The reversibility of exogenous corticosteroid-induced osteoporosis

Rizzato, G; Montemurro, L

doi:10.1016/0169-6009(92)91903-v

Cited by 32 publications

(35 citation statements)

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“…Glucocorticoid-induced osteoporosis is known to be reversible. 27,28 However, nothing is known about the reversibility of CsA-induced osteoporosis. Thus, the more severe bone loss in the group treated for a long period of time (corticosteroids or CsA), observed by Kananen et al, 14 may have been due to the negative influence of CsA.…”

Section: Discussionmentioning

confidence: 99%

Bone metabolism in patients more than five years after bone marrow transplantation

Kerschan‐Schindl

Mitterbauer

Füreder

et al. 2004

Bone Marrow Transplant

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Summary:We investigated the bone metabolism of 22 patients (median age 38 years) over 6 years after allogeneic bone marrow transplantation (BMT). Biplanar roentgenograms of the thoracic and lumbar spine were used to diagnose vertebral deformities caused by fractures. The actual bone mineral density (BMD) of the lumbar spine and the femoral neck were measured. Laboratory tests included calcium, phosphate, parathyroid hormone, a marker of bone resorption (beta-crosslaps, CTX), markers of bone formation (osteocalcin, bone-specific alkaline phosphatase), osteoprotegerin (OPG) -an antagonist of the osteoclast differentiation factor RANKL, and sex hormone status. One patient had a vertebral fracture. Seven patients (28%) had osteopenia in the lumbar spine while 12 patients (48%) had osteopenia in the femoral neck. Bone resorption was increased in nine patients (43%) and bone formation was increased in four patients (20%). BMT recipients had significantly increased serum levels of OPG (P ¼ 0.029). Three women (75%) and four men (25%) were hypogonadal. The data showed that BMD is reduced and bone metabolism is still disturbed more than 6 years after BMT. The RANKL/osteoprotegerin system appears to play an important role in the pathophysiology of late post transplantation osteoporosis.

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Section: Discussionmentioning

confidence: 99%

Bone metabolism in patients more than five years after bone marrow transplantation

Kerschan‐Schindl

Mitterbauer

Füreder

et al. 2004

Bone Marrow Transplant

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“…Bone loss induced by corticosteroid therapy is only partly reversible, as observations after successful treatment of Cushing's disease [97] or after discontinuing corticosteroid treatment [48,117] show.…”

Section: Characteristics Of Gc-induced Bone Lossmentioning

confidence: 99%

Glucocorticosteroid-induced spinal osteoporosis: scientific update on pathophysiology and treatment

et al. 2006

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“…As expected, these patients showed very little bone loss, and in fact, had gains in their spine BMD (mean Ϯ SEM 2.3 Ϯ 1.2%) and total hip BMD (1.2 Ϯ 0.7%) (P not statistically significant). This could be due to the recovery of bone formation after GCs were tapered or discontinued (17)(18)(19), and could be due to the continuation of ALN therapy after the first year.…”

Section: Changes In Bmd Gc Users (ͼ6 Mg/day)mentioning

confidence: 99%

Changes in bone mineral density following discontinuation or continuation of alendronate therapy in glucocorticoid‐treated patients: A retrospective, observational study

Emkey¹,

Delmas²,

Goemaere³

et al. 2003

Arthritis & Rheumatism

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Objective. To evaluate the effects of discontinuing or continuing alendronate (ALN) therapy on bone mineral density (BMD) after patients on a long-term regimen of glucocorticoids (GCs) completed a 1-year treatment period with ALN.Methods. Eligible patients were individuals with GC-induced osteoporosis who had received ALN (5 or 10 mg) for 1 year in a prior clinical trial and, at the end of the year, were still taking GCs at an average daily dose of >7.5 mg of prednisone or equivalent. Patients were contacted 3-5 years after completion of the prior ALN trial for followup measurements of the lumbar spine BMD and hip BMD, and retrospective information was collected about serious or drug-related adverse experiences and concomitant medication use. Some patients remained on GCs, and some remained on ALN, either alone or in combination with other drugs. The primary response parameter was the percentage change in lumbar spine BMD from the end of year 1 to the followup visit. Change in BMD at the hip was a secondary response parameter.Results. Ninety (49.2%) of the eligible 183 patients participated in the retrospective study. The followup period, which began at the end of year 1 of the original clinical trial, ranged from 3.3 years to 4.6 years. The mean number of days of treatment with ALN was 507. Fifty patients were included in the analysis because they had received supraphysiologic doses of GCs (doses above the lowest tertile of GC use for the study population; that is, higher than ϳ6 mg/day), and they had not taken (defined as <6 months of use) other boneaffecting agents except ALN. Eleven of the 50 patients discontinued taking ALN (duration of use <90 days), 8 took ALN between 90 days and 300 days, and 31 continued to take ALN for >300 days after year 1 of the clinical trial. GC users who discontinued treatment with ALN (<90 days of therapy) had numerically greater decreases in BMD at the lumbar spine, femoral neck, and total hip from the end of year 1 (mean change ؊5.1%, ؊9.2%, and ؊6.6%, respectively), compared with patients who continued to take ALN for >300 days (mean change 0.1%, ؊0.9%, and 1.8%, respectively). Conclusion. Substantial loss of BMD in the lumbar spine and hip was seen in patients who discontinued treatment with ALN but who continued to take >6 mg/day of GCs. However, patients receiving GCs who remained on the ALN regimen appeared to benefit from continued ALN treatment, since BMD was maintained in this latter group.Glucocorticoid (GC)-induced osteoporosis (GIOP) is the most common form of iatrogenic osteoporosis (1,2). It is the most debilitating side effect of GC treatment because of osteoporosis-associated fractures (especially those at the vertebrae, hip, and rib), which

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The reversibility of exogenous corticosteroid-induced osteoporosis

Cited by 32 publications

References 0 publications

Bone metabolism in patients more than five years after bone marrow transplantation

Bone metabolism in patients more than five years after bone marrow transplantation

Glucocorticosteroid-induced spinal osteoporosis: scientific update on pathophysiology and treatment

Changes in bone mineral density following discontinuation or continuation of alendronate therapy in glucocorticoid‐treated patients: A retrospective, observational study

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