The effect of the steroid-sparing response to low-dose methotrexate on bone metabolism in glucocorticoid-dependent asthmatics
Background: The skeletal effects of low-dose methotrexate (MTX), in glucocorticoid-dependent asthmatics (GCDA), are unknown. Methods: We studied 9 patients from a total of 26 chronic GCDA who completed 28 weeks of MTX (15 mg weekly, intramuscularly). Prednisolone dose was not altered during the firs...
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| Veröffentlicht in: | Clinica chimica acta 2004-03, Vol.341 (1), p.157-163 |
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| creator | Girgis, Samia I. Nwokeji, Amanda Shakur, B.Haleema Ind, Philip W. Shiner, Robert J. |
| description | Background: The skeletal effects of low-dose methotrexate (MTX), in glucocorticoid-dependent asthmatics (GCDA), are unknown.
Methods: We studied 9 patients from a total of 26 chronic GCDA who completed 28 weeks of MTX (15 mg weekly, intramuscularly). Prednisolone dose was not altered during the first 12 weeks, and was then reduced between 12 and 28 weeks. Mean (S.E.M.) age of the patients was 54 (4.0) years. They had normal bone mineral density (BMD), were not taking medication that affected bone metabolism (except prednisolone and inhaled corticosteroids) and all achieved at least 50% reduction in prednisolone dose at 28 weeks. Blood and urine samples were obtained at baseline, 12, 28 and 40 weeks for measurement of serum osteocalcin (OC) and bone alkaline phosphatase (Bone-ALP) as formation markers and urinary deoxypyridinoline (DPD) and N-terminal cross-linked telopeptide of type I collagen (NTX-I) as resorption markers.
Results: Concurrently with the changes in prednisolone dosage serum OC levels increased significantly at 28 weeks (
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| doi_str_mv | 10.1016/j.cccn.2003.11.022 |
| format | Article |
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Methods: We studied 9 patients from a total of 26 chronic GCDA who completed 28 weeks of MTX (15 mg weekly, intramuscularly). Prednisolone dose was not altered during the first 12 weeks, and was then reduced between 12 and 28 weeks. Mean (S.E.M.) age of the patients was 54 (4.0) years. They had normal bone mineral density (BMD), were not taking medication that affected bone metabolism (except prednisolone and inhaled corticosteroids) and all achieved at least 50% reduction in prednisolone dose at 28 weeks. Blood and urine samples were obtained at baseline, 12, 28 and 40 weeks for measurement of serum osteocalcin (OC) and bone alkaline phosphatase (Bone-ALP) as formation markers and urinary deoxypyridinoline (DPD) and N-terminal cross-linked telopeptide of type I collagen (NTX-I) as resorption markers.
Results: Concurrently with the changes in prednisolone dosage serum OC levels increased significantly at 28 weeks (
p<0.008) (8.1±1.0 ng/ml) compared to baseline (4.7±0.6 ng/ml) and 12 weeks (5.1±0.6 ng/ml), but trended back by 40 weeks (6.6±0.6 ng/ml). No significant changes were observed for the other bone markers between baseline and the other time points.
