Cyclical etidronate for treatment of osteopenia in patients with cirrhosis of the liver

Osteoporosis is associated with cirrhosis of the liver. We evaluated the effects of cyclical etidronate on osteopenia in women with cirrhosis of the liver. The subjects were 50 women with cirrhosis who had underlying hepatitis viral infection. Half of the patients were randomly assigned to receive cyclical etidronate (200 mg). The bone mineral density (BMD) of the lumbar vertebrae was measured by dual-energy X-ray absorptiometry at entry and at 1 year intervals for at least 2 years. After 1 year of treatment, the median BMD was +0.7% in the treated group and −2.0% in the control group. After 2 years of treatment, the median BMD was +0.1% in the treated group and −3.4% in the control group. After 3 years of treatment, the median BMD was −0.6% in the treated group and −5.2% in the control group. These differences between the groups were significant. No adverse effects of cyclical etidronate were noted. These results suggest that cyclical etidronate can prevent bone loss and may therefore be useful in the management of bone disease in women with cirrhosis of the liver.