A study published on the website of the American Gastroenterological Association journal Clinical Gastroenterology and Hepatology in February 2005, found that adding the bone building drug etidronate to a regimen of calcium and vitamin D in Crohn's disease patients did not result in any additional improvement in bone mineral density. Treatment of Crohn's disease with corticosteroid drugs and the poor nutrition that results from the disease causes diminished bone mass and increased fracture risk. Calcium and vitamin D are routinely given to Crohn's disease patients to improve bone density.
In the current study, researchers from the University of Alberta randomly assigned 154 patients with Crohn's disease and osteopenia or osteoporosis to receive 400 milligrams etidronate or no drug for two weeks, followed by a 76 day period during which both groups received 500 milligrams calcium and 400 international units vitamin D. This treatment was repeated 8 times over a two year period. Bone mineral density was measured at the beginning of the study and at 6, 12 and 24 months.
Bone mineral density improved in both drug-treated and nontreated participants by 3 to 4 percent per year. At 24 months, bone mineral density had significantly increased in the lumbar spine, distal radius and trochanter, but not in the hip. There was no improvement observed in those who received etidronate in comparison to participants who did not receive the drug.
Study author Richard Fedorak, MD, commented, "Calcium and vitamin D therapy alone provide benefit to Crohn's patients who suffer from osteoporosis and osteopenia. We encourage physicians to look for loss of bone density in high risk patients with Crohn's disease and to start calcium and vitamin D therapy immediately if there is either osteoporosis or osteopenia."
The results of other trials currently testing the effect of newer bone-building drugs in Crohn's disease patients will be available in 2006.
Clinical Gastroenterology and Hepatology, Feb, 2005, American Gastroenterological Association www.cghjournal.org