Document Detail


Osteoporosis and thyrotropin-suppressive therapy: reduced effectiveness of alendronate.
MedLine Citation:
PMID:  19415993     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Many reports of the effect of exogenous thyroxine therapy on bone mineral density (BMD) show a relationship between excess thyroid hormone administration and osteoporosis. The aim of this study was to evaluate the effect of antibone resorptive agents, in particular alendronate (ALN) on BMD in postmenopausal osteoporotic women with thyroid carcinoma who were receiving long-term thyrotropin (TSH)-suppressive therapy with thyroxine. METHODS: Seventy-four postmenopausal women with low BMD (T-score < or =-2.5) and differentiated thyroid carcinoma on long-term TSH-suppressive therapy (TSH > or =0.05 and < or =0.1 microU/mL) for about 3-9 years were selected for the study. The patients were divided into three groups according to the length of levothyroxine (LT(4)) treatment prior to the beginning of the study: group A (TSH-suppressive therapy for about 3 years), group B (for about 6 years), and group C (for about 9 years). These patients were compared with 74 matched women not taking LT(4). All patients and controls were treated with bisphosphonates, calcium, and vitamin D for 2 years and evaluated. RESULTS: After 24 months of treatment group A showed a 7.8% increase in lumbar BMD; group B, a 4.6% increase; and group C, a 0.86% increase. In the control group BMD increased 8.2%. A significant difference was found in both lumbar and femoral BMD increase among the three groups: group C had a lower BMD increase than group A (p < 0.001) and B (p < 0.001). CONCLUSIONS: In postmenopausal women who were receiving adequate amounts of calcium and vitamin D in their diet ALN was less effective for those who were also receiving TSH-suppressive doses of LT(4) for either 6 or 9 years. The positive effect of ALN on BMD was less for longer periods of LT(4) treatment. It seems likely that other bisphosphonates would also be less effective in increasing BMD in postmenopausal women receiving TSH-suppressing doses of LT(4).
Authors:
Annalisa Panico; Gelsy Arianna Lupoli; Francesco Fonderico; Francesca Marciello; Addolorata Martinelli; Roberta Assante; Giovanni Lupoli
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Thyroid : official journal of the American Thyroid Association     Volume:  19     ISSN:  1557-9077     ISO Abbreviation:  Thyroid     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-05-06     Completed Date:  2009-07-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9104317     Medline TA:  Thyroid     Country:  United States    
Other Details:
Languages:  eng     Pagination:  437-42     Citation Subset:  IM    
Affiliation:
Department of Endocrinology and Molecular and Clinical Oncology, University of Naples Federico II, Naples, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adult
Alendronate / therapeutic use*
Antineoplastic Agents, Hormonal / adverse effects*
Bone Density / drug effects*
Bone Density Conservation Agents / therapeutic use*
Calcium / therapeutic use
Carcinoma / complications,  drug therapy*,  pathology
Case-Control Studies
Dietary Supplements
Drug Interactions
Female
Femur / drug effects,  radiography
Humans
Lumbar Vertebrae / drug effects,  radiography
Middle Aged
Osteoporosis, Postmenopausal / complications,  drug therapy*,  radiography
Thyroid Neoplasms / complications,  drug therapy*,  pathology
Thyroxine / adverse effects*
Time Factors
Treatment Outcome
Vitamin D / therapeutic use
Chemical
Reg. No./Substance:
0/Antineoplastic Agents, Hormonal; 0/Bone Density Conservation Agents; 1406-16-2/Vitamin D; 66376-36-1/Alendronate; 7440-70-2/Calcium; 7488-70-2/Thyroxine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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