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Alendronate Ups BMD in Patients Taking Steroids for Skin Diseases

Bone mineral density increased at lumbar spine, femoral neck in immunobullous disorders

WEDNESDAY, Nov. 23 (HealthDay News) -- Alendronate therapy is associated with significantly increased bone mineral density (BMD) at the lumbar spine and femoral neck at 12 months in patients with immunobullous skin diseases and glucocorticoid-induced osteoporosis, according to a study published online Nov. 21 in the Archives of Dermatology.

Shang-Ian Tee, M.R.C.P., from the National Skin Center in Singapore, and colleagues evaluated the safety and efficacy of daily oral alendronate sodium therapy for preventing glucocorticoid-induced bone loss in 29 patients with immunobullous skin diseases treated with long-term glucocorticoid therapy. Patients were randomly assigned to receive 10 mg/day oral alendronate sodium (15 patients) or matching placebo (14 patients) for 12 months. The percent change in BMD at the lumbar spine and the femoral neck at 12 months was the main outcome measure.

The investigators found that the percent change in BMD was +3.7 and +3.5 percent at the lumbar spine and femoral neck, respectively, with alendronate therapy, compared with −1.4 and −0.7 percent, respectively, with placebo. The increase in BMD at the lumbar spine and femoral neck was significant in the alendronate group, compared with the placebo group. In the aledronate group, but not the placebo group, there was a significant decrease in serum heat-labile alkaline phosphatase levels after 12 months. Generally minor adverse effects were observed, with no significant difference in the frequency of occurrence between the two groups (P = 0.59).

"It is imperative to use bisphophonate therapy in patients with immunobullous disorders who are receiving oral corticosteroids because it largely prevents the morbidity associated with low BMD," the authors write.

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