Treatment of glucocorticoid-induced osteoporosis with active vitamin D3 analogues

Abstract

Objective : Glucocorticoid-induced osteoporosis (GIO) can occur when patients with autoimmune disease are treated with steroids. In this study, we evaluated the efficacy of active vitamin D₃ (VitD) alone (without Bisphosphonates) in patients receiving GIO treatment. Materials and Methods : Fifty-one outpatients with GIO were divided into 2 groups : 39 patients (35 females and 4 males) were treated with VitD, and 12 patients without VitD were included as the control group. Bone mineral density (BMD) was serially, measured by dual energy X-ray absorptiometry before the administration of VitD, and after 6, 12, 18, 24 and 30 months, respectively. We then analyzed the efficacy of VitD. Results : 1) In the VitD group, BMD was increased while that in the controls was decreased. 2) When treated with a lower dose of steroid, the BMD of patients was liable to be higher after treatment with VitD. 3) BMD in younger patients was higher than that in older patients, and was also increased after treatment with VitD. BMD in elderly patients showed a downward tendency after VitD was used. Conclusions : When bisphosphonate use is contraindicated for patients with GIO, it is effective to use VitD alone. However, with large doses of steroids or elderly patients, VitD needs to be considered earlier along with other treatments.