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The effect of rectally administered steroids on bone turnover: a comparative study
R J Robinson1, S J Iqbal, R Wolfe
1Gastrointestinal Research Unit, Leicester General Hospital, UK.
Alimentary Pharmacology & Therapeutics
|May 7, 1998
Summary
Rectal steroid foams, including prednisolone and hydrocortisone, do not significantly impact bone turnover markers in inflammatory bowel disease patients over a 2-week treatment period. This suggests these treatments may not pose a high risk for bone metabolism issues.
Area of Science:
- Gastroenterology
- Endocrinology
- Bone Metabolism
Background:
- Oral glucocorticoids are a known risk factor for osteoporosis in inflammatory bowel disease (IBD).
- The impact of rectally administered steroids on bone metabolism in IBD patients is less understood.
- This study focuses on the bone health implications of commonly used rectal steroid foam preparations.
Purpose of the Study:
- To evaluate the effects of rectal prednisolone metasulphobenzoate and hydrocortisone acetate on bone turnover markers.
- To determine if short-term use of these rectal steroid foams influences bone formation or resorption.
- To assess the safety of these treatments concerning bone metabolism in IBD patients.
Main Methods:
- Twenty-four IBD patients received a 2-week course of either rectal prednisolone metasulphobenzoate or hydrocortisone acetate.
- Biochemical markers of bone turnover, including serum osteocalcin (BGP), bone-specific alkaline phosphatase (BALP), and urinary deoxypyridinoline (DPD), were measured.
- Measurements were taken before, during, and after the 2-week treatment period to assess changes in bone formation and resorption.
Main Results:
- Both rectal steroid preparations effectively improved IBD disease activity scores.
- No significant changes were observed in bone formation markers (BALP, BGP) during treatment with either steroid.
- Urinary deoxypyridinoline (DPD), a marker of bone resorption, also showed no significant alteration.
- Disease activity improved similarly in both treatment groups.
Conclusions:
- A 2-week course of rectal hydrocortisone acetate or prednisolone metasulphobenzoate did not significantly alter biochemical markers of bone formation or resorption.
- These findings suggest that pharmacological doses of rectal steroid foam preparations do not substantially impair bone turnover.
- Rectal steroid foams may represent a safer alternative regarding bone metabolism compared to oral glucocorticoids in IBD management.