Conclusions: The beneficial effects of steroid reduction on bone metabolism do not appear to be impaired by concomitant MTX treatment at least over 12 weeks.</description><identifier>ISSN: 0009-8981</identifier><identifier>EISSN: 1873-3492</identifier><identifier>DOI: 10.1016/j.cccn.2003.11.022</identifier><identifier>PMID: 14967172</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Adult ; Aged ; Alkaline Phosphatase - analysis ; Alkaline Phosphatase - metabolism ; Amino Acids - chemistry ; Amino Acids - metabolism ; Anti-Inflammatory Agents - administration & dosage ; Anti-Inflammatory Agents - therapeutic use ; Asthma - drug therapy ; Biomarkers ; Bone and Bones - enzymology ; Bone and Bones - metabolism ; Bone markers ; Bone metabolism ; Clinical Trials as Topic ; Collagen Type I - chemistry ; Collagen Type I - metabolism ; Creatinine - urine ; Drug Therapy, Combination ; Female ; Glucocorticoid-dependent asthmatics ; Glucocorticoids - administration & dosage ; Glucocorticoids - therapeutic use ; Humans ; Immunosuppressive Agents - therapeutic use ; Male ; Methotrexate ; Methotrexate - therapeutic use ; Middle Aged ; Osteocalcin - analysis ; Osteocalcin - metabolism ; Prednisolone - administration & dosage ; Prednisolone - therapeutic use ; Retrospective Studies ; Steroids</subject><ispartof>Clinica chimica acta, 2004-03, Vol.341 (1), p.157-163</ispartof><rights>2004 Elsevier B.V.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c352t-470f2ec793dd57161462c75a06fbd5502f317ceec177371e2eefbc55b8b9f2eb3</citedby><cites>FETCH-LOGICAL-c352t-470f2ec793dd57161462c75a06fbd5502f317ceec177371e2eefbc55b8b9f2eb3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.cccn.2003.11.022$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,781,785,3551,27929,27930,46000</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/14967172$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Girgis, Samia I.</creatorcontrib><creatorcontrib>Nwokeji, Amanda</creatorcontrib><creatorcontrib>Shakur, B.Haleema</creatorcontrib><creatorcontrib>Ind, Philip W.</creatorcontrib><creatorcontrib>Shiner, Robert J.</creatorcontrib><title>The effect of the steroid-sparing response to low-dose methotrexate on bone metabolism in glucocorticoid-dependent asthmatics</title><title>Clinica chimica acta</title><addtitle>Clin Chim Acta</addtitle><description>Background: The skeletal effects of low-dose methotrexate (MTX), in glucocorticoid-dependent asthmatics (GCDA), are unknown.
Methods: We studied 9 patients from a total of 26 chronic GCDA who completed 28 weeks of MTX (15 mg weekly, intramuscularly). Prednisolone dose was not altered during the first 12 weeks, and was then reduced between 12 and 28 weeks. Mean (S.E.M.) age of the patients was 54 (4.0) years. They had normal bone mineral density (BMD), were not taking medication that affected bone metabolism (except prednisolone and inhaled corticosteroids) and all achieved at least 50% reduction in prednisolone dose at 28 weeks. Blood and urine samples were obtained at baseline, 12, 28 and 40 weeks for measurement of serum osteocalcin (OC) and bone alkaline phosphatase (Bone-ALP) as formation markers and urinary deoxypyridinoline (DPD) and N-terminal cross-linked telopeptide of type I collagen (NTX-I) as resorption markers.
Results: Concurrently with the changes in prednisolone dosage serum OC levels increased significantly at 28 weeks (
p<0.008) (8.1±1.0 ng/ml) compared to baseline (4.7±0.6 ng/ml) and 12 weeks (5.1±0.6 ng/ml), but trended back by 40 weeks (6.6±0.6 ng/ml). No significant changes were observed for the other bone markers between baseline and the other time points.
