Dr Kent Haderslev and colleagues from Copenhagen, Denmark, investigated the effect of alendronate therapy on the BMD of 32 Crohn's disease patients in remission (van Hess index <150), but with osteoporosis.
Patients with a Bone Mass T score of -1 of hip or lumbar spine were administered 10 mg alendronate or placebo over a 12-month period, in a double-blind, randomised trial.
Outcomes were assessed by dual-energy x-ray absorption of the lumber spine at 6 and 12 months, by hip and whole body BMD recording, and by regular bone turnover marker monitoring.
Alendronate +4.6% /12 m
Placebo -0.9% / 12m.
The mean lumbar BMD of treated patients increased by 4.6% over 12 months, against a decrease of 0.9% for placebo.
Non-significant BMD increases were observed in the hip and whole body values of the alendronate group. Improvements were consistent in male and both pre-menopausal and post-menopausal females who received alendronate. Bone turnover markers decreased significantly in the treated group.
"Treatment with alendronate 10mg daily is well tolerated and significantly improves BMD in Crohn's disease."
Alendronate was well tolerated, 67% of subjects reporting no or mild adverse symptoms.
Kent Haderslev concludes that alendronate therapy is useful in management of osteoporosis in Crohn's disease in remission, and should be considered for patients at risk of developing osteoporosis.