Clodronate Is Effective in Preventing Corticosteroid-Induced Bone Loss Among Asthmatic Patients

• Published in: Bone (New York, N.Y.) Vol. 22; no. 5; pp. 577 - 582
• Main Authors: Herrala, J, Puolijoki, H, Liippo, K, Raitio, M, Impivaara, O, Tala, E, Nieminen, M.M
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-05-1998; Elsevier Science
• Subjects: Absorptiometry, Photon; Administration, Inhalation; Administration, Oral; Analgesics, Non-Narcotic - administration & dosage; Analgesics, Non-Narcotic - therapeutic use; Anti-Asthmatic Agents - administration & dosage; Anti-Asthmatic Agents - adverse effects; Asthma; Asthma - drug therapy; Beclomethasone - administration & dosage; Beclomethasone - adverse effects; Biological and medical sciences; Bisphosphonates; Bone Density - drug effects; Clodronate; Clodronic Acid - administration & dosage; Clodronic Acid - therapeutic use; Corticosteroids; Dose-Response Relationship, Drug; Double-Blind Method; Drug toxicity and drugs side effects treatment; Female; Femur - drug effects; Femur Neck - drug effects; Glucocorticoids - administration & dosage; Glucocorticoids - adverse effects; Humans; Lumbar Vertebrae - drug effects; Male; Medical sciences; Osteoporosis; Osteoporosis - chemically induced; Osteoporosis - prevention & control; Pharmacology. Drug treatments; Prednisolone - administration & dosage; Prednisolone - adverse effects; Toxicity: osteoarticular system; Osteoporosis; Corticosteroids; Bisphosphonates; Clodronate; Asthma; Human; Corticosteroid; Respiratory disease; Toxicity; Treatment efficiency; Diseases of the osteoarticular system; Antiinflammatory agent; Bone disease; Antiasthma agent; Clodronic acid; Prevention; Treatment; Obstructive pulmonary disease; Osteopenia
• ISSN: 8756-3282; 1873-2763
• DOI: 10.1016/S8756-3282(98)00051-9

Clodronate is a novel drug used for inhibiting osteoclastic activity. The aim of the present double-blind study was to evaluate the efficacy and tolerability of clodronate (Leiras, Finland) in corticosteroid-induced bone loss among asthmatic patients. Seventy-four adult patients (41 women and 33 men, mean age 57.3 years) having a long history (mean 8.1 years) of oral and inhaled corticosteroid therapy were randomized to four parallel treatment groups: clodronate 800, 1600, or 2400 mg/day, or an identical placebo. The bone mineral density (BMD) of the lumbar spine (L2–4), femoral neck, and trochanter were assessed using dual-energy X-ray absortiometry at entry, 6 months, and 12 months. The baseline BMDs did not differ significantly between the study groups. In the lumbar spine, the mean BMD increased significantly between the baseline and 12-month visit in the clodronate groups of 1600 and 2400 mg/day, 2.6% (0.02 g/cm
2,
p < 0.02) and 3.0% (0.03 g/cm
2,
p < 0.01), respectively, but not in the placebo and clodronate 800 mg/day groups. The test for a linear trend (BMD percent change for L2–4) at 12 months was significant (
p < 0.02), indicating a dose response to clodronate. The mean BMD values of the femoral neck increased significantly in the 2400 mg/day group, 4.3% (0.03 g/cm
2,
p < 0.0001), as well as in the trochanter region 2.8% (0.02 g/cm
2,
p < 0.02). Gastric irritation was the most common adverse effect noted on a clodronate dose of 2400 mg/day. We conclude that oral clodronate is effective in preventing bone loss or increasing bone mass in asthmatic patients having a long history of continuous peroral and inhaled corticosteroid administration.