Attention to bones important in women with lupus

Among premenopausal women taking steroids for lupus, various treatments preserve bone mineral density and “should be considered” for preventing the bone-thinning disease osteoporosis, advise researchers in a report published this month.

Lupus, technically known as systemic lupus erythematosus or SLE, is a chronic “autoimmune” disease in which the immune system can confuse healthy and foreign tissues and sometimes attacks both.

“Whether due to the corticosteroid treatment, or to the disease itself, osteoporosis is being increasingly recognized in patients with SLE,” Dr. Swan S. Yeap, of the University of Malaya, Kuala Lumpur, and colleagues explain in the Journal of Rheumatology.

Yeap’s team assessed changes over 2 years in bone mineral density (BMD) in 98 premenopausal women with SLE on long-term steroid therapy while taking calcium only, calcium plus calcitriol (the active form of vitamin D) or calcium plus the bone-strengthening drug alendronate (Fosamax).

Women taking calcium plus alendronate saw significant increases in BMD at both the lumbar spine (2.69 percent) and hip (1.41 percent) compared to baseline, the researchers report.

In contrast, there were no significant changes found in the calcium-only and the calcium plus calcitriol groups, except for a 0.93 percent reduction in hip BMD in the calcium-only group. The medications were well tolerated.

In premenopausal women taking steroids for SLE, the researchers conclude, bone mineral density can be preserved or increased with prophylactic therapy.

SOURCE: Journal of Rheumatology, December 2008.

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