Transplantation osteoporosis and corticosteroid-induced osteoporosis in autoimmune diseases: experience with alfacaleidol

The effect of alfacalcidol therapy on bone mineral density at the spine and proximal femur was evaluated in 112 transplant recipients (59 heart, 26 li ver and 27 lung); 45 transplant cases served as controls (included in a ran domised way in a placebo group) and in 42 rheumatoid arthritis cases. Liver and lung transplantation cases had before transplantation a lower bon e density at the spine and femur compared to heart transplant cases. Heart transplant cases lost considerably more bone immediately after transplantat ion than liver and lung transplant recipients. A positive effect of 2 years alfacalcidol treatment (0.5-1 mu g/day) on bon e loss was observed in all treated groups. Alfacalcidol was particularly ef fective against trabecular bone loss at the spine in rheumatoid arthritis p atients and transplant recipients. There is a manifest difference in evolut ion between organ transplant groups and bone sites measured. Liver and lung transplant recipients respond better to therapy than cardiac recipients.