Summary
Altogether forty-four patients with giant cell arteritis (GCA) were randomly allocated to either daily morning or alternate-day administration of prednisolone. The BMC of the third lumbar vertebra was determined using dual photon absorptiometry. At least ten measurements were performed in each patient during a period of 18 months. During the course of treatment there was no significant change of the mean BMC in either group compared to the pre-treatment value. The changes of BMC were independent of such potentially explanatory variables as cumulative dose of prednisolone, initial BMC, sex and body weight. Corticosteroid treatment in patients with GCA, in the doses used by us, does not appear to cause excessive bone loss.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Birkhead, N.C., Wagener, H.B., Schick, R.M. Treatment of temporal arteritis with adrenal corticosteroids. JAMA 1975, 163, 821–827.
Nordborg, E., Bengtsson, B.Å. Death rates and causes of death in 284 consecutive patients with giant-cell arteritis confirmed by biopsy. BMJ 1989, 299, 549–50.
Albright, F. Osteoporosis. Ann Intern Med 1947, 27, 861–882.
Hahn, T.J. Corticosteroid-induced osteopenia. Arch Intern Med 1978, 138, 882–885.
Bengtsson, B.A., Malmwall, B.E. The epidemiology of giant-cell arteritis including temporal arteritis and polymyalgia rheumatica. Arthritis Rheum 1981, 24, 899–904.
Hansson, T., Roos, B. Age changes in the bone mineral of the lumbar spine in normal women. Calcif Tissue Int 1986, 38, 249–251.
Hansson, T., Roos, B., Nachemson, A. The bone mineral content and ultimate compressive strength of lumbar vertebrae. Spine 1980, 5, 46–55.
Granhed, H., Hansson, T., Jonson, R. Mineral content and ultimate compressive strength of lumbar vertebrae. A cadaver study. Acta Orthop Scand 1989, 60 (1), 105–109.
Roos, B., Sköldborn, H. Dual photon absorptiometry in lumbar vertebrae I. Theory and method. Acta Radiol 1974, 3, 266–280.
Roos, B. Dual photon absorptiometry in lumbar vertebrae II. Precision and reproducibility. Acta Radiol 1975, 3, 291–303.
Bradley, J.W. Distribution-free statistical tests. London Prentice-Hall 1968, 68–86.
Hansson, T., Roos, B. The influence of age, height, and weight on the bone mineral content of lumbar vertebrae. Spine 1980, 5, 545–551.
Curtiss, P.H. Jr., Clark, W.S., Herndon, C.H. Vertebral fractures resulting from prolonged cortisone and corticotropin therapy. J Am Med Ass 1954, 156, 467–469.
Schaadt, O., Bohr, H. Bone mineral in lumbar spine, femoral neck and femoral shaft measured by dual photon absorptiometry with 153-gadolinium in prednisone treatment. Adv Exp Med Biol 1984, 171, 201–208.
Adinoff, A.D., Hollister, J.G. Steroid-induced fractures and bone loss in patients with asthma. N Engl J Med 1983, 309, 265–268.
Gluck, O.S., Murphy, W.A., Hahn, B. Bone loss in adults receiving alternate day glucocorticoid therapy. Arthritis Rheum 1985, 24, 892–898.
Greenberger, P.A., Hendrix, R.W., Patterson, R., Chmiel, J.S. Bone studies in patients on prolonged systemic corticosteroid therapy for asthma. Clin Allergy 1982, 12, 363–368.
Mueller, M.N. Effects of corticosteroids on bone mineral in rheumatoid arthritis and asthma. Am J Roentgenol 1976, 126, 1300.
Sambrook, P.N., Eisman, J.A., Yeates, M.G., Poeock, N.A., Eberl, S. Champion G.D. Osteoporosis in rheumatoid arthritis: safety of low dose corticosteroids. Ann Rheum Dis 1986, 45, 950–953.
Verstraeten, A., Dequeker, J. Vertebral and peripheral bone mineral content and fracture incidence in postmenopausal patients with rheumatoid arthritis: effect of low dose corticosteroids. Ann Rheum Dis 1986, 45, 852–857.
Als, O.S., Gotfredsen, A., Christiansen, C. The effect of glucocorticoids on bone mass in arthritis patients. Arthritis Rheum 1985, 28, 369–375.
Rickers, H., Deding, A., Christiansen, C., Rodbro, P. Mineral loss in cortical and trabecular bone during high-dose prednisone treatment. Calcif Tissue Int 1984, 36, 269–273.
Reid, D.M., Nicoll, J.J., Smith, M.A., Higgins, B., Tothill, P., Nuki, G. Corticosteroids and bone mass in asthma: comparisons with rheumatoid arthritis and polymyalgia rheumatica. Br Med J (Clin Res) 1986, 293, 1463–1466.
Ruegsegger, P., Medici, T.C., Anliker, M. Corticosteroid-bone loss. A longitudinal study of alternate day treatment in patients with bronchial asthma using quantitative computed tomography. Eur J Clin Pharmacol 1983, 25, 615–620.
Gennari, C. Glucocorticoids and bone. In: Bone and Mineral Research/3. Ed.: Peck, W.A., Amsterdam, Elsevier Publishers B.V. 1985, 213–232.
de Deuxchaisnes, C.N., Devogelaer, J.P., Esselinckx, W. The effect of low dosage glucocorticoids on bone mass in rheumatoid arthritis: a cross-sectional and longitudinal study using single-photon absorptiometry. Adv Exp Med Biol 1984, 171, 210–239.
Riggs, B.L., Wahner, H.W., Dunn, W.L., Mazess, R.B., Offord, K.P., Melton, L.J. III. Differential changes in bone mineral density of appendicular and axial skeleton with aging: relationship to spinal osteoporosis. J Clin Invest 1981, 63, 328–335.
Andersson, R., Rundgren, A., Rosengren, K., Bengtsson, B.Å., Malmvall, B.E., Mellström, D. Osteoporosis after long-term corticosteroid treatment of giant-cell arteritis. J Intern Med 1990, 227, 391–395.
Kennedy, A.C., Lindsay, R. Bone involvement in rheumatoid arthritis. Clin Rheum Dis 1977, 3, 403–420.
Hansson, T., Roos, B.O., Nachemson, A. Development of osteopenia in the fourth lumbar vertebra during prolonged bed rest after operation for scoliosis. Acta Orthop Scand 1975, 46, 621–630.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Nordborg, E., Hansson, T., Jonson, R. et al. Bone mineral content of the third lumbar vertebra during 18 months of prednisolone treatment for giant cell arteritis. Clin Rheumatol 12, 455–460 (1993). https://doi.org/10.1007/BF02231770
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02231770