Table 3—

Studies on the treatment with bisphosphonates in chronic lung diseases

1st author [ref no.] yrType of studyPatients' characteristicsTreatment with bisphosphonatesComparative treatmentOutcome measuresMain results
Wang 127 1998Prospective randomised controlled over 18 monthsAsthma, inhaled CS>1.5 mg·day−1 (beclomethasone or budesonide) for >12 months, no continuous systemic CS (n=28)Cyclical etidronate, 400 mg·day−1 for 14 days, then calcium lactate-gluconate, 1000 mg·day−1 for 76 days.1) No supplements 2) Calcium lactate-gluconate, 1000 mg·day−1BMD at lumbar spine and hip, bone markersLoss of BMD (spine) for no supplements group; increased BMD (spine) for calcium and for etidronate + calcium groups; increased BMD (hip) in calcium only group
Gallacher 129 1992Prospective over 12 monthsAsthma (n=15) and sarcoidosis (n=2), prednisolone for 3–30 yrs, 7.5–40 mg·day−1Pamidronate, 30 mg every 3 monthsBMD at lumbar spine and hipMean gain in BMD 3.4% at spine, no change at femoral neck
Muratore 130 2000Prospective randomised over 12 monthsAsthma (n=60), inhaled CS fluticasone 1 mg·day−1 or beclomethasone 1 mg·day−1Clodronate 100 mg every 14 days. All received calcium 1000 mg·day−1Calcium 1000 mg·day−1BMD lumbar spine, bone markersMean gain in BMD (clodronate groups) 0.7–1.2%. Loss in BMD (no clodronate) (−1) – (−0.5)%
Herrala 131 1998Prospective randomised double-blind placebo controlled over 12 monthsAsthma, long-term (>6 months) oral CS and inhaled CS (n=74)1) Clodronate 800 mg·day−1 (capsules); 2) clodronate 1600 mg·day−1 (capsules); 3) clodronate 2400 mg·day−1 (capsules)Placebo capsulesBMD lumbar spine, femoral neck and trochanter, bone markersBMD increased in groups 2 and 3 at spine and in group 3 at trochanter and femoral neck. Increased PTH in groups 2 and 3
Lau 132 2001Prospective randomised placebo controlled over 12 monthsAsthma (n=70) or COPD (n=8) inhaled CS (beclonethasone, budesonide or fluticasone) 0.8 mg to >1.6 mg·day−1Alendronate 10 mg·day−1 (oral) and calcium carbonate 500 mg·day−1Placebo (oral) and calcium carbonate 500 mg·day−1BMD lumbar spine and hipMean gain in BMD 3% (spine) and 1.6% (total hip) in alendronate group; loss of BMD 0.8% (spine) and 0.37% (total hip) in placebo group
Struys 128 1995Prospective open-label over 12 monthsPatients with CS induced osteoporosis on chronic prednisolone treatment (>10 mg·day−1) for pulmonary and other diseases (n=39)Cyclic etidronate 400 mg·day−1 for 14 days, then calcium 500 mg·day−1 for 76 daysCalcium 500 mg·day−1BMD lumbar spine and hipMean gain in BMD 5.7% (spine) and 6.8% (total hip); loss of 3.4% (spine) and 4.1% (hip) in the calcium only group
Haworth 133 2001Prospective randomisedCystic fibrosis (n=28)Pamidronate 30 mg every 3 months and calcium 1000 mg·day−1Calcium 1000 mg·day−1BMD lumbar spine, hip and distal forearmMean gain in BMD after 6 months was 5.8% (spine) and 3.0 (hip) but reduction of 1.7% (forearm) in pamidronate group
Aris 134 2000Prospective randomised over 2 yrsCystic fibrosis after lung transplant (n=34)Pamidronate 30 mg every 3 months with ergocalciferol 800 IU·day−1 and calcium carbonate 1000 mg·day−1Ergocalciferol 800 IU·day−1 and calcium carbonate 1000 mg·day−1BMD spine and femur, bone markers, vertebral and long bone fractures, kyphosis anglesIncreased spine and femur BMD in pamidronate group. NTx levels decreased in pamidronate group. Four (pamidronate group) and seven (control group) patients had vertebral fractures.