Prevention of steroid-induced osteonecrosis by intravenous administration of vitamin E in a rabbit model

We focused on vitamins with marked antioxidant potency to see whether their use might prevent the development of steroid-induced osteonecrosis.

Fifteen Japanese white rabbits weighing about 3.5 kg were injected once into the right gluteal muscle with methylpred-nisolone (MPSL) 40 mg/kg (S group). In addition, 10 other rabbits received consecutive daily intravenous injections of vitamin E 50 mg/kg, starting from the day of MPSL administration (E group). All animals were killed 2 weeks after MPSL administration, and femurs were extracted and stained with H&E. Blood levels of reduced glutathione (GSH) were also measured.

In the S group the osteonecrosis development rate was 93%, in contrast to 0% in the E group (P < 0.01). Also, GSH levels in the S group abruptly decreased from the first day after MPSL administration, whereas in the E group, the decline in GSH levels was significantly suppressed on days 1 and 3 after MPSL administration (P< 0.05).

Vitamin E administration significantly inhibited steroid-induced oxidative stress. The results of this study suggest that the administration of vitamin E may be a novel and simple method to prevent the development of steroid-induced osteonecrosis.