Alendronate or Alfacalcidol in Glucocorticoid-Induced Osteoporosis | NEJM

glucocorticoid induced osteoporosis nejm

Discrepancies in pediatric bone mineral density reference data: This uncoupling of the components of bone turnover may have severe consequences in the growing skeleton. Use of oral corticosteroids and risk of fractures. Although osteoporosis may occur with chronic inflammatory diseases, glucocorticoid exposure further increases this risk. Prevalence and treatment of decreased bone density in renal transplant recipients: Patients were excluded if they had fewer than three lumbar vertebrae that could be evaluated on dual energy x-ray absorptiometry, abnormal laboratory values, unresolved skeletal diseases other than glucocorticoid-induced osteoporosis, a history of cancer within 5 years before screening with the exception of superficial basal-cell or squamous-cell carcinomas of the skin that had been definitively treated , an increased risk of osteosarcoma, gastrointestinal disorders that would be likely to reduce tolerance of oral alendronate, or substantial renal impairment on the basis of the Cockcroft—Gault formula. Recovery from osteoporosis through skeletal growth:

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Res Exp Med Berl ; Glucocorticoid-induced increases in body-mass index were associated with increased whole-body bone mineral content and maintenance test prop tren ace cycle the bone mineral content glucocorticoid induced osteoporosis nejm the spine. Bone density threshold and other predictors of vertebral fracture in patients receiving oral glucocorticoid therapy. Eighty-three patients from countries other than the United States were randomly assigned to receive 2. Written informed consent was obtained from the parents glucocotticoid guardians glucocorticoid induced osteoporosis nejm all subjects. Conclusions During this month inxuced in patients with rheumatic diseases, alendronate was more effective in the prevention of glucocorticoid-induced bone loss than was alfacalcidol.

Adverse Effects Table 4. The failure to consider these issues may result in the glucocorticoid induced osteoporosis nejm treatment of children with bone-active therapies or inappropriate gpucocorticoid in treatment trials. You can follow any responses to this entry through the RSS 2. Statistical Analysis Two-sided tests of hypotheses were used, and a P value of less than glucocorticoid induced osteoporosis nejm. In contrast to side effects of depo testosterone injection conditions requiring long-term glucocorticoid therapy in childhood, glucocorticoid-sensitive nephrotic syndrome remits completely and quickly in response to glucocorticoids. We tested for the presence of a treatment effect on the incidence of vertebral fractures using Fisher's exact test after combining the alendronate groups. Ambulatory patients were eligible for enrollment if they met the following criteria:

Iamges: glucocorticoid induced osteoporosis nejm

glucocorticoid induced osteoporosis nejm

Sixty-one percent of their subjects were given a diagnosis of osteopenia areal bone mineral density z score, less than —1 , and 22 percent received a diagnosis of osteoporosis z score, less than —2. Ponce Medical School, Ponce — E. In this active-comparator trial, the anabolic agent teriparatide appeared to show significant skeletal benefits in patients with glucocorticoid-induced osteoporosis, as compared with the bisphosphonate alendronate. Radiographic Analysis Radiography of the lateral lumbar and thoracic spine was performed at baseline and at 18 months and at any time during the study in patients with new back pain. We believe that with the use of alendronate, adequate supplementation with calcium and vitamin D 3 is required. No other potential conflict of interest relevant to this article was reported.

glucocorticoid induced osteoporosis nejm

Clin Nephrol ; Effect of deflazacort versus methylprednisone on growth, body composition, lipid profile, and bone mass after renal transplantation. Prevention and treatment of glucocorticoid-induced osteoporosis with active vitamin D 3 analogues: Two-year effects of alendronate on bone mineral density and vertebral fracture in patients receiving glucocorticoids: Biom J ; Jergas M, San Valentin R.

glucocorticoid induced osteoporosis nejm

Study Design During our month, double-blind, double-placebo—controlled study, we enjm patients of all racial and ethnic groups between the ages of 18 and 90 years who had a rheumatic disease and either were starting glucocorticoid therapy or had begun glucocorticoid glucocorticoid induced osteoporosis nejm within the previous 12 weeks at a daily dose of at least 7. Calcif Tissue Cortisone injections for acne safe during pregnancy ; Babb questions the recommendation to use teriparatide, given the lower cost and greater convenience of alendronate. Among the patients in the alendronate groups there were no significant differences in these changes in biochemical glucocorticoid induced osteoporosis nejm of bone turnover according to sex, menopausal status, or estrogen therapy. Macfarlane; Isala Hospital, Zwolle — S. Methods We performed dual-energy x-ray absorptiometry of the whole body and spine in 60 children and adolescents with the nephrotic syndrome and control subjects. None of our patients had sustained a low-impact fracture.