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Journal of Endocrinological Investigation

Published in:

01-07-2019 | Original Article

Bone turnover markers, BMD and TBS after short-term, high-dose glucocorticoid therapy in patients with Graves’ orbitopathy: a small prospective pilot study

Authors: S. Censi, J. Manso, G. Pandolfo, G. Franceschet, E. Cavedon, Y. H. Zhu, S. Carducci, W. Gomiero, M. Plebani, M. Zaninotto, S. Watutantrige-Fernando, C. Mian, V. Camozzi

Published in: Journal of Endocrinological Investigation | Issue 7/2019

Abstract

Purpose

Chronic GC administration has numerous side effects, but little is known about the side effects of their short-term use (< 3 months)—particularly, when high doses are involved, as in the treatment of Graves’ orbitopathy (GO). We investigated the effects of short-term, high-dose GC on bone turnover markers, bone mineral density (BMD), and trabecular bone scores (TBS).

Methods

Eleven patients (10 females and 1 male; median age 56 years) with active GO who were candidates for treatment with intravenous (iv) methylprednisone were consecutively enrolled. All patients were pretreated with a loading dose of 300,000 units of cholecalciferol, then given a median cumulative dose of 4.5 g (range 1.5–5.25 g) iv methylprednisone. Biochemical parameters of bone metabolism (25OHD3, PTH, P1NP, CTX and bALP) were measured at the baseline, and then 1 week and 1, 3, 6 and 12 months. BMD and TBS were obtained by X-ray absorptiometry (DXA) at the baseline and at 6 and 12 months. On DXA image, morphometric vertebral fracture assessment (VFA) was done.

Results

There were no significant changes in PTH, bALP or P1NP. A significant drop in CTX was seen at 1 month (down Δ49.31% from the baseline, p = 0.02), with a return to the baseline at the 3-month measurement. There was a moderate (not significant), but persistent reduction in P1NP. No changes in BMD or TBS came to light. No vertebral fractures were documented.

Conclusions

Short-term, high-dose GC treatment caused a rapid, transient suppression of bone resorption, with no effects on BMD or bone micro-architecture (TBS).

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Title: Bone turnover markers, BMD and TBS after short-term, high-dose glucocorticoid therapy in patients with Graves’ orbitopathy: a small prospective pilot study
Authors: S. Censi
J. Manso
G. Pandolfo
G. Franceschet
E. Cavedon
Y. H. Zhu
S. Carducci
W. Gomiero
M. Plebani
M. Zaninotto
S. Watutantrige-Fernando
C. Mian
V. Camozzi
Publication date: 01-07-2019
Publisher: Springer International Publishing
Published in: Journal of Endocrinological Investigation / Issue 7/2019
Electronic ISSN: 1720-8386
DOI: https://doi.org/10.1007/s40618-018-0992-z

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Abstract

Purpose

Methods

Results

Conclusions

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