Nav: Home

UAB-led study shows drug effectiveness in reducing glucocorticoid-induced bone loss

April 27, 2018

BIRMINGHAM, Ala. - About one in every 100 people in the world takes glucocorticoids long term to treat immune-mediated diseases. However, glucocorticoids, such as prednisone, have a side effect -- they induce the bone loss called osteoporosis, causing an estimated yearly bone fracture rate of 5 percent.

An alternative treatment option now appears promising, according to results of an international study published in the journal The Lancet Diabetes & Endocrinology. The study was headed by Kenneth Saag, M.D., the Jane Knight Lowe Professor of Medicine at the University of Alabama at Birmingham.

Saag and colleagues compared the monoclonal antibody denosumab against a standard treatment for glucocorticoid-induced secondary osteoporosis, the bisphosphonate risedronate. In the 12-month results of their 24-month study, they have found that denosumab was superior to risedronate, as measured by increased bone density in the lower spine.

"To our knowledge, ours is the first large, randomized controlled trial of denosumab in patients with glucocorticoid-induced osteoporosis who were either prevalent glucocorticoid users or newly initiating glucocorticoid therapy," they wrote. "Denosumab could be a useful addition to the treatment armamentarium for glucocorticoid-induced osteoporosis."

The double-blind study enrolled 795 patients at 79 health care centers in Europe, Latin America, Asia and North America. Of these, 505 were glucocorticoid-continuing patients who had received glucocorticoids for at least three months, and 290 were glucocorticoid-initiating patients who had received glucocorticoids for less than three months.

Patients were randomly assigned to one of two groups. The denosumab group got a shot of denosumab underneath the skin every six months and took a placebo pill every day. The risedronate group got a placebo shot every six months and took oral risedronate every day.

Besides the superior lumbar spine bone density with denosumab after 12 months, researchers also found that denosumab was superior to risedronate for bone density measured in the total hip and at the neck of the femur, the large bone of the thigh.

The two treatment groups had similar safety profiles.

The researchers note that the study compared denosumab with risedronate, so the relative performance of denosumab compared with osteoporosis treatments besides risedronate has not yet been established.
-end-
Co-authors with Saag on the paper, "Denosumab versus risedronate in glucocorticoid-induced osteoporosis: a multicentre, randomised, double-blind, active-controlled, double-dummy, non-inferiority study," are Rachel B. Wagman, Andrea Wang and Nicola Pannacciulli, Amgen, Thousand Oaks, California; Piet Geusens, Maastricht University, Maastricht, Netherlands; Jonathan D. Adachi, McMaster University, Hamilton, Ontario, Canada; Osvaldo D. Messina, Cosme Argerich Hospital, Buenos Aires, Argentina; Ronald Emkey, Emkey Arthritis & Osteoporosis Clinic, Wyomissing, Pennsylvania; Roland Chapurlat, Hôpital Edouard Herriot, Lyon, France; and Willem F. Lems, Amsterdam Rheumatology & Immunology Center, Amsterdam, Netherlands.

The study was funded by Amgen, which markets denosumab under the trade name Xgeva.

University of Alabama at Birmingham

Related Glucocorticoids Articles:

Biomarker predicts who will have severe COVID-19
KAIST researchers have identified key markers that could help pinpoint patients who are bound to get a severe reaction to COVID-19 infection.
Baboon matriarchs enjoy less stress
You know the type: Loud. Swaggering. Pushy. The alpha male clearly runs the show.
Reducing corticosteroid use in rheumatoid arthritis
Is the long-term use of glucocorticoids essential in people with chronic inflammatory diseases such as rheumatoid arthritis, or can early discontinuation prevent characteristic side effects?
URI researcher: Antioxidant-rich diet reduces stress response during bird migration
A research team led by a University of Rhode Island ornithologist had birds fly in a wind tunnel to simulate migration and found that birds that consume dietary antioxidants before and during fall migration can reduce the endocrine stress response triggered by long-duration flights.
Glucocorticoids are harmful in treating viral respiratory infections
Glucocorticoids, which are widely used as treatment in intensive care, can nearly quadruple the death rate of patients suffering from acute respiratory distress syndrome.
Long-term use of synthetic corticosteroid drugs increases adrenal gland inflammation
New research by academics at the University of Bristol has found evidence that prolonged treatment of synthetic corticosteroid drugs increases adrenal gland inflammation in response to bacterial infection, an effect that in the long-term can damage adrenal function.
Medical teams need to be alert to the extra risks faced by diabetics from COVID-19
Doctors need to pay particular attention to patients with endocrine disorders and diabetes mellitus in relation to COVID-19 infections, say leading endocrinologists.
Individuals taking class of steroid medications at high risk for COVID-19
Individuals taking a class of steroid hormones called glucocorticoids for conditions such as asthma, allergies and arthritis on a routine basis may be unable to mount a normal stress response and are at high risk if they are infected with the virus causing COVID-19, according to a new editorial published in the Endocrine Society's Journal of Clinical Endocrinology & Metabolism.
The harmful effects of stress during pregnancy can last a lifetime
Mice exposed to stress in the womb and soon after birth can expect a lifetime of immune system deficiencies that hinder the ability to ward off infections and cancer, Yale University researchers report March 5, 2020 in the journal Cell.
Fewer steroids, no plasma exchange: A change in treatment for vasculitis
The insights from the PEXIVAS Trial, a 10-year study, shows treatment for ANCA-associated vasculitis can use half the standard dosage of steroids and involve no blood plasma exchanges.
More Glucocorticoids News and Glucocorticoids Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Listen Again: The Power Of Spaces
How do spaces shape the human experience? In what ways do our rooms, homes, and buildings give us meaning and purpose? This hour, TED speakers explore the power of the spaces we make and inhabit. Guests include architect Michael Murphy, musician David Byrne, artist Es Devlin, and architect Siamak Hariri.
Now Playing: Science for the People

#576 Science Communication in Creative Places
When you think of science communication, you might think of TED talks or museum talks or video talks, or... people giving lectures. It's a lot of people talking. But there's more to sci comm than that. This week host Bethany Brookshire talks to three people who have looked at science communication in places you might not expect it. We'll speak with Mauna Dasari, a graduate student at Notre Dame, about making mammals into a March Madness match. We'll talk with Sarah Garner, director of the Pathologists Assistant Program at Tulane University School of Medicine, who takes pathology instruction out of...
Now Playing: Radiolab

What If?
There's plenty of speculation about what Donald Trump might do in the wake of the election. Would he dispute the results if he loses? Would he simply refuse to leave office, or even try to use the military to maintain control? Last summer, Rosa Brooks got together a team of experts and political operatives from both sides of the aisle to ask a slightly different question. Rather than arguing about whether he'd do those things, they dug into what exactly would happen if he did. Part war game part choose your own adventure, Rosa's Transition Integrity Project doesn't give us any predictions, and it isn't a referendum on Trump. Instead, it's a deeply illuminating stress test on our laws, our institutions, and on the commitment to democracy written into the constitution. This episode was reported by Bethel Habte, with help from Tracie Hunte, and produced by Bethel Habte. Jeremy Bloom provided original music. Support Radiolab by becoming a member today at Radiolab.org/donate.     You can read The Transition Integrity Project's report here.