Effectiveness of chronic treatment with alendronate in the osteoporosis of Cushing's disease

Carolina Di Somma, Annamaria Colao, Rosario Pivonello, Michele Klain, Antongiulio Faggiano, Francesca S. Tripodi, Bartolomeo Merola, Marco Salvatore, Gaetano Lombardi

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BACKGROUND: Osteoporosis is common in patients with Cushing's disease and is likely due to an imbalance between bone formation and resorption. Alendronate is an aminobisphosphonate that is able to increase bone mass mainly by inhibiting bone resorption. OBJECTIVE: We have evaluated the effect of chronic treatment with alendronate on bone mineral density (BMD) in patients with Cushing's disease. PATIENTS: 39 patients with Cushing's disease entered this study. 39 age-, sex- and BMI-matched normals served as controls for baseline evaluation. The 39 patients were divided into four groups: 1) 10 patients with active disease treated with alendronate and ketoconazole; 2) 11 patients with inactive disease treated with alendronate; 3) 8 patients with active disease treated with ketoconazole alone, 4) 10 patients with inactive disease received no treatment. TREATMENT PROTOCOL: Alendronate was given for 12 months in a dose of 10 mg orally once daily after fasting at 0800h in the morning. Ketoconazole was given in a dose of 200-600mg orally daily, when pituitary surgery was unsuccessful. STUDY DESIGN: Lumbar spine (L1-L4) and femoral neck BMD, serum osteocalcin (OC), urinary cross-linked N-telopeptides of type I collagen (Ntx) levels were evaluated at study entry, in patients and controls, and were repeated after 6 and 12 months in the 39 patients. RESULTS: BMD values were lower in patients with Cushing's disease than in controls at both L1-L4 (0.72±0.4 vs. 1.01±0.6 g/cm2, P2, P

Original languageEnglish
Pages (from-to)655-662
Number of pages8
JournalClinical Endocrinology
Issue number5
Publication statusPublished - 1998


ASJC Scopus subject areas

  • Endocrinology

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