Prevention and treatment of glucorticoid-induced osteoporosis in patients with severe bronchial asthma: combination of calcium, alfa-calcidol and calcitonin
Abstract
The effectiveness of the main antiresorptive agents was assessed for the treatment of glucocorticoid-induced osteoporosis in patients with severe asthma. Alfacalcidol plus calcium, but not calcium alone, was effective in patients with osteopenia. Combined therapy (calcium, alfacalcidol, calcitonin, anabolic hormone) not only prevented bone loss but had a positive effect on the bone mineral density, relieved the pain, increased the physical activity in patients with severe osteoporosis.
About the Authors
I. A. BaranovaRussian Federation
K. Z. Gadjiev
Russian Federation
A. G. Chuchalin
Russian Federation
References
1. Дамбахер М.А., Шахт Е. Остеопороз и активные метаболиты витамина D: мысли, которые приходят в голову. Basle: EULAR Publishers; 1996.
2. EULAR Publishers; 1996. Насонов Е.Л. Дефицит кальция и витамина D: Новые факты и гипотезы (обзор литературы). Остеопороз и остеопатии 1998; 3: 42-47.
3. Aditioff A.D., Hollister J.R. Steroid-induced fractures and bone loss in patients with asthma. N. Engl. J. Med. 1983; 309: 265-268.
4. Als O.S., Gotfredsen A., Christiansen C. The effect of glucocorticoids on bone mass in rheumatoid arthritis patients. Arthr. and Rheum. 1985; 28: 369-375.
5. Avioli L.V. Clinician's manual on osteoporosis. London: Science Press; 1997.
6. Chestnut C.H., Silverman S.L. et al. A randomized trial of nasal spray salmon calcitonin in postmenopausal women with established osteoporosis: The Prevent Reccurence of Osteoporotic Fracture Study. Am. J. Med. 2000; 109: 267-276.
7. Gulko P .S., M ulloy A.L. Glucocorticoid-induced osteoporosis: pathogenesis, prevention and treatment. Clin. Exp. Rheumatol. 1996; 14 (2): 199-206.
8. Kanis J.A., Pitt F.A. Epidemiology of osteoporosis. Bone 1992; 13: S7-S15.
9. Lukert B.P., Raisz L.G. Glucocorticoid-induced osteoporosis: pathogenesis and management. Ann. Intern. Med. 1990; 112 (5): 352-364.
10. McLeod J.F. Osteoporosis, cytokines, and glucocorticoids. Allergy Proc. 1993; 14 (5): 363-364.
11. Osteoporosis: Review oi the evidence for prevention, diagnosis, and treatment and cost-eifectiveness analysis. Osteoporosis Int. 1998; 8 (suppl.4): 31-35.
12. Reddy B.M., Villar M.E., Silverman B.A. et al. Osteoporosis among adult asthma patients receiving chronic glucocorticoid therapy [abstract]. J. Allergy Clin. Immunol. 1998; 101: 290.
13. Scopasaca F., Horowitz M., Wishart J.M. et al. Calcium supplementation suppress bone resorbtion in early postmenopausal women. Calcif. Tissue Int. 1998: 62: 8-12.
14. Silverman S.L., Chesnnt C., Baylink D. et al. In: 4-th Miacalcic expert meeting. Athens, 2001. 45-47.
15. Van Sta T.P., Leafkrens H.G.M., Abenheim L. et al. Use of corticosteroids and risk of vertebral fractures. J. Bone Miner. Res. 2000; 15: 993-1000.
16. Wallach S., Rousseau G., Martin L., Azria M. Effects of calcitonin on animal and in vitro models of skeletal metabolism. Bone 1999; 25 (3): 509-516.
17. Walsh L.J., Wong C.A., Pringle M. et al. Use of oral corticosteroids in the community and the prevention of secondary osteoporosis: a cross sectional study. Br. Med. J. 1996; 313: 344-346.
Review
For citations:
Baranova I.A., Gadjiev K.Z., Chuchalin A.G. Prevention and treatment of glucorticoid-induced osteoporosis in patients with severe bronchial asthma: combination of calcium, alfa-calcidol and calcitonin. PULMONOLOGIYA. 2003;(2):85-90. (In Russ.)