Decreased bone mineral density during low dose glucocorticoid administration in a randomized, placebo controlled trial

R. McKenzie, J. C. Reynolds, A. O'Fallon, James Dale, M. Deloria, W. Blackwelder, S. E. Straus

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Objective. While osteoporosis and bone fractures are clearly recognized side effects of high dose glucocorticoids, the effect of low dose glucocorticoids remains controversial. We investigated the effect of 3 months of low dose hydrocortisone on bone mineral density (BMD). Methods. Subjects, 18 to 55 years old with chronic fatigue syndrome and no medical or psychiatric illness requiring medication, were randomized in a double blind, placebo controlled trial to receive oral hydrocortisone, 13 mg/m2 body surface area every morning and 3 mg/m2 every afternoon (25 to 35 mg/day, equivalent to about 7.5 mg prednisone/day) or placebo for 12 weeks. Before and after treatment BMD of the lumbar spine was measured by dual energy x-ray absorptiometry. Results. We studied 23 subjects (19 women, 4 men). For the 11 hydrocortisone recipients there was a mean decrease in BMD: mean change from baseline of the lateral spine was -2.0% (95% CI -3.5 to -0.6, p = 0.03) and mean change of the anteroposterior spine was -0.8% (95% CI -1.5 to -0.1, p = 0.06). Corresponding changes for the 12 placebo recipients were -1.0% (95% CI -1.0 to 3.0, p = 0.34) and +0.2% (95% CI -1.4 to 1.5, p = 0.76). Conclusion. A 12 week course of low dose glucocorticoids given to ambulatory subjects with chronic fatigue syndrome was associated with a decrease in BMD of the lumbar spine. This decrease was statistically significant in lateral spine measurements and nearly so in anteroposterior spine measurements.

Original languageEnglish (US)
Pages (from-to)2222-2226
Number of pages5
JournalJournal of Rheumatology
Volume27
Issue number9
StatePublished - Sep 28 2000
Externally publishedYes

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Bone Density
Glucocorticoids
Spine
Randomized Controlled Trials
Placebos
Hydrocortisone
Chronic Fatigue Syndrome
Body Surface Area
Bone Fractures
Prednisone
Osteoporosis
Psychiatry
X-Rays

All Science Journal Classification (ASJC) codes

  • Rheumatology
  • Immunology and Allergy
  • Immunology

Cite this

McKenzie, R., Reynolds, J. C., O'Fallon, A., Dale, J., Deloria, M., Blackwelder, W., & Straus, S. E. (2000). Decreased bone mineral density during low dose glucocorticoid administration in a randomized, placebo controlled trial. Journal of Rheumatology, 27(9), 2222-2226.

Decreased bone mineral density during low dose glucocorticoid administration in a randomized, placebo controlled trial. / McKenzie, R.; Reynolds, J. C.; O'Fallon, A.; Dale, James; Deloria, M.; Blackwelder, W.; Straus, S. E.

In: Journal of Rheumatology, Vol. 27, No. 9, 28.09.2000, p. 2222-2226.

Research output: Contribution to journalArticle

McKenzie, R, Reynolds, JC, O'Fallon, A, Dale, J, Deloria, M, Blackwelder, W & Straus, SE 2000, 'Decreased bone mineral density during low dose glucocorticoid administration in a randomized, placebo controlled trial', Journal of Rheumatology, vol. 27, no. 9, pp. 2222-2226.
McKenzie R, Reynolds JC, O'Fallon A, Dale J, Deloria M, Blackwelder W et al. Decreased bone mineral density during low dose glucocorticoid administration in a randomized, placebo controlled trial. Journal of Rheumatology. 2000 Sep 28;27(9):2222-2226.
McKenzie, R. ; Reynolds, J. C. ; O'Fallon, A. ; Dale, James ; Deloria, M. ; Blackwelder, W. ; Straus, S. E. / Decreased bone mineral density during low dose glucocorticoid administration in a randomized, placebo controlled trial. In: Journal of Rheumatology. 2000 ; Vol. 27, No. 9. pp. 2222-2226.
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