Prevention and treatment of glucocorticoid-induced osteoporosis with active vitamin D3 analogues: a review with meta-analysis of randomized controlled trials including organ transplantation studies

Nijs, R. N. J. de; Jacobs, Johannes W G; Algra, Ale; Lems, Willem F.; Bijlsma, J. W. J.

doi:10.1007/s00198-004-1614-5

Cited by 113 publications

(50 citation statements)

References 96 publications

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“…On the other hand, a pooled data analysis also revealed the efficacy of active vitamin D in reducing the incidence of vertebral fractures in patients with GC-induced osteoporosis ( 6 ). A metaanalysis revealed that bisphosphonates were the most efficacious agents for improving lumbar BMD ( 7 ).…”

mentioning

confidence: 99%

Comparative Effects of Risedronate and Calcitriol on Cancellous Bone in Rats with Glucocorticoid-Induced Osteopenia

Iwamoto

Seki

Takeda

et al. 2006

J Nutr Sci Vitaminol

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Summary Objectives: To compared the effects of risedronate (Ris) and calcitriol (Cal) on cancellous bone in rats with glucocorticoid (GC)-induced osteopenia. Materials and Methods: Thirty female Sprague-Dawley rats, 4 mo of age, were randomly divided by the stratified weight method into three groups of 10 rats each according to the following treatment schedule: 8-wk GC administration with 4-wk vehicle (control), Ris, and Cal as therapeutic treatment initiated after 4-wk GC administration. The GC (methylprednisolone sodium succinate, 5.0 mg/kg, s.c.), Ris (10 g/kg, s.c.), and Cal (0.1 g/kg, p.o.) were administered 3 times a week. At the end of the 8-wk treatment period, two-dimensional (2D) bone histomorphometric analysis was performed for cancellous bone of the proximal tibial metaphysis, 3D micro-computed tomographic analysis was performed for the distal femoral metaphysis, and the mechanical strength of the distal femoral metaphysis was evaluated by a compression test. Results: Ris and Cal treatment increased both 2D and 3D cancellous bone mass. However, Ris treatment exhibited more pronounced effects on 2D and 3D cancellous bone mass than Cal treatment, and the effects of both Ris and Cal treatment were greater on 3D cancellous bone mass than on 2D cancellous bone mass. The response of 2D and 3D cancellous bone mass to Ris treatment was characterized by its effect on trabecular number and thickness, which was associated with markedly suppressed bone resorption and bone formation in terms of suppressed bone turnover. On the other hand, the response of 2D cancellous bone mass to Cal treatment was attributed to the effect of Cal on 2D trabecular thickness, and the response of 3D cancellous bone mass to Cal treatment might be characterized by the effect of Cal on 3D trabecular number and thickness, with a more marked effect of trabecular thickness. These effects were primarily due to mildly suppressed bone resorption and maintained or even increased bone formation. Despite the differential effect of Ris and Cal treatment on the cancellous bone structure and bone metabolism, both treatment increased the maximum load and braking energy of the distal femoral metaphysis to a similar extent, suggesting different mechanisms for improving bone strength. Conclusions: This study showed the differential effects of Ris and Cal on cancellous bone in rats with GC-induced osteopenia.

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confidence: 99%

Comparative Effects of Risedronate and Calcitriol on Cancellous Bone in Rats with Glucocorticoid-Induced Osteopenia

Iwamoto

Seki

Takeda

et al. 2006

J Nutr Sci Vitaminol

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“…В то же время в американских рекомендациях вообще не рассмат-ривается вопрос о назначении активных метаболитов вита-мина D, которые способны повышать МПК как в пояс-ничном отделе позвоночника, так и в проксимальном от-деле бедра у пациентов, принимающих ГК. При сравнении эффективности альфакальцидола и алендроната было про-демонстрировано преимущество последнего, но прекра-щение лечения и тем, и другим препаратом приводило к возникновению новых переломов позвонков у 24% паци-ентов в течение последующих в среднем примерно 3 лет наблюдения [31,32]. В связи с этим активные метаболиты витамина D рекомендованы Российской ассоциацией по остеопорозу для использования у пациентов с ГК-ОП в ка-честве препаратов «второй линии» [27,28].…”

Section: таблицаunclassified

Review of American College of Rheumatology (Acr) Clinical Guidelines for the Prevention and Treatment of Glucocorticoid-Induced Osteoporosis

Торопцова¹

2018

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“…Analyzing the subgroups of analogues, alfacalcidol prevented fractures and calcitriol showed only a tendency towards a protective effect (B). 18 The direct comparison of alfacalcidol and non-active vitamin D showed that the active form was signifi cantly more effective regarding bone mass gain and spinal fracture risk reduction, because alfacalcidol determines a signifi cant 61% reduction in vertebral fractures and a 52% reduction in all vertebral and combined fractures, as compared with the vitamin D group (B). 19 Alfacalcidol at the dose of 0.25-1.0 µg/day can prevent bone mass reduction, providing, in addition, a protective effect on vertebral fracture.…”

