EFFECT OF SODIUM-FLUORIDE ON THE PREVENTION OF CORTICOSTEROID-INDUCEDOSTEOPOROSIS

To investigate whether sodium fluoride (NaF) is able to prevent bone l oss in patients treated with corticosteroids (Cs), we performed a rand omized, double-masked, placebo-controlled trial with 44 Cs-treated pat ients without established osteoporosis, defined as the absence of prev ious peripheral fractures and Vertebral deformities on radiographs. Th e effects of NaF (25 mg twice daily) and placebo on the bone mineral d ensity (BMD) of the lumbar spine and hips were compared at baseline an d at 6, 12, 18 and 24 months. After 2 years, the BMD of the lumbar spi ne had decreased in the placebo group by 3.0% (95% CI: -4.9% to -1.0%; p<0.01); in the NaF group there was a statistically insignificant inc rease in BMD of 2.2% (95% CI: -0.8% to +5.3%). The difference in the c hanges in BMD between the two groups was +5.2% (95% CI: +1.8% to +8.6% ; p<0.01). In the hips, BMD had decreased after 2 years in both groups : in the placebo group by -3.0% (95% CI: -5.0% to -1.0%; p<0.05) and i n the NaF group by 3.8% (95% CI: -6.1% to -1.5%; p<0.01). The differen ce in the changes in BMD between the two groups was not significant: 0.8% (95% CI: -2.1% to +3.8%). Three vertebral deformities were observ ed in the placebo group and one in the NaF group (insignificant differ ence), while no peripheral fractures occurred during the study period. It is concluded that in Cs-treated patients without established osteo porosis NaF prevents bone loss in the lumbar spine but does not have a positive effect on the BMD of the hips.