Does alternate-day cloprednol therapy prevent bone loss? A longitudinal double-blind, controlled clinical study

Area of Science:

• Endocrinology
• Bone Metabolism
• Pharmacology

Background:

• Systemic steroid treatment is linked to osteoporosis.
• Glucocorticoids like prednisone can cause significant bone mineral density loss.
• Cloprednol is a potent synthetic glucocorticoid with potentially fewer side effects.

Purpose of the Study:

• To compare the effects of alternate-day cloprednol and prednisone on bone mineral density.
• To evaluate bone loss in patients with lung diseases receiving glucocorticoid therapy.
• To assess the impact on trabecular and total bone density over one year.

Main Methods:

• A double-blind study comparing alternate-day cloprednol and prednisone.
• Inclusion of 39 patients with lung diseases and 10 asthma patients on beclomethasone as controls.
• Bone mineral density of the distal tibia and radius measured quarterly using computed tomography over one year.

Main Results:

• Initial mean trabecular bone density was 17% below normal in both treatment groups.
• After one year, radial trabecular bone loss was 1.33% with cloprednol and 2.38% with prednisone.
• Prednisone, but not cloprednol, caused significant bone loss in postmenopausal women (5.29% vs. 0.70%).

Conclusions:

• Alternate-day cloprednol therapy is associated with less bone loss than prednisone.
• Cloprednol may be a safer alternative for long-term glucocorticoid treatment concerning bone health.
• Further research is warranted to confirm these findings in diverse patient populations.