Comparison of changes in bone mineral in idiopathic and secondary osteoporosis following therapy with cyclical disodium etidronate and high dose calcium supplementation

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Abstract
Summary: OBJECTIVE Our clinical practice has been to offer treatment with cyclical disodlum etidronate and high dose calcium supplements (1500–1600 mg/day) to ail female patients with osteoporosis who are unable or unwilling to take hormone replacement therapy (HRT), and male osteoporotics. In a retrospective study we compared the effect of this treatment on measures of bone mineral over a 12‐month period in women wlth post‐menopausal and secondary osteoporosis. We also assessed its effects in 10 male osteoporotics.DESIGN A retrospective analysis of 83 consecutive patients with osteoporosis who completed 12 months of treatment with disodlum etldronate and calcium and who had a dual energy X‐ray absorptiometry (DEXA) scan at baseline and foilowing 12 months of therapy.PATIENTS The study Included 73 women (45 post‐meno‐pausal and 28 secondary osteoporotics) and 10 men with established osteoporosis as shown by spinal and femoral bone mineral densities (BMD) > 2 standard deviations (SD) below young normals, and radioiogical evidence of osteoporosis.MEASUREMENTS Each patient had routine biochemistry at baseline, an X‐ray of thoracic and lumbar spine and a DEXA scan of lumbar spine (L2‐L4) and femoral neck. The DEXA scan was repeated following 12 months of therapy.RESULTS There was no difference between increase in spinal BMD in the post‐menopausal (5·7%) versus secondary osteoporotic group (6·7%). There was a significant increase in spinal BMD at 12 months in the 10 male osteoporotics (9·0%, P < 0·01). No overall change in femoral neck BMD was noted.CONCLUSIONS Cyclical disodium etidronate given with hlgh dose calcium supplements is equally effective in increasing spinal bone mineral density in post‐menopausal and secondary osteoporosis. It also results in a significant rise In spinal bone mineral density in male osteoporotics. Whether this produces a reduction in fracture rates is unknown.