Posted by: Indonesian Children | April 29, 2010

Effects of Risedronate on Bone Density in Anorexia Nervosa


Effects of Risedronate on Bone Density in Anorexia Nervosa

The Journal of Clinical Endocrinology & Metabolism Vol. 89, No. 8 3903-3906
Copyright © 2004 by The Endocrine Society

RAPID COMMUNICATION

Effects of Risedronate on Bone Density in Anorexia Nervosa

Karen K. Miller, Kelly A. Grieco, Jean Mulder, Steven Grinspoon, Diane Mickley, Revital Yehezkel, David B. Herzog and Anne Klibanski

Neuroendocrine Unit (K.K.M., K.A.G., J.M., S.G., R.Y., A.K.), and the Eating Disorders Unit (D.B.H.), Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114; and Wilkins Center for Eating Disorders (D.M.), Greenwich, Connecticut 06831

Address all correspondence and requests for reprints to: Karen K. Miller, M.D., Neuroendocrine Unit, Massachusetts General Hospital, Boston, Massachusetts 02114. E-mail: kkmiller{at}partners.org

Abstract

Anorexia nervosa (AN), a psychiatric disease characterized by chronic starvation, is complicated by severe bone loss (1), for which there is no effective, available therapy. Although bone resorption is markedly increased in these patients, estrogen is an ineffective anti-resorptive therapy in the setting of undernutrition. We hypothesized bisphosphonate administration would result in a decrease in bone resorption and an increase in bone density in women with AN and bone loss, despite undernutrition. We therefore administered risedronate 5 mg daily for nine months to 10 women with AN, all of whom had osteopenia (mean AP spine T score: –2.7 ± 2) and compared NTX and bone density with baseline values and with those from available control data prospectively followed for the same time period. Bone density increased significantly in patients who received risedronate compared with controls and compared with baseline, despite lack of significant weight gain, for an increase of AP spine bone density of 4.1 ± 1.6% at six months and 4.9 ± 1.0% at nine months. Bone resorption, as measured by NTX, decreased 23.8% at one month and 29.6% at three months, from the high-normal to mid-normal range of young women. Our data suggest that risedronate 5 mg daily administered to women with AN and osteopenia may increase in bone density at the AP spine despite low weight. This is the first study to demonstrate marked increases in bone density in women with AN. Because of the lack of data regarding the safety of such medications in women of reproductive age, bisphosphonates are not approved in the U.S. for premenopausal women other than those receiving glucocorticoids. Further studies are needed to establish the efficacy and safety of bisphosphonate therapy in this population.

Supported by

PICKY EATERS CLINIC

KLINIK KHUSUS KESULITAN MAKAN PADA ANAK

JL TAMAN BENDUNGAN ASAHAN 5 JAKARTA PUSAT, JAKARTA INDONESIA 10210

PHONE :62 (021) 70081995 – 5703646

Email : judarwanto@gmail.com

https://mypickyeaters.wordpress.com/

Clinical and Editor in Chief :

DR WIDODO JUDARWANTO, pediatrician

email : judarwanto@gmail.com,

Copyright © 2010, Picky Eaters Clinic Information Education Network. All rights reserved.


Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

Categories