COMPARISON OF CHANGES IN BONE-MINERAL IN IDIOPATHIC AND SECONDARY OSTEOPOROSIS FOLLOWING THERAPY WITH CYCLICAL DISODIUM ETIDRONATE AND HIGH-DOSE CALCIUM SUPPLEMENTATION

OBJECTIVE Our clinical practice has been to offer treatment with cycli cal disodium etidronate and high dose calcium supplements (1500-1600 m g/day) to all female patients with osteoporosis who are unable or unwi lling to take hormone replacement therapy (HRT), and male osteoporotic s. In a retrospective study we compared the effect of this treatment o n measures of bone mineral over a 12-month period in women with post-m enopausal and secondary osteoporosis. We also assessed its effects in 10 male osteoporotics. DESIGN A retrospective analysis of 83 consecuti ve patients with osteoporosis who completed 12 months of treatment wit h disodium etidronate and calcium and who had a dual energy X-ray abso rptiometry (DEXA) scan at baseline and following 12 months of therapy. PATIENTS The study included 73 women (45 post-menopausal and 28 secon dary osteoporotics) and 10 men with established osteoporosis as shown by spinal and femoral bone mineral densities (BMD) >2 standard deviati ons (SD) below young normals, and radiological evidence of osteoporosi s. 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 i n the 10 male osteoporotics (9.0%, P < 0.01). No overall change in fem oral neck BMD was noted. CONCLUSIONS Cyclical disodium etidronate give n with high dose calcium supplements is equally effective in increasin g spinal bone mineral density in post-menopausal and secondary osteopo rosis. It also results in a significant rise in spinal bone mineral de nsity in male osteoporotics. Whether this produces a reduction in frac ture rates is unknown.