Therapy of steroid-induced bone loss in adult asthmatics with calcium, vitamin D, and a diphosphonate

Am J Respir Crit Care Med. 1994 Aug;150(2):394-7. doi: 10.1164/ajrccm.150.2.8049820.


In a prospective, controlled, and randomized clinical trial, we examined the effects of treatment with vitamin D (1,000 IU/d), calcium (1 g/d), and ethane-1-hydroxy-1,1-diphosphonate (EHDP; 7.5 mg/kg body weight) on vertebral bone mass in fourteen asthmatics undergoing long-term treatment with systemically applied corticosteroids. The extent of steroid-induced bone loss was judged by vertebral bone density of the lumbar spine measured by dual-photon absorptiometry as well as by vertebral crush fracture incidence examined by conventional X-ray. Results of the measurements before treatment and after six mo were compared with those of an untreated control group of nineteen asthmatics. Bone density increased during the observation period by 5% in the treated group, compared with a decrease of 4.3% in the untreated control group (p < 0.01). Moreover, in the treated group no radiologically visible new fractures occurred; in the control group new fractures were observed in four patients. There were no serious side effects of the applied drugs during the 6-mo period. Therefore, the combination of EHDP, calcium, and vitamin D appears to be a useful regimen for the management of steroid-induced bone loss in adult asthmatics.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Adrenal Cortex Hormones / adverse effects*
  • Adrenal Cortex Hormones / therapeutic use
  • Asthma / drug therapy*
  • Bone Density
  • Calcium / administration & dosage*
  • Calcium / therapeutic use
  • Drug Therapy, Combination
  • Etidronic Acid / administration & dosage*
  • Etidronic Acid / therapeutic use
  • Female
  • Humans
  • Male
  • Middle Aged
  • Osteoporosis / chemically induced
  • Osteoporosis / drug therapy*
  • Osteoporosis / metabolism
  • Prednisone / adverse effects
  • Prednisone / therapeutic use
  • Prospective Studies
  • Radiography
  • Spinal Fractures / diagnostic imaging
  • Spinal Fractures / etiology
  • Vitamin D / administration & dosage*
  • Vitamin D / therapeutic use


  • Adrenal Cortex Hormones
  • Vitamin D
  • Etidronic Acid
  • Calcium
  • Prednisone