Medicine Halts Steroid-Linked Bone Loss
Injection may even reverse damage from arthritis, asthma drugs

(HealthDay News) -- A once-a-year injection of a bone-strengthening drug appears to help counter the devastating effect that steroid medications can have on bone density.

People with asthma or rheumatoid arthritis often must rely on steroid medications, such as prednisone, to control their disease. However, that control comes with a cost. One of the major side effects of long-term use of steroids is the erosion of bone.

But a report in The Lancet on the drug Reclast (zoledronic acid), suggested that an annual shot might be able to stop or even reverse the side effect.

"The important point is that people who take glucocorticoid steroids for asthma or arthritis are all in danger of getting osteoporosis or fractures as a consequence," the study's lead author, Dr. David M. Reid, a rheumatology professor and head of the applied medicine division at the University of Aberdeen, in Scotland, told HealthDay. "But now, we have found that there is a simple way of preventing that almost absolutely by applying a single infusion once a year of this safe and effective drug."

Although it might seem that a person's skeletal structure is fixed and unchanging, the fact that bone is living tissue means that it's constantly shedding and regenerating, according to the American College of Rheumatology. And because people begin to make less bone as they age, more bone can be lost than is replaced. If bones become thin enough, the condition is known as osteoporosis, and the person becomes more at risk for fractures.

And though age is one of the biggest risk factors for osteoporosis, use of steroid medications is another, according to the college.

The study included more than 800 people who were taking steroid medications. Some were given an annual injection of Reclast, and others took a daily dose of risedronate (Actonel). The study was funded by Novartis, which makes Reclast.

In people who had been taking steroids for more than three months, the annual shot increased bone density by 4 percent, compared with a 2.7 percent boost with the daily medication.

In those on steroids for less than three months, Reclast raised bone density by 2.7 percent, and Actonel increased it 2 percent.

"I think the successful once-a-year use of this long-acting bisphosphonate is perhaps one of the most dramatic events that has occurred in the osteoporosis arena in the last few years," Dr. Mone Zaidi, a professor of medicine, endocrinology, diabetes and bone disease at the Mount Sinai School of Medicine in New York City told HealthDay.

Though the researchers didn't find any serious adverse events among the participants, some problems have been reported with bisphosphonates, the class of medications that Reclast and Actonel belong to. Other oral bisphosphonate medications have been linked to a higher risk of irregular heartbeats and certain types of fractures.

Some people on Reclast did report a slightly flu-like feeling after getting the injection, Reid said, but the study found no increase in fracture risk. In fact, he said, "there were virtually no fractures among the zoledronic [Reclast] patients."

On the Web

To learn more about medications that treat bone loss, visit the National Osteoporosis Foundation.

SOURCES: HealthDay News; David M. Reid, M.D., professor, rheumatology, and head, division of applied medicine, University of Aberdeen, Aberdeen, Scotland; Mone Zaidi, M.D., Ph.D., professor, medicine, endocrinology, diabetes and bone disease, Mount Sinai School of Medicine, New York City; April 11, 2009, The Lancet; American College of Rheumatology (www.rheumatology.org)
Author: Serena Gordon
Publication Date: May 31, 2010
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