Alendronate increases lumbar spine bone mineral density in patients with Crohn's disease

Background & Aims: Low bone mineral density (BMD) is a common complication of Crohn's disease and may lead to increased morbidity and mortality becaus e of fractures. We investigated the effect of treatment with the bisphospho nate alendronate on bone mass and markers of bone remodeling in patients wi th Crohn's disease. Methods: A 12-month double-blind, randomized, placebo-c ontrolled trial examined the effect of a 10-mg daily dose of alendronate. T hirty-two patients with a bone mass T score of -1 of the hip or lumbar spin e were studied. The main outcome measure was the difference in the mean per cent change in BMD of the lumbar spine measured by dual-energy x-ray absorp tiometry. Secondary outcome measures included changes in BMD of the hip and total body and biochemical markers of bone turnover (S-osteocalcin, urine pyridinoline, and urine deoxypyridinoline excretion). Results: Mean (+/-SEM ) BMD of the lumbar spine showed an increase of 4.6% +/- 1.2% in the alendr onate group compared with a decrease of 0.9% +/- 1.0% in patients receiving placebo (P < 0.01). BMD of the hip increased by 3.3% +/- 1.5% in the alend ronate group compared with a smaller increase of 0.7% +/- 1.1% in the place bo group (P = 0.08). Biochemical markers of bone turnover decreased signifi cantly in the alendronate group (P < 0.001). Alendronate was well tolerated , and there was no difference in adverse events among treatment groups. Con clusions: Treatment with alendronate, 10 mg daily, significantly increased BMD in patients with Crohn's disease and was safe and well tolerated.