Calcified Tissue International

, Volume 60, Issue 2, pp 155–159

Calcitonin, Etidronate, and Calcidiol Treatment in Bone Loss after Cardiac Transplantation

  • I.  Garcia-Delgado
  • S.  Prieto
  • L.  Gil-Fraguas
  • E.  Robles
  • J. J.  Rufilanchas
  • F.  Hawkins
Article

DOI: 10.1007/s002239900206

Cite this article as:
Garcia-Delgado, I., Prieto, S., Gil-Fraguas, L. et al. Calcif Tissue Int (1997) 60: 155. doi:10.1007/s002239900206

Abstract.

Cardiac transplantation is associated with severe bone loss caused by glucocorticoids, immunosuppressive treatment, and other factors. Treatment protocols for the prevention of bone loss is being studied. Forty patients who underwent cardiac transplantation were randomly given calcitonin (n= 13; 100 UI/d, nasal route), etidronate (n= 14; cyclical treatment 400 mg p.o./d/2 weeks/3 months), or calcidiol (n= 13; 32,000 IU/weekly) therapy for at least 18 months. Serum parameters (Ca, P, alkaline phosphatase, osteocalcin, intact PTH), urinary calcium, and vertebral mineral density (VMD; L2–L4, DXA Hologic QDR 1000) were measured immediately before treatment and after 6, 12, and 18 months of therapy after cardiac transplantation. Patients with cardiac transplantation had a VMD significantly lower than age and sex-matched Spanish controls. Prevalence of osteoporosis (Z-score below −2 SD) was 30%. Osteocalcin levels increased at 6, 12, and 18 months of treatment in the three groups. After 18 months of treatment, VMD increased significantly in the calcidiol 4.9%, vs. −1.19% and −0.19% in the calcitonin and etidronate groups, respectively. A lower incidence of fracture was found in patients treated with calcidiol during the study. In summary, we have found in this open randomized study that calcidiol was the most effective drug in the prevention and treatment of bone loss in patients after cardiac transplantation.

Key words: Dual X-ray absorptiometry — Cardiac transplantation — Bone markers — Vitamin D — Bone loss. 

Copyright information

© Springer-Verlag New York Inc. 1997

Authors and Affiliations

  • I.  Garcia-Delgado
    • 1
  • S.  Prieto
    • 2
  • L.  Gil-Fraguas
    • 1
  • E.  Robles
    • 1
  • J. J.  Rufilanchas
    • 2
  • F.  Hawkins
    • 3
  1. 1.Service of Rehabilitation, University Hospital, 12 de Octubre, Ctra. Andalucia Km 5.4, 28041 Madrid, SpainES
  2. 2.Service of Cardiac Surgery, University Hospital, 12 de Octubre, Ctra. Andalucia Km 5.4, 28041 Madrid, SpainES
  3. 3.Service of Endocrinology, University Hospital, 12 de Octubre, Ctra. Andalucia Km. 5.4, 28041 Madrid, SpainES

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