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Decrease in Bone Formation and Bone Resorption during Intravenous Methylprednisolone Pulse Therapy in Patients with

Joanna Rymuza¹, Klaudia Gutowska^1,2, Dagmara Kurpios-Piec³

¹Department of Internal Medicine and Endocrinology, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland.

Journal of Clinical Medicine

|September 9, 2022

Summary

Intravenous methylprednisolone (IVMP) transiently decreases bone turnover markers after a single dose. Full IVMP therapy suppresses both bone formation and resorption markers in patients with Graves’ orbitopathy.

Keywords:

Graves’ ophthalmopathy Graves’ orbitopathy bone turnover marker intravenous glucocorticoids intravenous methylprednisolone

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Area of Science:

Endocrinology
Bone Metabolism
Ophthalmology

Background:

Glucocorticoids (GCs) have known bone side effects, particularly oral formulations.
Limited data exist on the skeletal impact of intravenous GCs.
Intravenous methylprednisolone (IVMP) is used for conditions like Graves’ orbitopathy.

Purpose of the Study:

To investigate the effects of IVMP on bone turnover markers (BTM) and calcium metabolism.
To assess changes in P1NP, CTX, vitamin D, calcium, phosphate, and iPTH following IVMP treatment.

Main Methods:

Prospective study of 23 patients with Graves’ orbitopathy receiving IVMP therapy.
Evaluation of BTM and calcium parameters after the first 0.5 g IVMP pulse.
Assessment after a full course of 12 IVMP pulses (4.5 g cumulative dose).

Main Results:

A single 0.5 g IVMP pulse caused a rapid, transient decrease in P1NP and CTX.
Following the complete IVMP therapy, significant reductions in both P1NP and CTX were observed.
No specific mention of calcium metabolism parameters' results in the abstract.

Conclusions:

Even a single IVMP pulse impacts bone formation and resorption, though transiently.
The full IVMP therapy course leads to a sustained suppression of overall bone turnover.
Further research may be needed to fully elucidate effects on calcium metabolism.