The bisphosphonate alendronate sodium increases bone mineral density in patients with immunobullous diseases and glucocorticoid-induced osteoporosis, according to study results.
The double blind, placebo-controlled trial was conducted during a 12-month period at a Singapore immunodermatology center. Initially 44 patients were accepted into the randomized study. Patients had been newly diagnosed with one of five immunobullous diseases — bullous pemphigoid, pemphigus vulgaris, pemphigus foliaceus, epidermolysis bullosa acquisita, or cicatricial pemphigoid — and required at least 6 months of systemic therapy with glucocorticoids.
Researchers developed the study to assess the percentage change in bone mineral density (BMD) in all participants. It comprised an alendronate sodium group (n=22) and a placebo group (n=22), although only 15 patients receiving alendronate and 14 patients receiving placebo completed the study.
The alendronate group received 10 mg oral alendronate sodium daily for one year along with calcium plus vitamin D. The placebo group received calcium plus vitamin D only. The combined initial study group was primarily of Asian ethnicity (Chinese, Malay and Indian) with one white patient in the placebo group.
Investigators observed differences in BMD at the lumbar spine and femoral neck that were statistically significant (both P=.01). The mean percent increase in lumbar spine T score was 3.7% at 12 months; the femoral neck T score increased 3.5% during the same period.
“It is imperative to use bisphosphonates in patients with immunobullous disorders who are receiving oral corticosteroids,” researchers concluded, because they found “[bisphosphonates] significantly prevented the morbidity associated with low [bone mineral density] in this group.”