Section: Recommendationmentioning

confidence: 99%

“…Zoledronic acid is a bisphosphonate, which, when administered through annual intravenous infusion, increases BMD and reduces the incidence of fractures in postmenopausal women after the fi rst year of treatment, with NNT = 18 (95% CI; [15][16][17][18][19][20][21][22] for vertebral fractures and NNT = 100 (95% CI; 63-245) for hip fractures (A). 51 That medication, when administered within 90 days after repair surgery for low-impact traumatic hip fracture, reduces mortality in patients ≥ 50 years (NNT = 26; 95% CI; 15-92), and also reduces the risk of new fractures (NNT = 22; 95% CI; 14-54) (A).…”

Section: Can Zoledronic Acid Be Used To Prevent and Treat Gio?mentioning

confidence: 99%

“…Hormonal defi ciencies should be identifi ed and fi xed, especially in women with amenorrhea (D). 61 However, that population should be carefully considered due to the chance of pregnancy, because those medicaments can cross the placenta and affect the fetus, and, in addition, the effects of their prolonged use have not been well established in that population (see question 18).…”

Section: Which Variables Indicate Prevention/treatment Of Gio In Premmentioning

confidence: 99%

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Diretrizes para prevenção e tratamento da osteoporose induzida por glicocorticoide

Pereira¹,

Carvalho²,

Paula³

et al. 2012

Rev. Bras. Reumatol.

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Glucocorticoids (GC) are used in almost all medical specialties, and approximately 0.5% of the general population of the United Kingdom receives those medications. With the increased survival of patients with rheumatological diseases, morbidity secondary to the use of those medications represents an important aspect of the management of our patients. The incidences of vertebral and non-vertebral fractures are elevated, ranging from 30% to 50% of the individuals on GC for over three months. Thus, osteoporosis and frailty fractures should be prevented and treated in all patients initiating or already on GC. There are several recommendations on this topic elaborated by several international societies, but consensus still lacks. Recently, the American College of Rheumatology has published new recommendations, but they are based on the WHO Fracture Risk Assessment Tool (FRAX®) to evaluate the risk for each individual, and, thus, cannot be completely used for the Brazilian population. Thus, the Committee for Osteoporosis and Bone Metabolic Disorders of the Brazilian Society of Rheumatology, along with the Brazilian Medical Association and the Brazilian Association of Physical Medicine and Rehabilitation, has elaborated the Brazilian Guidelines for Glucocorticoid-Induced Osteoporosis (GIO), based on the better available scientifi c evidence and/or expert experience. Method of evidence collection: The bibliographic review of scientifi c articles of this guideline was performed in the MEDLINE database. The search for evidence was based on real clinical scenarios, and used the following keywords (MeSH Osteoporosis/prevention & control, Calcium, Vitamin D, Vitamin D defi ciency, Calcitriol, Receptors, Calcitriol; Hydroxycholecalciferols, Prevention and Control, Spinal fractures/prevention & control, Fractures, Spontaneous, Lumbar Vertebrae/injuries, Lifestyle, Alcohol Drinking, Smoking OR tobacco use disorder, Movement, Resistance Training, Exercise Therapy, Bone density OR Bone and Bones, Densitometry, Radiography, (Diphosphonates Alendronate OR Risedronate Pamidronate OR propanolamines OR Ibandronate OR Zoledronic acid, Men AND premenopause, pregnancy, pregnancy outcome maternal, fetus, lactation, teratogens,, adolescence (13-18 years). Grade of recommendation and level of evidence: A) Data derived from more consistent experimental and observational studies; B) Data derived from less consistent experimental and observational studies; C) Case reports (uncontrolled studies); D) Expert opinion without explicit critical appraisal, or based on consensus, physiological studies or animal models. Objective: To establish guidelines for the prevention and treatment of GIO.

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Prevention and treatment of glucocorticoid-induced osteoporosis with active vitamin D3 analogues: a review with meta-analysis of randomized controlled trials including organ transplantation studies

Cited by 113 publications

References 96 publications

Comparative Effects of Risedronate and Calcitriol on Cancellous Bone in Rats with Glucocorticoid-Induced Osteopenia

Comparative Effects of Risedronate and Calcitriol on Cancellous Bone in Rats with Glucocorticoid-Induced Osteopenia

Review of American College of Rheumatology (Acr) Clinical Guidelines for the Prevention and Treatment of Glucocorticoid-Induced Osteoporosis

Diretrizes para prevenção e tratamento da osteoporose induzida por glicocorticoide

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