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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/2856

Title: A pooled data analysis on the use of intermittent cyclical etidronate therapy for the prevention and treatment of corticosteroid induced bone loss
Authors: Adachi, Jonathan D.
Roux, C
Pitt, PI
Cooper, C
Moniz, C
Dequeker, J
Ioannidis, G
Cawley, MID
Jenkins, EA
Walker-Bone, KE
Pack, S
Stephenson, GF
Laan, RF
Brown, J
GEUSENS, Piet
Issue Date: 2000
Publisher: J RHEUMATOL PUBL CO
Citation: JOURNAL OF RHEUMATOLOGY, 27(10). p. 2424-2431
Abstract: Objective. To conduct a pooled data analysis in a group of patients defined by sex, menopausal status, and underlying disease in order to examine the effect of intermittent cyclical etidronate in the prevention and treatment of corticosteroid induced osteoporosis. Methods. We selected 5 randomized, placebo controlled studies that examined the efficacy of intermittent cyclical etidronate therapy in which the raw data were available for analysis. Three were prevention studies and 2 treatment studies. The primary outcome was the difference between treatment groups in the percentage change from baseline in lumbar spine bone density. Secondary outcomes included the difference between treatment groups in the percentage change from baseline in femoral neck and trochanter bone density, and vertebral fracture rates. Results. Results are separately pooled for the prevention and treatment studies. The prevention studies had significant mean differences (95% CI) between groups in mean percentage change from baseline in lumbar spine, femoral neck, and trochanter bone density of 3.7 (2.6 to 4.7), 1.7 (0.4 to 2.9), and 2.8% (1.3 to 4.2) after one year of treatment, in favor of the etidronate group. The treatment studies displayed a mean difference between groups in mean percentage change from baseline in lumbar spine bone density of 4.8 (2.7 to 6.9) and 5.4% (2.5 to 8.4) after one and 2 years of therapy. In the prevention studies, a reduced fracture incidence was observed in the etidronate group compared with the placebo group (relative risk 0.50; CI 0.21 to 1.19). Conclusion. Etidronate therapy was effective in preventing bone loss in the prevention studies and in preventing or slightly increasing bone mass in the treatment studies. A fracture benefit was observed in postmenopausal women treated with etidronate in the prevention studies.
Notes: McMaster Univ, St Josephs Hosp, Hamilton, ON, Canada. Univ Paris 05, Cochin Hosp, Paris, France. Farnborough Hosp, Orpington, Kent, England. Southampton Gen Hosp, Southampton SO9 4XY, Hants, England. Univ London Kings Coll Hosp, Denmark Hill, England. KU Leuven, Univ Hosp, Louvain, Belgium. Procter & Gamble Pharmaceut, Cincinnati, OH USA. Univ Nijmegen Hosp, NL-6500 HB Nijmegen, Netherlands. Procter & Gamble Pharmaceut, Toronto, ON, Canada. Ctr Hosp Univ Laval, St Foy, PQ, Canada. Limburgs Univ Ctr, Dr L Willems Inst, Diepenbeek, Belgium.Adachi, JD, 501-25 Charlton Ave E, Hamilton, ON L8N 1Y2, Canada.
URI: http://hdl.handle.net/1942/2856
ISI #: 000089669300022
ISSN: 0315-162X
Category: A1
Type: Journal Contribution
Validation: ecoom, 2001
Appears in Collections: Research publications

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