Am. J. Respir. Crit. Care Med., Vol 150, No. 2, 08 1994, 394-397.
Therapy of steroid-induced bone loss in adult asthmatics with calcium, vitamin D, and a diphosphonate
H Worth, D Stammen and E Keck
Department of Medicine, MNR-Clinic, Heinrich-Heine-University, Duesseldorf, Germany.
In a prospective, controlled, and randomized clinical trial, we examined
the effects of treatment with vitamin D (1,000 IU/d), calcium (1 g/d), and
ethane-1-hydroxy-1,1-diphosphonate (EHDP; 7.5 mg/kg body weight) on
vertebral bone mass in fourteen asthmatics undergoing long- term treatment
with systemically applied corticosteroids. The extent of steroid-induced
bone loss was judged by vertebral bone density of the lumbar spine measured
by dual-photon absorptiometry as well as by vertebral crush fracture
incidence examined by conventional X-ray. Results of the measurements
before treatment and after six mo were compared with those of an untreated
control group of nineteen asthmatics. Bone density increased during the
observation period by 5% in the treated group, compared with a decrease of
4.3% in the untreated control group (p < 0.01). Moreover, in the treated
group no radiologically visible new fractures occurred; in the control
group new fractures were observed in four patients. There were no serious
side effects of the applied drugs during the 6-mo period. Therefore, the
combination of EHDP, calcium, and vitamin D appears to be a useful regimen
for the management of steroid-induced bone loss in adult asthmatics.
