Does alternate-day cloprednol therapy prevent bone loss? A longitudinal double-blind, controlled clinical study.

Abstract

Osteoporosis is a serious side effect of systemic treatment with steroids. Cloprednol, a synthetic glucocorticoid with an anti-inflammatory potency twice that of prednisone, causes less calcium and nitrogen excretion than does prednisone in equipotent doses. Therefore a double-blind study was undertaken comparing the effects of alternate-day cloprednol and prednisone therapy on bone mineral density in 39 patients (cloprendol: 13 men and 8 women aged 48.5 +/- 2.8 years; prednisone: 9 men and 9 women aged 49.7 +/- 1.7 years) with lung diseases. Ten patients with asthma (9 men and 1 woman aged 37.8 +/- 3.7 years) inhaling daily beclomethasone served as control subjects. Trabecular and total bone density of the distal tibia and radius was determined quarterly during 1 year with a special-purpose computed tomographic system. Initial mean trabecular bone density of the patients receiving cloprednol and prednisone was 17% below normal. After a treatment period of 1 year, we found a loss of radial trabecular bone density (mean +/- SEM) of 1.33% +/- 0.49% in the cloprednol group and 2.38% +/- 0.69% in the prednisone group. In postmenopausal women, prednisone but not cloprednol therapy caused significant (p less than 0.01) trabecular bone loss (5.29% +/- 0.99% versus 0.70% +/- 0.65%). The control group lost 0.91% +/- 0.79%. Loss of cortical bone was insignificant in all three groups. In post-menopausal women, 1 year of alternate-day cloprednol therapy was associated with significantly less bone loss than was prednisone therapy in equipotent dosages.

• Authors: T C Medici, P Rüegsegger
• Journal: Clinical pharmacology and therapeutics (Clin Pharmacol Ther) Vol. 48 Issue 4 Pg. 455-66 (Oct 1990) ISSN: 0009-9236 [Print] United States
• PMID: 2225706 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Adrenal Cortex Hormones
• Pregnenediones
• Beclomethasone
• cloprednol
• Prednisone

Topics

• Administration, Inhalation
• Adrenal Cortex Hormones (therapeutic use)
• Adult
• Aged
• Beclomethasone (administration & dosage, adverse effects, therapeutic use)
• Bone Density (drug effects)
• Double-Blind Method
• Drug Administration Schedule
• Female
• Humans
• Longitudinal Studies
• Lung Diseases (drug therapy)
• Male
• Middle Aged
• Osteoporosis (prevention & control)
• Prednisone (adverse effects, therapeutic use)
• Pregnenediones (administration & dosage, adverse effects, therapeutic use)
• Prospective Studies