Five year study of etidronate and/or calcium as prevention and treatment for osteoporosis and fractures in patients with asthma receiving long term oral and/or inhaled glucocorticoids

Iw, Campbell; Douglas, J. G.; Rm, Francis; Rj, Prescott; Reid, D. M.

doi:10.1136/thx.2003.013839

Cited by 52 publications

(24 citation statements)

References 44 publications

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“…The systemic side-effects of long-term oral or parenteral glucocorticosteroid treatment include osteoporosis, arterial hypertension, diabetes, hypothalamic-pituitary-adrenal (HPA) axis suppression, obesity, cataracts, glaucoma, skin thinning leading to cutaneous striae and easy bruising, and muscle weakness. Patients with asthma who are on long-term systemic glucocorticosteroids in any form should receive preventive treatment for osteoporosis [124][125][126]. Caution and close medical supervision are recommended when considering the use of systemic glucocorticosteroids in patients with asthma who also have tuberculosis, parasitic infections, osteoporosis, glaucoma, diabetes, severe depression or peptic ulcers.…”

Section: Systemic Glucocorticosteroidsmentioning

confidence: 99%

Global strategy for asthma management and prevention: GINA executive summary

Bateman

Ss²,

Barnes³

et al. 2007

Eur Respir J

2,666

2,301

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Asthma is a serious health problem throughout the world. During the past two decades, many scientific advances have improved our understanding of asthma and ability to manage and control it effectively. However, recommendations for asthma care need to be adapted to local conditions, resources and services. Since it was formed in 1993, the Global Initiative for Asthma, a network of individuals, organisations and public health officials, has played a leading role in disseminating information about the care of patients with asthma based on a process of continuous review of published scientific investigations. A comprehensive workshop report entitled ''A Global Strategy for Asthma Management and Prevention'', first published in 1995, has been widely adopted, translated and reproduced, and forms the basis for many national guidelines. The 2006 report contains important new themes. First, it asserts that ''it is reasonable to expect that in most patients with asthma, control of the disease can and should be achieved and maintained,'' and recommends a change in approach to asthma management, with asthma control, rather than asthma severity, being the focus of treatment decisions. The importance of the patient-care giver partnership and guided self-management, along with setting goals for treatment, are also emphasised.

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Section: Systemic Glucocorticosteroidsmentioning

confidence: 99%

Global strategy for asthma management and prevention: GINA executive summary

Bateman

Ss²,

Barnes³

et al. 2007

Eur Respir J

2,666

2,301

View full text Add to dashboard Cite

show abstract

“…Glucocorticoid treatment is known to promote secondary osteoporosis (53). Glucocorticoids may serve to prime monocytes/ macrophages toward differentiation into osteoclasts (26,27).…”

Section: Degs Validated Through Real-time Rt-pcr-mentioning

confidence: 99%

A Novel Pathophysiological Mechanism for Osteoporosis Suggested by an in Vivo Gene Expression Study of Circulating Monocytes

Liu

Dvornyk

Lü

et al. 2005

Journal of Biological Chemistry

116

128

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Bone mineral density (BMD) is a major risk factor for osteoporosis. Circulating monocytes may serve as early progenitors of osteoclasts and produce a wide variety of factors important to bone metabolism. However, little is known about the roles of circulating monocytes in relation to the pathophysiology of osteoporosis. Using the Affymetrix HG-U133A GeneChip® array, we performed a comparative gene expression study of circulating monocytes in subjects with high and low BMD. We identified in total 66 differentially expressed genes including some novel as well as some already known to be relevant to bone metabolism. Three genes potentially contributing to bone metabolism, CCR3 (chemokine receptor 3), HDC (histidine decarboxylase, i.e. the histamine synthesis enzyme), and GCR (glucocorticoid receptor), were confirmed by quantitative real-time reverse transcriptase-PCR as up-regulated in subjects with lower BMD. In addition, significant negative correlation was observed between expression levels of the genes and BMD Z-scores. These three genes and/or their products mediate monocyte chemotaxis, histamine production, and/or sensitivity to glucocorticoids. Our results suggest a novel pathophysiological mechanism for osteoporosis that is characterized by increased recruitment of circulating monocyte into bone, enhanced monocyte differentiation into osteoclasts, as well as osteoclast stimulation via monocyte functional changes. This is the first in vivo microarray study of osteoporosis in humans. The results may contribute to identification of new genes and their functions for osteoporosis and suggest genetic markers to discern individuals at higher risk to osteoporosis with an aim for preventive intervention and treatment.

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“…On the other hand, etidronate used as a bisphosphonate reverses the decrease of bone density by inhibiting bone resorption 20,21) . Furthermore, since a high calcium intake raises calcium absorption in the intestine, we considered the combined treatment of high calcium and bisphosphonate for the treatment of secondary osteoporosis in childhood.…”

Section: Discussionmentioning

confidence: 99%

Biomechanical analysis of combined treatment of high calcium and bisphosphonate in tibia of steroid-treated growing-phase rats

Yokote

Kimura

et al. 2008

Dent. Mater. J.

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Childhood systemic diseases are commonly treated with steroids. Consequently, steroid-induced osteoporosis is often observed as a side effect of steroid therapy. However, osteoporosis of tibia resulting from steroid therapy has not been reported yet. Herein we constructed a steroid-induced osteoporosis in tibia of the growing phase rats to examine internal structural changes of the bone and tried to find out the effect of bisphosphonates as a new and early treatment method. Biomechanical analysis was performed using two-dimensional microdensitometry and three-dimensional pQCT method. In addition, the following evaluations were carried out: noninvasive bone strength measurements in steroid-induced osteoporotic rat tibiae; comparing the effectiveness of single high-calcium diet versus combined treatment of high calcium and bisphosphonate for osteoporosis; and quantitative measurement of four elements (Ca, P, Mg, Zn) in bone matrix. Our data suggested that a combined treatment of high calcium and bisphosphonate was an effective new method to improve and treat steroid-induced osteoporosis in childhood.

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Five year study of etidronate and/or calcium as prevention and treatment for osteoporosis and fractures in patients with asthma receiving long term oral and/or inhaled glucocorticoids

Cited by 52 publications

References 44 publications

Global strategy for asthma management and prevention: GINA executive summary

Global strategy for asthma management and prevention: GINA executive summary

A Novel Pathophysiological Mechanism for Osteoporosis Suggested by an in Vivo Gene Expression Study of Circulating Monocytes

Biomechanical analysis of combined treatment of high calcium and bisphosphonate in tibia of steroid-treated growing-phase rats

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