RESUMO
Background: Osteoporosis is defined as a reduction of bone density or the presence of a fragility fracture. One class of new antiosteoporotic drugs is the bisphosphonates. Oral bisphosphonates seems to induce serious gastrointestinal (GI) side effects in some patients. The aim of the study is to comparison the GI symptoms of Alendronate daily 10mg versus weekly 70mg administration in osteoporotic patients during 8 weeks. Materials and Methods: This is a clinical trial study that was conducted in the department of Internal Medicine, Shohada Ashayer Hospital, Khorramabad, Iran, 2002-2007. 195 osteoporotic patients selected for this study. They separated in three groups (first group: Placebo for eight weeks, 2 nd group 70 mg Alendronate at single dose per weeks for eight weeks and 3 rd group 10 mg Alendronate per day for 8 weeks). Then GI symptoms were detected for each person at different groups. Statistical Analysis: The Data was analyzed with Chi-square test and ANOVA. Results: comparison of mean of complications between groups shows that the patients in placebo group had lesser complications (P < 0.001). Comparison of each symptom between patients in 2 nd and 3 rd groups shows that only eructation had lesser frequency in first group of patients and other complications had not significant difference during 8 weeks of treatment. Conclusion: there is significant differences in GI symptoms between placebo and Alendronate but between Alendronate in doses of 10mg per day and 70 mg per week had not significant difference. Using of Alendronate must be cautiously because of producing severe GI disorders.
RESUMO
Objective: Evaluate the characteristics of arthropathy and musculoskeletal pain after chemotherapy in patients with breast cancer. Materials and Methods: In this study, we evaluate the characteristics of 15 patients with joint symptoms after receiving chemotherapy for breast cancer. Demographic information including sex, age, time of rheumatologic findings after starting of chemotherapy, and time of improvement after starting of medication, and laboratory findings detected for each patient. Results: Patients comprised 15 women with mean age 43.4 ± 10.6 years that received classic chemotherapy for breast cancer according to stage of disease including cyclophosphamide, and tamoxifen. Joint symptoms usually began about 6 months after the first session of chemotherapy. Patients had an average of 2 tender joints and 1 hour of morning stiffness. None of patients were positive for anti-nuclear antibody, and just 1 patient was positive for rheumatoid factor. Non-steroidal anti-inflammatory drugs, disease modifying anti-rheumatic drugs (DMARD), corticosteroids, and venlafaxine were prescribed. 5 patients did not show an improvement and were also given low dose oral corticosteroids. Follow-up was available for all patients. 13 patients showed favorable responses, characterized by a significant decrease (more than 50%) in morning stiffness, pain, and tender joint counts after a mean of 3 months' treatment. 9 patients had complete resolution of symptoms and stopped all medications. Conclusion: Chemotherapy-related arthropathy is not rare, and the prognosis is fairly good with early treatment using NSAID, DMARD, and corticosteroids.