Alendronate in the treatment of low bone mass in steroid-treated boys with Duchenne's muscular dystrophy
Alendronate in the treatment of low bone mass in steroid-treated boys with Duchenne's muscular dystrophy
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DOI:
10.1016/j.apmr.2004.04.021
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发表时间:
2005-02-01
影响因子:
4.3
通讯作者:
Biggar, WD
中科院分区:
文献类型:
--
作者:
Hawker, GA;Ridout, R;Biggar, WD
Objective: To examine alendronate's side-effect profile and effect on bone mineral density (BMD) in deflazacort-treated boys with Duchenne's muscular dystrophy (DMD) and low BMD.Design: Before-after trial.Setting: Neuromuscular clinic at a children's hospital in Canada between 1999 and 2000.Participants: All consenting boys with DMD who had z scores less than -1.00 (spine and/or total body) and in whom BMD testing was feasible.Intervention: Boys received .08 mg(.)kg(-1.)d(-1) of alendronate orally, with 750mg of daily calcium and 1000IU of vitamin D. BMD, height, weight, physical activity, Tanner stage, and adverse effects were followed for 2 years.Main Outcome Measures: BMD z scores at the lumbar spine (L1-4) and total body.Results: Of the 42 eligible boys assessed, 23 had low BMD; for 16 of the 23, future BMD testing was feasible. Mean age was 10.8 years (range, 6.9-15.6y). Mean baseline z scores at the total body and spine were -0.80 and -1.94, respectively. At 2 years, mean z scores were unchanged. Furthermore, alendronate response varied by baseline age. In multivariable analysis, improvement in total body and spine z scores was associated with younger age at baseline (P=.01 for both).Conclusions: In deflazacort-treated boys, alendronate had a positive effect on BMD z scores; the effect was greatest when given early in the course of disease.