Uncertainty over whether corticosteroids cause bone loss in patients with Crohn's disease may reflect their short, intermittent use.
Researchers from Bristol, England investigated whether a 2-month course of prednisolone is associated with detectable bone loss.
The research group recruited 15 patients with active Crohn's disease and 19 controls with inactive Crohn's disease.
The investigators measured bone mineral density of the lumbar spine and hip at baseline and 2 and 8 months.
At 2 months, the researchers found significant bone loss in patients with active disease (femoral neck 2.7%; Ward's triangle 3.9%).
In addition, the researchers found that although bone mineral density was still lower at 8 months, these differences were no longer significant (1.3% and 3.4%, femoral neck and Ward's triangle, respectively).
|Rapid bone loss may represent a risk factor for fracture and justify bone protective therapy|
|Alimentary Pharmacology and Therapeutics|
The group observed no significant change in hip bone mineral density in controls.
Previous corticosteroid use was not significantly associated with baseline bone mineral density.
Although the researchers did note that there were significant independent associations between weight, site of disease and lumbar spine bone mineral density, and between dietary calcium deficiency and femoral neck and Ward's triangle bone mineral density.
Dr Probert, speaking on behalf of the group concluded, "Significant bone loss at the hip can be detected in patients receiving corticosteroid treatment for 2 months for active Crohn's disease."
"However, it remains unclear whether this is because of disease activity or its treatment."
"This rapid bone loss may represent a risk factor for fracture and justify bone protective therapy."