Conclusions: The beneficial effects of steroid reduction on bone metabolism do not appear to be impaired by concomitant MTX treatment at least over 12 weeks.</description><subject>Adult</subject><subject>Aged</subject><subject>Alkaline Phosphatase - analysis</subject><subject>Alkaline Phosphatase - metabolism</subject><subject>Amino Acids - chemistry</subject><subject>Amino Acids - metabolism</subject><subject>Anti-Inflammatory Agents - administration & dosage</subject><subject>Anti-Inflammatory Agents - therapeutic use</subject><subject>Asthma - drug therapy</subject><subject>Biomarkers</subject><subject>Bone and Bones - enzymology</subject><subject>Bone and Bones - metabolism</subject><subject>Bone markers</subject><subject>Bone metabolism</subject><subject>Clinical Trials as Topic</subject><subject>Collagen Type I - chemistry</subject><subject>Collagen Type I - metabolism</subject><subject>Creatinine - urine</subject><subject>Drug Therapy, Combination</subject><subject>Female</subject><subject>Glucocorticoid-dependent asthmatics</subject><subject>Glucocorticoids - administration & dosage</subject><subject>Glucocorticoids - therapeutic use</subject><subject>Humans</subject><subject>Immunosuppressive Agents - therapeutic use</subject><subject>Male</subject><subject>Methotrexate</subject><subject>Methotrexate - therapeutic use</subject><subject>Middle Aged</subject><subject>Osteocalcin - analysis</subject><subject>Osteocalcin - metabolism</subject><subject>Prednisolone - administration & dosage</subject><subject>Prednisolone - therapeutic use</subject><subject>Retrospective Studies</subject><subject>Steroids</subject><issn>0009-8981</issn><issn>1873-3492</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE9v1DAQxS0EotvCF-CAfOKW4HH-OJG4VBXQSpW4lLPl2OOuV4kdbG9bDnx3vN2VeutpZp7ee9L8CPkErAYG_dddrbX2NWesqQFqxvkbsoFBNFXTjvwt2TDGxmoYBzgj5yntytmyHt6TM2jHXoDgG_LvbosUrUWdabA0lytljMGZKq0qOn9PI6Y1-IQ0BzqHx8qEsi-YtyFHfFIZafB0Cv5ZVFOYXVqo8_R-3uugQ8xOH-oMrugN-kxVyttFFTl9IO-smhN-PM0L8vvH97ur6-r218-bq8vbSjcdz1UrmOWoxdgY0wnooe25Fp1ivZ1M1zFuGxAaUYMQjQDkiHbSXTcN01iCU3NBvhx71xj-7DFlubikcZ6Vx7BPcig4edeOxciPRh1DShGtXKNbVPwrgckDdLmTB-jyAF0CyAK9hD6f2vfTguYlcqJcDN-OBiw_PjiMMmmHXqNxsYCXJrjX-v8DcYWWFw</recordid><startdate>20040301</startdate><enddate>20040301</enddate><creator>Girgis, Samia I.</creator><creator>Nwokeji, Amanda</creator><creator>Shakur, B.Haleema</creator><creator>Ind, Philip W.</creator><creator>Shiner, Robert J.</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20040301</creationdate><title>The effect of the steroid-sparing response to low-dose methotrexate on bone metabolism in glucocorticoid-dependent asthmatics</title><author>Girgis, Samia I. ; Nwokeji, Amanda ; Shakur, B.Haleema ; Ind, Philip W. ; Shiner, Robert J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c352t-470f2ec793dd57161462c75a06fbd5502f317ceec177371e2eefbc55b8b9f2eb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Alkaline Phosphatase - analysis</topic><topic>Alkaline Phosphatase - metabolism</topic><topic>Amino Acids - chemistry</topic><topic>Amino Acids - metabolism</topic><topic>Anti-Inflammatory Agents - administration & dosage</topic><topic>Anti-Inflammatory Agents - therapeutic use</topic><topic>Asthma - drug therapy</topic><topic>Biomarkers</topic><topic>Bone and Bones - enzymology</topic><topic>Bone and Bones - metabolism</topic><topic>Bone markers</topic><topic>Bone metabolism</topic><topic>Clinical Trials as Topic</topic><topic>Collagen Type I - chemistry</topic><topic>Collagen Type I - metabolism</topic><topic>Creatinine - urine</topic><topic>Drug Therapy, Combination</topic><topic>Female</topic><topic>Glucocorticoid-dependent asthmatics</topic><topic>Glucocorticoids - administration & dosage</topic><topic>Glucocorticoids - therapeutic use</topic><topic>Humans</topic><topic>Immunosuppressive Agents - therapeutic use</topic><topic>Male</topic><topic>Methotrexate</topic><topic>Methotrexate - therapeutic use</topic><topic>Middle Aged</topic><topic>Osteocalcin - analysis</topic><topic>Osteocalcin - metabolism</topic><topic>Prednisolone - administration & dosage</topic><topic>Prednisolone - therapeutic use</topic><topic>Retrospective Studies</topic><topic>Steroids</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Girgis, Samia I.