ABSTRACT
We investigated the effect of short-term, 1,25-dihydroxyvitamin D3 therapy (4 micrograms/day for 4 days) on calcium metabolism in 27 postmenopausal women (11 cases with osteoporosis and 16 cases with osteoarthritis). Bone mass at the axial and appendicular skeleton was higher in osteoarthritis than in osteoporosis. Initial values of calcium metabolism were similar. Osteoporotic and osteoarthritic patients responded with a similar significant increase in serum osteocalcin (+61% and +54%, respectively), fasting urinary calcium excretion (+178% and +124%, respectively) and 24 hour calcium excretion (+148% and +142%, respectively). Parathyroid hormone (PTH) levels decreased significantly in both groups (-30% and -18%, respectively). Osteoclastic bone resorption, evaluated by urinary hydroxyproline excretion, was not stimulated in either group. We conclude that in osteoporosis and also in osteoarthritis (1) 1,25-dihydroxy-vitamin D3 (1,25(OH)2D3) stimulation of osteoblast function is similar in production of osteocalcin; (2) the vitamin D target tissues react adequately to 1,25(OH)2D3 stimulation; (3) short-term high dose of 1,25(OH)2D3 does not stimulate bone resorption; and (4) the differences in bone mass between osteoarthritis and osteoporosis are not related to an alteration of the responsiveness to stimulation by 1,25 (OH)2D3.
Subject(s)
Calcitriol/therapeutic use , Osteoarthritis/drug therapy , Osteoblasts/drug effects , Osteoclasts/drug effects , Osteoporosis/drug therapy , Aged , Bone Development/drug effects , Bone Resorption , Calcitriol/pharmacology , Calcium/urine , Female , Humans , Hydroxyproline/urine , Middle Aged , Osteoarthritis/metabolism , Osteoarthritis/pathology , Osteoblasts/pathology , Osteocalcin/blood , Osteoclasts/pathology , Osteoporosis/metabolism , Osteoporosis/pathology , Parathyroid Hormone/blood , Time Factors , Vitamin D/metabolismABSTRACT
Forty patients with active rheumatoid arthritis were included in this monocentre double-blind study comparing the therapeutic efficacy and safety of the immunomodulator OM-8980 with that of D-penicillamine. After 12 months of treatment, the parameters of Ritchie index, duration of morning stiffness, pain assessed by a visual analogue scale and categories, number of swollen joints, grip strength and erythrocyte sedimentation rate (ESR) were all significantly improved with OM-8980, as was the case for the Ritchie index, number of swollen joints and ESR with D-penicillamine. Significant intergroup differences were recorded for pain categories in favour of OM-8980 and for the Ritchie index and number of swollen joints in favour of D-penicillamine. The need for concomitant anti-inflammatory therapies and the assessment of efficacy by physicians and patients did not differ significantly between the two groups. OM-8980 was significantly better tolerated than D-penicillamine (5 patients with 5 side effects as compared with 12 patients with 16 side effects). OM-8980 can thus be regarded as an efficient and well-tolerated slow-acting drug for the treatment of rheumatoid arthritis.
Subject(s)
Adjuvants, Immunologic/therapeutic use , Antigens, Bacterial , Arthritis, Rheumatoid/drug therapy , Penicillamine/therapeutic use , Adjuvants, Immunologic/administration & dosage , Adjuvants, Immunologic/adverse effects , Adult , Aged , Analysis of Variance , Arthritis, Rheumatoid/therapy , Chi-Square Distribution , Delayed-Action Preparations , Female , Humans , Male , Middle Aged , Penicillamine/administration & dosage , Penicillamine/adverse effects , Prospective StudiesABSTRACT
Three different immunotherapy regimens were given during 4 years to 60 randomized patients. One can conclude from the symptom and medication scores that a tyrosine-bound mixture is less active. The results obtained with mixed grass and with highly purified timothy pollen are comparable, but in favour of the latter.