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OBJECTIVE—To study the effect of cyclic etidronate in secondary prevention of corticosteroid induced osteoporosis.
METHODS—A double blind, randomised placebo controlled study comparing cyclic etidronate and placebo during two years in 37 postmenopausal women receiving long term corticosteroid treatment, mainly for polymyalgia rheumatica (40% of the patients) and rheumatoid arthritis (30%). Bone density was measured in the lumbar spine, femoral neck, and femoral trochanter.
RESULTS—After two years of treatment there was a significant difference between the groups in mean per cent change from baseline in bone density in the spine in favour of etidronate (p=0.003). The estimated treatment difference (mean (SD)) was 9.3 (2.1)%. Etidronate increased bone density in the spine (4.9 (2.1)%, p<0.05) whereas the placebo group lost bone (−2.4 (1.6)%). At the femoral neck there was an estimated difference of 5.3 (2.6)% between the groups (etidronate: 3.6 (1.4)%, p<0.05, placebo: −2.4 (2.1)%). The estimated difference at the trochanter was 8.2 (3.0) (etidronate: 9.0 (1.5)%, p<0.0001, placebo: 0.5 (2.3)%). No significant bone loss occurred in the hip in placebo treated patients.
CONCLUSIONS—Cyclic etidronate is an effective treatment for postmenopausal women receiving corticosteroid treatment and is well tolerated.
Keywords: etidronate; calcium; bone density; corticosteroid induced osteoporosis