</creatorcontrib><creatorcontrib>Nwokeji, Amanda</creatorcontrib><creatorcontrib>Shakur, B.Haleema</creatorcontrib><creatorcontrib>Ind, Philip W.</creatorcontrib><creatorcontrib>Shiner, Robert J.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinica chimica acta</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Girgis, Samia I.</au><au>Nwokeji, Amanda</au><au>Shakur, B.Haleema</au><au>Ind, Philip W.</au><au>Shiner, Robert J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The effect of the steroid-sparing response to low-dose methotrexate on bone metabolism in glucocorticoid-dependent asthmatics</atitle><jtitle>Clinica chimica acta</jtitle><addtitle>Clin Chim Acta</addtitle><date>2004-03-01</date><risdate>2004</risdate><volume>341</volume><issue>1</issue><spage>157</spage><epage>163</epage><pages>157-163</pages><issn>0009-8981</issn><eissn>1873-3492</eissn><abstract>Background: The skeletal effects of low-dose methotrexate (MTX), in glucocorticoid-dependent asthmatics (GCDA), are unknown.
Methods: We studied 9 patients from a total of 26 chronic GCDA who completed 28 weeks of MTX (15 mg weekly, intramuscularly). Prednisolone dose was not altered during the first 12 weeks, and was then reduced between 12 and 28 weeks. Mean (S.E.M.) age of the patients was 54 (4.0) years. They had normal bone mineral density (BMD), were not taking medication that affected bone metabolism (except prednisolone and inhaled corticosteroids) and all achieved at least 50% reduction in prednisolone dose at 28 weeks. Blood and urine samples were obtained at baseline, 12, 28 and 40 weeks for measurement of serum osteocalcin (OC) and bone alkaline phosphatase (Bone-ALP) as formation markers and urinary deoxypyridinoline (DPD) and N-terminal cross-linked telopeptide of type I collagen (NTX-I) as resorption markers.
Results: Concurrently with the changes in prednisolone dosage serum OC levels increased significantly at 28 weeks (
p<0.008) (8.1±1.0 ng/ml) compared to baseline (4.7±0.6 ng/ml) and 12 weeks (5.1±0.6 ng/ml), but trended back by 40 weeks (6.6±0.6 ng/ml). No significant changes were observed for the other bone markers between baseline and the other time points.
Conclusions: The beneficial effects of steroid reduction on bone metabolism do not appear to be impaired by concomitant MTX treatment at least over 12 weeks.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>14967172</pmid><doi>10.1016/j.cccn.2003.11.022</doi><tpages>7</tpages></addata></record> |
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| ispartof | Clinica chimica acta, 2004-03, Vol.341 (1), p.157-163 |
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| source | MEDLINE; Elsevier ScienceDirect Journals Complete |
| subjects | Adult Aged Alkaline Phosphatase - analysis Alkaline Phosphatase - metabolism Amino Acids - chemistry Amino Acids - metabolism Anti-Inflammatory Agents - administration & dosage Anti-Inflammatory Agents - therapeutic use Asthma - drug therapy Biomarkers Bone and Bones - enzymology Bone and Bones - metabolism Bone markers Bone metabolism Clinical Trials as Topic Collagen Type I - chemistry Collagen Type I - metabolism Creatinine - urine Drug Therapy, Combination Female Glucocorticoid-dependent asthmatics Glucocorticoids - administration & dosage Glucocorticoids - therapeutic use Humans Immunosuppressive Agents - therapeutic use Male Methotrexate Methotrexate - therapeutic use Middle Aged Osteocalcin - analysis Osteocalcin - metabolism Prednisolone - administration & dosage Prednisolone - therapeutic use Retrospective Studies Steroids |
| title | The effect of the steroid-sparing response to low-dose methotrexate on bone metabolism in glucocorticoid-dependent asthmatics |
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