Alendronate or Alfacalcidol in Glucocorticoid-Induced Osteoporosis

In this clinical trial, patients who had a rheumatic disease and were receiving glucocorticoids were given either daily alendronate and alfacalcidol placebo or daily alfacalcidol and alendronate placebo. Alendronate was more effective than alfacalcidol in the prevention of glucocorticoid-induced bone loss in the lumbar spine. In patients who had a rheumatic disease and were receiving glucocorticoids, alendronate was more effective than alfacalcidol in the prevention of glucocorticoid-induced bone loss in the lumbar spine. Glucocorticoids are frequently used in patients with rheumatic diseases and are associated with increased bone loss and a risk of fracture. 1 – 3 An important effect of glucocorticoids on bone is the inhibition of bone formation by decreasing the number of osteoblasts and hampering their function. 4 , 5 Glucocorticoids also increase the rate of bone resorption by stimulating the formation and action of osteoclasts. Furthermore, glucocorticoids decrease intestinal absorption of calcium and increase renal calcium excretion. 5 – 8 Although daily doses of prednisone of 7.5 mg or more have been associated with glucocorticoid-induced osteoporosis, 9 , 10 lower doses of the drug have also been . . .