PMC3150473_01
PMC3150473_02
PMC3150473_03
Radiographs of the thoracic and lumbar spine - lateral views before treatment. The radiographs of the thoracic and lumbar spine at her first consultation with our clinic showed multiple vertebral fractures (morphometric fractures) in the thoracic and lumbar spine and increased kyphosis of the thoracic spine.
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The radiographs of the thoracic and lumbar spine showed multiple vertebral fractures (morphometric fractures) in the thoracic and lumbar spine according to the Japanese diagnostic criteria for osteoporotic vertebral fractures and increased kyphosis of the thoracic spine (Figure 1).
PMC3150473_04
Changes in lumbar spine BMD. After 1 year of alfacalcidol treatment, the lumbar spine BMD decreased. Then, treatment was switched to cyclical etidronate and was sustained for 7 years. The lumbar spine BMD increased after the start of etidronate treatment. The increase rate was 3.6% at 1 year, 8.4% at 2 years, 8.4% at 3 years, 6.8% at 4 years, 6.7% at 5 years, 8.3% at 6 years, and 8.1% at 7 years.. Abbreviations: ALF, alfacalcidol; BMD, bone mineral density; ETD, etidronate.
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Figure 2 shows the longitudinal changes in the lumbar spine BMD during the 7-year period of etidronate treatment.
Changes in serum calcium, phosphorus, ALP, and creatinine. After 1 year of treatment with alfacalcidol, the serum ALP level did not change significantly. Then, treatment was switched to cyclical etidronate and was sustained for 7 years. The serum ALP markedly decreased. The rate of reduction in the serum ALP level was 40.0% at 1 year, 51.5% at 2 years, and 48.8% at 3 years. This reduction was sustained after 3 years (46.4% at 4 year, 46.7% at 5 years, 46.7% at 5 years, and 46.1% at 7 years). The serum calcium, phosphorus, and creatinine levels stayed within the normal ranges during the 7-year period of etidronate treatment.. Abbreviations: ALF, alfacalcidol; ALP, alkaline phosphatase; ETD, etidronate.
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Figure 3 shows the longitudinal changes in the serum calcium, phosphorus, ALP, and creatinine levels during the 7-year period of etidronate treatment.
PMC3150473_05
PMC3150473_06
Changes in lumbar spine BMD. After 1 year of alfacalcidol treatment, the lumbar spine BMD decreased. Then, treatment was switched to cyclical etidronate and was sustained for 7 years. The lumbar spine BMD increased after the start of etidronate treatment. The increase rate was 3.6% at 1 year, 8.4% at 2 years, 8.4% at 3 years, 6.8% at 4 years, 6.7% at 5 years, 8.3% at 6 years, and 8.1% at 7 years.. Abbreviations: ALF, alfacalcidol; BMD, bone mineral density; ETD, etidronate.
tcrm-7-275f2.jpg
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Figure 2 shows the longitudinal changes in the lumbar spine BMD during the 7-year period of etidronate treatment.
Changes in serum calcium, phosphorus, ALP, and creatinine. After 1 year of treatment with alfacalcidol, the serum ALP level did not change significantly. Then, treatment was switched to cyclical etidronate and was sustained for 7 years. The serum ALP markedly decreased. The rate of reduction in the serum ALP level was 40.0% at 1 year, 51.5% at 2 years, and 48.8% at 3 years. This reduction was sustained after 3 years (46.4% at 4 year, 46.7% at 5 years, 46.7% at 5 years, and 46.1% at 7 years). The serum calcium, phosphorus, and creatinine levels stayed within the normal ranges during the 7-year period of etidronate treatment.. Abbreviations: ALF, alfacalcidol; ALP, alkaline phosphatase; ETD, etidronate.
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Figure 3 shows the longitudinal changes in the serum calcium, phosphorus, ALP, and creatinine levels during the 7-year period of etidronate treatment.
Radiographs of the thoracic and lumbar spine - lateral views after treatment. The radiographs of the thoracic and lumbar spine after 1 year of treatment with alfacalcidol and 7-year treatment with etidronate showed no new incident vertebral fractures.
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After 7 years of etidronate treatment, radiographs of the thoracic and lumbar spine revealed no evidence of new thoracic or lumbar vertebral fractures (Figure 4).
PMC3150473_07