus, inflammatory bowel disease, celiac disease, cystic fibrosis and chronic obstructive pulmonary disease have been associated to bone resorption. The link between osteoclast, macrophage colony stimulating factor and pro-inflammatory cytokines, especially tumor necrosis factor-α and interleukin-1 explain the association between inflammation and osteoporosis. These diseases are related to osteoporosis and high fracture risk independent of other risk factors common to inflammatory diseases such as reduced physical activity, poor nutritional status, hypovitaminosis D, decrease in calcium intake and glucocorticoid treatment. Erythrocyte sedimentation rate and C-reactive protein should always be performed, but the indication about when to perform the densitometry test should be analyzed for each disease. Bisphosphonates are nowadays the best choice of therapy but new medications such as denosumab, IL-1 receptor antagonist, and TNF-α antibody have risen as new potential treatments for osteoporosis secondary to inflammation. Arq Bras Endocrinol Metab. 2010;54(2):123-32 Keywords Osteoporosis; inflammation; arthritis, rheumatoid; lupus erythematosus, systemic; interleukin-1; tumor necrosis factor-alpha SUMÁRIO Diversas doenças inflamatórias têm sido associadas à reabsorção óssea, como a artrite reumatoide, o lúpus eritematoso sistêmico, a doença inflamatória intestinal, a doença celíaca, a fibrose cística e a doença pulmonar obstrutiva crônica. A ligação entre osteoclastos, fator estimulador de colônia de macrófagos e citocinas pró-inflamatórias, principalmente o fator de necrose tumoral-α e interleucina-1, explica a associação entre a inflamação e a osteoporose. Essas doenças estão relacionadas com osteoporose e aumento do risco de fratura, independentemente de outros fatores de risco comuns às doenças inflamatórias, tais como redução da atividade física, estado nutricional, hipovitaminose D, diminuição da ingestão de cálcio e uso de glicocorticoides. A velocidade de hemossedimentação e proteína C-reativa devem ser sempre realizadas, mas a indicação do exame de densitometria óssea deve ser analisada em cada doen ça. Os bisfosfonatos são atualmente a melhor opção de terapia, mas novos medicamentos, tais como denosumabe, antagonista do receptor de IL-1 e anticorpos anti-TNF-α, surgem como novos potenciais tratamentos para a osteoporose secundária à inflamação. Arq Bras Endocrinol Metab. 2010;54(2):123-32 Descritores Osteoporose; inflamação; artrite reumatoide; lúpus eritematoso sistêmico; interleucina-1; fator de necrose tumoral-alfa

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“…To date, there has only been one published randomized controlled trial of oral bisphosphonates in patients with Crohn's disease. 18 As far as we are aware, this is the first randomized controlled trial of intravenous bisphosphonates in patients with Crohn's disease and low BMD.…”

Section: Introductionmentioning

confidence: 97%

A randomized controlled trial of calcium with vitamin D, alone or in combination with intravenous pamidronate, for the treatment of low bone mineral density associated with Crohn's disease

Bartram

Peaston

Rawlings

et al. 2003

Aliment Pharmacol Ther

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SummaryBackground : Osteoporosis is a common complication of Crohn's disease.Aim : To study the effect on the bone mineral density of a bisphosphonate (pamidronate) given intravenously, in combination with oral calcium and vitamin D supplements, compared with oral calcium and vitamin D supplements alone.Methods : Seventy‐four patients with Crohn's disease and low bone mineral density at the lumbar spine and/or hip were randomized to receive either a daily dose of 500 mg of calcium with 400 IU of vitamin D alone or in combination with four three‐monthly infusions of 30 mg of intravenous pamidronate over the course of 12 months. The main outcome measure was the change in bone mineral density at the lumbar spine and hip, measured by dual X‐ray absorptiometry, at baseline and 12 months.Results : Both groups gained bone mineral density at the lumbar spine and hip after 12 months. There were significant (P < 0.05) changes in the pamidronate group, with gains of + 2.6%[95% confidence interval (CI), 1.4–3.0] at the spine and + 1.6% (95% CI, 0.6–2.5) at the hip, compared with gains of + 1.6% (95% CI, − 0.1–3.2) and + 0.9% (95% CI, − 0.4–2.1) at the spine and hip, respectively, in the group taking vitamin D and calcium supplements alone.Conclusions : In patients with Crohn's disease and low bone mineral density, intravenous pamidronate significantly increases the bone mineral density at the lumbar spine and hip.

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Alendronate increases lumbar spine bone mineral density in patients with Crohn's disease

Cited by 147 publications

References 36 publications

Clinical trial: comparison of alendronate and alfacalcidol in glucocorticoid‐associated osteoporosis in patients with ulcerative colitis

Clinical trial: comparison of alendronate and alfacalcidol in glucocorticoid‐associated osteoporosis in patients with ulcerative colitis

Osteoporosis and inflammation

A randomized controlled trial of calcium with vitamin D, alone or in combination with intravenous pamidronate, for the treatment of low bone mineral density associated with Crohn's disease

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