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Rectal steroids suppress bone formation in patients with colitis
R J Robinson1, S J Iqbal, R P Whitaker
1Gastrointestinal Research Unit, Leicester General Hospital, UK.
Alimentary Pharmacology & Therapeutics
|February 1, 1997
Summary
Rectal steroids for distal colitis significantly reduced bone-specific alkaline phosphatase, a marker of bone formation. This suggests rectal steroid use may suppress bone formation in inflammatory bowel disease patients.
Area of Science:
- Gastroenterology
- Endocrinology
- Bone Metabolism
Background:
- Inflammatory bowel disease (IBD) is linked to bone loss, with corticosteroids being a major factor.
- Rectal steroids are common for distal IBD, but their bone metabolism effects are unclear.
- This study examines rectal prednisolone's impact on bone turnover markers.
Purpose of the Study:
- To investigate the effect of a standard 2-week course of rectal prednisolone on biochemical markers of bone turnover.
- To assess the impact of rectal steroid therapy on bone formation and resorption in patients with distal colitis.
Main Methods:
- A longitudinal study involving 10 patients treated with rectal prednisolone metasulphobenzoate (20 mg twice daily for 2 weeks).
- Measurement of bone formation markers: serum osteocalcin (BGP), bone-specific alkaline phosphatase (BALP), and procollagen carboxy-terminal propeptide (PICP).
- Measurement of bone resorption marker: urinary deoxypyridinoline (dPyr).
Main Results:
- Disease activity scores improved significantly during treatment (P=0.04).
- A significant decrease in bone-specific alkaline phosphatase (BALP) was observed (P=0.02).
- Serum osteocalcin (BGP), PICP, and urinary deoxypyridinoline (dPyr) showed non-significant changes.
Conclusions:
- A 2-week course of rectal prednisolone metasulphobenzoate significantly reduced bone-specific alkaline phosphatase activity.
- These findings suggest that pharmacological doses of rectal steroids may suppress bone formation in patients with distal colitis.