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Article: Osteopenia in young hypogonadal women with systemic lupus erythematosus receiving chronic steroid therapy: A randomized controlled trial comparing calcitriol and hormonal replacement therapy

TitleOsteopenia in young hypogonadal women with systemic lupus erythematosus receiving chronic steroid therapy: A randomized controlled trial comparing calcitriol and hormonal replacement therapy
Authors
Issue Date1999
PublisherOxford University Press. The Journal's web site is located at http://rheumatology.oxfordjournals.org/
Citation
Rheumatology, 1999, v. 38 n. 12, p. 1239-1244 How to Cite?
AbstractObjective. To evaluate the efficacy of calcitriol and hormonal replacement therapy (HRT) in the treatment of steroid-induced osteoporosis in hypogonadal women. Methods. We studied 28 young patients (aged 37 ± 6 yr) with systemic lupus erythematosus (SLE) on chronic steroid therapy for 130 ± 22 months and requiring more than 10 mg/day prednisone. They were amenorrhoeic for more than 2 yr with proven ovarian failure. All had osteopenia with a T score at L2-4 of less than -1. They were randomized to receive HRT (conjugated oestrogen 0.625 mg daily from day 1 to day 21 plus medroxyprogesterone acetate 5 mg daily days 10-21) or calcitriol 0.5 μg daily. All received calcium carbonate 1 g/day. Results. There were no differences in the baseline demographic, bone mineral density (BMD) and biochemical data between the two groups. Lumbar spine BMD increased by 2.0 ± 0.4% after 2 yr with HRT (P < 0.05), but reduced by 1.74 ± 0.4% (P < 0.05) with calcitriol treatment. No change was seen at the distal one-third radius with HRT treatment but significant bone loss (2.3 ± 1.4%, P < 0.02) was observed with calcitriol therapy. BMD at the hip did not change in both groups. Comparing both treatment groups, significant differences in the BMD at the spine (P < 0.03) and radius (P < 0.05) were seen at the end of 2 yr. The changes in urinary n-telopeptide excretion but not serum osteocalcin at 6 months and 12 months were inversely correlated with the changes in lumbar spine BMD at 24 months. HRT did not cause an adverse effect on SLE disease activity. Conclusion. HRT but not calcitriol could prevent bone loss in young hypogonadal women on chronic steroid therapy.
Persistent Identifierhttp://hdl.handle.net/10722/77295
ISSN
2015 Impact Factor: 4.524
2015 SCImago Journal Rankings: 1.449
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorKung, AWCen_HK
dc.contributor.authorChan, TMen_HK
dc.contributor.authorLau, CSen_HK
dc.contributor.authorWong, RWSen_HK
dc.contributor.authorYeung, SSCen_HK
dc.date.accessioned2010-09-06T07:30:21Z-
dc.date.available2010-09-06T07:30:21Z-
dc.date.issued1999en_HK
dc.identifier.citationRheumatology, 1999, v. 38 n. 12, p. 1239-1244en_HK
dc.identifier.issn1462-0324en_HK
dc.identifier.urihttp://hdl.handle.net/10722/77295-
dc.description.abstractObjective. To evaluate the efficacy of calcitriol and hormonal replacement therapy (HRT) in the treatment of steroid-induced osteoporosis in hypogonadal women. Methods. We studied 28 young patients (aged 37 ± 6 yr) with systemic lupus erythematosus (SLE) on chronic steroid therapy for 130 ± 22 months and requiring more than 10 mg/day prednisone. They were amenorrhoeic for more than 2 yr with proven ovarian failure. All had osteopenia with a T score at L2-4 of less than -1. They were randomized to receive HRT (conjugated oestrogen 0.625 mg daily from day 1 to day 21 plus medroxyprogesterone acetate 5 mg daily days 10-21) or calcitriol 0.5 μg daily. All received calcium carbonate 1 g/day. Results. There were no differences in the baseline demographic, bone mineral density (BMD) and biochemical data between the two groups. Lumbar spine BMD increased by 2.0 ± 0.4% after 2 yr with HRT (P < 0.05), but reduced by 1.74 ± 0.4% (P < 0.05) with calcitriol treatment. No change was seen at the distal one-third radius with HRT treatment but significant bone loss (2.3 ± 1.4%, P < 0.02) was observed with calcitriol therapy. BMD at the hip did not change in both groups. Comparing both treatment groups, significant differences in the BMD at the spine (P < 0.03) and radius (P < 0.05) were seen at the end of 2 yr. The changes in urinary n-telopeptide excretion but not serum osteocalcin at 6 months and 12 months were inversely correlated with the changes in lumbar spine BMD at 24 months. HRT did not cause an adverse effect on SLE disease activity. Conclusion. HRT but not calcitriol could prevent bone loss in young hypogonadal women on chronic steroid therapy.en_HK
dc.languageengen_HK
dc.publisherOxford University Press. The Journal's web site is located at http://rheumatology.oxfordjournals.org/en_HK
dc.relation.ispartofRheumatologyen_HK
dc.rightsRheumatology. Copyright © S Karger AG.en_HK
dc.subject.meshAdulten_HK
dc.subject.meshBone Density - drug effectsen_HK
dc.subject.meshBone Diseases, Metabolic - chemically induced - drug therapy - etiologyen_HK
dc.subject.meshCalcitriol - therapeutic useen_HK
dc.subject.meshCalcium - urineen_HK
dc.subject.meshCalcium Channel Agonists - therapeutic useen_HK
dc.subject.meshEstrogen Replacement Therapyen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHumansen_HK
dc.subject.meshHypogonadism - complicationsen_HK
dc.subject.meshLupus Erythematosus, Systemic - complications - drug therapyen_HK
dc.subject.meshSteroids - adverse effectsen_HK
dc.titleOsteopenia in young hypogonadal women with systemic lupus erythematosus receiving chronic steroid therapy: A randomized controlled trial comparing calcitriol and hormonal replacement therapyen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0080-2727&volume=38&spage=1239&epage=1244&date=1999&atitle=Osteopenia+in+young+hypogonadal+women+with+systemic+lupus+erythematosus+receiving+chronic+steroid+therapy:+a+randomized+controlled+trial+comparing+calcitriol+and+hormonal+replacement+therapyen_HK
dc.identifier.emailKung, AWC:awckung@hku.hken_HK
dc.identifier.emailChan, TM:dtmchan@hku.hken_HK
dc.identifier.emailLau, CS:cslau@hku.hken_HK
dc.identifier.authorityKung, AWC=rp00368en_HK
dc.identifier.authorityChan, TM=rp00394en_HK
dc.identifier.authorityLau, CS=rp01348en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.pmid10587552-
dc.identifier.scopuseid_2-s2.0-0032778081en_HK
dc.identifier.hkuros51245en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0032778081&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume38en_HK
dc.identifier.issue12en_HK
dc.identifier.spage1239en_HK
dc.identifier.epage1244en_HK
dc.identifier.isiWOS:000084421800013-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridKung, AWC=7102322339en_HK
dc.identifier.scopusauthoridChan, TM=7402687700en_HK
dc.identifier.scopusauthoridLau, CS=14035682100en_HK
dc.identifier.scopusauthoridWong, RWS=34875928200en_HK
dc.identifier.scopusauthoridYeung, SSC=7102767673en_HK

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