RESUMO
BACKGROUND: Osteoporosis is a complication of multiple sclerosis (MS), especially if corticosteroid therapy is given. Little is known about the effect on bone of immunomodulatory therapy (IMT) for MS. AIM: We sought to evaluate bone mass in patients with MS on IMT. METHODS: We measured bone mineral density (BMD) by dual energy X-ray absorptiometry (DXA) in 37 patients with MS who received IMT. Different IMTs were administered: interferon beta-1a in 70%, interferon beta-1b in 27% and Glatiramer in 3%. High-dose pulse corticosteroid therapy (intravenous methylprednisolone 500 mg) was given to 81% ranging from 1 to 17 courses. RESULTS: Both mean BMD Z-score at spine of 0.53 (CI, 0.15-0.92; P = 0.0084) and mean BMD Z-score at femur of 0.72 (CI, 0.42-1.01; P < 0.0001) were significantly greater than zero. CONCLUSIONS: IMT may have a favorable effect on bone in patients with MS even in the presence of pulse steroid therapy.
Assuntos
Corticosteroides/uso terapêutico , Densidade Óssea/efeitos dos fármacos , Fatores Imunológicos/uso terapêutico , Imunossupressores/uso terapêutico , Interferon beta/uso terapêutico , Esclerose Múltipla/complicações , Osteoporose/etiologia , Peptídeos/uso terapêutico , Absorciometria de Fóton , Adjuvantes Imunológicos/uso terapêutico , Adulto , Intervalos de Confiança , Feminino , França , Acetato de Glatiramer , Humanos , Interferon beta-1a , Interferon beta-1b , Irlanda , Masculino , Esclerose Múltipla/fisiopatologia , Osteoporose/tratamento farmacológico , Osteoporose/prevenção & controle , EspanhaRESUMO
According to a radiograph survey in 1982, Paget's disease of bone is common in Ireland but, to date, there have been no clinical reports. In a survey of 24 patients with Paget's disease of bone, we found monostotic disease in 8 and polyostotic disease in 16. Complications were common including deformity (21%), fracture (17%) and deafness (8%). Bisphosphonate therapy induced a remission in 22 patients.
